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Toward a Satellite Account for Health Ana Aizcorbe Bureau of Economic Analysis. CSLS-CMA Conference Improved Measures of Health Outputs and Outcomes Ottawa, Ontario October 30,2007. The rapid growth in health care expenditures has raised difficult questions. .

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toward a satellite account for health ana aizcorbe bureau of economic analysis

Toward a Satellite Account for HealthAna AizcorbeBureau of Economic Analysis

CSLS-CMA Conference

Improved Measures of Health Outputs and Outcomes

Ottawa, Ontario

October 30,2007

the rapid growth in health care expenditures has raised difficult questions
The rapid growth in health care expenditures has raised difficult questions.
  • How do health expenditures translate into improvements in health?
  • What are the costs and benefits of treatments to society as a whole?

Source: Bureau of Economic Analysis

the type of information needed to address these questions is not readily available
The type of information needed to address these questions is not readily available.
  • For example,
    • Nominal expenditures broken down by disease to assess the benefit of treatment
    • Price measures that accurately account for increases in the quality of treatments
bea plans to develop a health satellite account to respond to these needs
BEA plans to develop a Health Satellite Account to respond to these needs.

The satellite account will provide:

  • A reconciliation of health care spending estimates from the Centers for Medicare and Medicaid Services (CMS) and those from the Bureau of Economic Analysis,
  • Data on nominal expenditures by disease that are consistent with CMS’s National Health Expenditures Accounts, and
  • Improved price deflators.
price indexes increasing prices are an important driver of cost increases
Price indexes: Increasing prices are an important driver of cost increases
  • PCE for medical care grew 9 % per year from 1980-2005.
  • Over ½ of that growth represents increases in prices, as measured in standard price indexes.
but existing price indexes have well known problems
But existing price indexes have well-known problems.

Sensitive to underlying assumptions:

  • BLS’ Medical Care Price Index (MCPI) focuses on consumer payments
  • BEA price index relies on indexes from the BLS PPI program

Both have problems accounting for

  • quality improvements, and
  • reduced cost of treatment
bea s satellite account will include a disease based price index
BEA’s satellite account will include a disease-based price index.
  • Disease-based price indexes will better account for changes in costs that arise from the substitution across treatment classes.
  • These disease-based indexes will be used to construct
    • Price indexes for health expenditures by disease and product class, as currently reported in the accounts, and
    • Industry contributions to changes in the price indexes .
  • The index will not address the problem of accounting for improvements in treatments.
    • Difficult problem where there is no consensus on the solution.
progress and plans
Progress and Plans

Two-year effort to study data sources and methods

  • Completed preliminary draft of study on disease-based price indexes.

Continued interaction with members of the academic and statistical communities

  • Participating in National Academies Panel on Health Accounts
  • Working closely with David Cutler and Allison Rosen’s Health Accounts Group
  • Maintaining contact with colleagues at CMS, BLS, and other statistical agencies.

Plan is to develop a detailed proposal for a BEA Health Satellite Account by the end of 2009.