Price of Care

April 30, 2012

Variation in Interventional Cardiac Care in Michigan

CHRT Issue Brief April 2012

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An extensive body of research has identified and examined the wide geographic variation in Medicare utilization and spending in the United States. A small but growing number of studies also assess such variation in commercially insured populations. Our previous report on health care variation (CHRTBook: Health Care Variation in Michigan) described geographic variation in the use of cardiac procedures in Blue Cross Blue Shield of Michigan (BCBSM) members in Michigan. This report focuses on coronary revascularization procedures and explores possible explanations for variation in observed rates of these procedures in the BCBSM commercial enrollment.

February 28, 2011

Antibiotic Prescribing and Use

CHRT Issue Brief February 2011

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The Institute of Medicine and the Centers for Disease Control and Prevention (CDC) have identified antibiotic resistance as a major public health problem in our country. One of the biggest contributors to antibiotic resistance is the inappropriate use of antibiotics. Of particular concern is the prescribing of antibiotics for infections that are usually viral in nature—colds, sore throats, and most upper respiratory infections. These illnesses do not respond to antibiotics and nearly always get better on their own. Since 1995 the CDC has run an outreach campaign to encourage appropriate use of antibiotics, and the overall rate of antibiotic prescribing decreased 23 percent from 1992 to 2000. Nevertheless, a high rate of inappropriate antibiotic use—a rate that continues to put population health at risk—persists. This issue brief examines antibiotic prescribing trends in Michigan in recent years.

November 16, 2010

Prematurity

CHRT Issue Brief November 2010

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One in eight babies are born prematurely in the United States and Michigan, with serious consequences for infant morbidity and mortality. Premature babies experience a variety of medical problems, resulting in more doctor visits and hospitalizations. Having a premature baby takes an enormous emotional toll on a family. Medical care for premature infants can cost over $100,000, and preterm births have been estimated to cost the U.S. more than $26 billion annually. While significant medical and technological advances in the treatment of preterm babies have allowed more babies to survive, preterm birth is still the leading cause of infant death. Preterm birth disproportionately affects blacks and contributes to the disparity between blacks and other races in infant mortality.

October 4, 2010

Health Care Variation in Michigan

CHRTBook September 2010

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For more than 20 years, researchers at Dartmouth Institute for Health Policy and Clinical Practice have been sharing data on regional variation in the use of health care services: variation that does not seem to be explained by health status or other relevant differences among the populations studied. Most of work done on geographic variation has been done on the Medicare population, and some could argue that the phenomenon of variation is unique to a senior population or some specific attribute of the Medicare structure. However, just over 10 years ago, we in Michigan were fortunate to have the opportunity to collaborate with our colleagues at Dartmouth to look at this same kind of data in the commercial Blue Cross and Blue Shield of Michigan (BCBSM) population. Our findings then showed that patterns of geographic variation in the commercial population were similar to those found in the Medicare population.

In this report, we are again comparing the commercial BCBSM population to the Medicare population, but we are also looking at changes within the commercial population in overall use and geographic variation over the past 10 years.

August 3, 2010

Health Care Cost Drivers: Chronic Disease, Comorbidity, and Health Risk Factors in the U.S. and Michigan

CHRT Issue Brief August 2010

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In our January 2010 issue brief, The Cost Burden of Disease, we presented the most common reasons for hospitalizations, the most expensive conditions, and gender differences between men and women with respect to the top ten diagnoses. In this issue brief, we focus on costs and risk factors relating to selected chronic conditions, comorbidities, and health risk factors of cigarette smoking and overweight/obesity.

January 25, 2010

The Cost Burden of Disease: U.S. and Michigan

CHRT Issue Brief January 2010

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There may be no broad consensus on the impact of recent health reform proposals on the growth of health care costs in the U.S., but few would dispute that rising health care costs are a threat to the U.S. economy, the health system, and the health and financial well-being of families and individuals in the United States. As we collectively seek ways to address the crisis of rising costs—as part of overall health reform or through regional, state, or local approaches—we must understand the factors that drive health care costs and where opportunities exist to affect those drivers.

December 14, 2009

Health Care Spending by Country, State and Payer

CHRT Issue Brief December 2009

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To enact reforms that have a positive impact on health care costs, we must first understand how and where we are spending our health care dollars today. This issue brief provides an overview of health care spending in the U.S., comparing U.S. spending to the rest of the world, Michigan spending to other U.S. states, and spending by payer (Medicare, Medicaid, and commercial).