Jeffrey Sullivan

Three Large-Scale Changes To The Medicare Program Could Curb Its Costs But Also Reduce Enrollment

With Medicare spending projected to increase to 24 percent of all federal spending and to equal 6 percent of the gross domestic product by 2037, policy makers are again considering ways to curb the programs spending growth. We used a microsimulation approach to estimate three scenarios: imposing a means-tested premium for Part A hospital insurance, introducing a premium support credit to purchase health insurance, and increasing the eligibility age to sixty-seven. We found that the scenarios would lead to reductions in cumulative Medicare spending in 2012-36 of 2.4-24.0 percent. However, the scenarios also would increase out-of-pocket spending for enrollees and, in some cases, cause millions of seniors not to enroll in the program and to be left without coverage. To achieve substantial cost savings without causing substantial lack of coverage among seniors, policy makers should consider benefit changes in combination with other options, such as some of those now being contemplated by the Obama administration and Congress.

Measuring Sarcopenia Severity in Older Adults and the Value of Effective Interventions

ObjectivesLittle is known about the severity and long-term health and economic consequences of sarcopenia. We developed a sarcopenia index to measure severity in older Americans and estimated the long-term societal benefits generated by effective interventions to mitigate severity.DesignUsing a micro-simulation model, we quantified the potential societal value generated in the US in 2010–2040 by reductions in sarcopenia severity in older adults. All analyses were performed in Stata and SAS. Setting & Participants: Secondary data from the National Health and Nutrition Examination Survey (NHANES) (N = 1634) and Health and Retirement Study (HRS) (N = 952) were used to develop a sarcopenia severity index in older adults.MeasurementsMultitrait multi-method and factor analyses were used to validate and calibrate the sarcopenia severity index, which was modeled as a function of gait speed, walking without an assistive device, and moderate physical activity.ResultsIn representative elderly populations, reducing sarcopenia severity by improving gait speed by 0.1 m/s in those with gait speed under 0.8 m/s generated a cumulative benefit of

The Long-Term Impact of Price Controls in Medicare Part D

65B by 2040 (2015 dollars). Improving walking ability in those with walking difficulty generated cumulative social benefit of

Substantial Health And Economic Returns From Delayed Aging May Warrant A New Focus For Medical Research

787B by 2040.ConclusionsReducing sarcopenia severity would generate significant health and economic benefits to society— almost

Overview of the COMPARE Microsimulation Model

800B in the most optimistic scenarios.

Medication adherence and measures of health plan quality.

Abstract Price controls for prescription drugs are once again at the forefront of policy discussions in the United States. Much of the focus has been on the potential short-term savings – in terms of lower spending – although evidence suggests price controls can dampen innovation and adversely affect long-term population health. This paper applies the Health Economics Medical Innovation Simulation, a microsimulation of older Americans, to estimate the long-term impacts of government price setting in Medicare Part D, using pricing in the Federal Veterans Health Administration program as a proxy. We find that VA-style pricing policies would save between

Measuring the Value of Better Diabetes Management

0.1 trillion and

The Future of Air Force Motion Imagery Exploitation: Lessons from the Commercial World

0.3 trillion (US

The Future of Air Force Motion Imagery Exploitation

2015) in lifetime drug spending for people born in 1949–2005. However, such savings come with social costs. After accounting for innovation spillovers, we find that price setting in Part D reduces the number of new drug introductions by as much as 25% relative to the status quo. As a result, life expectancy for the cohort born in 1991–1995 is reduced by almost 2 years relative to the status quo. Overall, we find that price controls would reduce lifetime welfare by

The Relationship Between Adherence and Total Spending Among Medicare Beneficiaries With Type 2 Diabetes

5.7 to