Kenneth E. Thorpe

The impact of obesity on rising medical spending.

Obese people incur higher health care costs at a given point in time, but how rising obesity rates affect spending growth over time is unknown. We estimate obesity-attributable health care spending increases between 1987 and 2001. Increases in the proportion of and spending on obese people relative to people of normal weight account for 27 percent of the rise in inflation-adjusted per capita spending between 1987 and 2001; spending for diabetes, 38 percent; spending for hyperlipidemia, 22 percent; and spending for heart disease, 41 percent. Increases in obesity prevalence alone account for 12 percent of the growth in health spending.

A study of medical injury and medical malpractice.

For nearly two decades, an atmosphere of crisis has enveloped our system of medical-malpractice litigation and liability insurance. Courts have expanded the limits of tort liability, an increasing number of patients have sought to redress their grievances in court, and juries have awarded ever-increasing damages for medical injuries. Legislatures have responded to the problems of a shrinking insurance market and rising insurance costs by restricting liability and, in some cases, limiting damages. The courts have reviewed some of these statutory restrictions and have struck down a number of them as unconstitutional. Mean-while, report after report has come from federal and .xa0.xa0.

Covering Uninsured Children and their Parents: Estimated Costs and Number of Newly Insured

The Child Health Insurance Program (CHIP) supplies

Regulatory intensity and hospital cost growth

20.4 billion over 5 years and nearly

Health Plan Switching Among Members of the Federal Employees Health Benefits Program

50 billion over 10 years to extend health insurance to uninsured children with family incomes up to 200 percent of poverty. This article analyzes the March 1997 Current Population Survey, estimating the number of children likely to be eligible for CHIP or currently eligible for Medicaid. Of the 8.6 million parents of uninsured children, four out of five were uninsured at the time of the survey. Expanding coverage to parents as well as children could make program participation more attractive and simplify the enrollment process. If 75 percent of uninsured parents of CHIP eligible children participated, 1.7 million parents could be insured, costing federal and state governments

Analysis of the treatment effect of Healthways' Medicare Health Support Phase 1 Pilot on Medicare costs.

4 billion. Another 3.4 million parents would be insured by expanding Medicaid to cover uninsured parents of Medicaid-eligible children.

Which Medical Conditions Account For The Rise In Health Care Spending

This article parameterizes and examines the regulatory intensity of New Yorks all-payer rate setting system. The model, using hospital level data, compares the effects of specific features of rate-setting designed to promote cost containment. Two indicators measuring regulatory intensity were examined; the extent of hospital-specific disallowances, and how frequently the base year was adjusted (the degree of prospectivity). The results indicate that both the degree of prospectivity and the extent of disallowances importantly affect cost growth. Hospitals, when constrained, primarily achieved cost savings through reductions in non-medical personnel.

The Medical Malpractice Crisis: Recent Trends And The Impact Of State Tort Reforms

This paper examines factors associated with switching health plans in the Federal Employees Health Benefits Program. Switching plans is not uncommon, with 12% of members switching plans annually. Individuals switch out of plans with premium increases and benefit decreases relative to other plans in the market. Switching is negatively associated with age due to increasing switching costs associated with age rather than decreasing premium sensitivity. Individuals in preferred provider organizations are less likely to switch, but are more responsive to premium increases than those in the managed care sector. Those who do switch plans are likely to switch to a different plan in the same sector.

House staff supervision and working hours. Implications of regulatory change in New York State.

The objective of this analysis is to evaluate the treatment effect of Healthways Medicare Health Support Pilot Program on total Medicare expenditures. Previous studies have analyzed the first 6 months of the program for all Medicare Health Support Organizations. The purpose of this analysis is to supplement and extend the previous work. The policy question addressed in this article is whether, on net, the intervention lowered total Medicare expenditures. The study was a retrospective analysis of data claims and membership databases. We used ordinary least squares regression techniques to estimate the effect of the intervention on total costs. We also stratified the data using risk scores calculated prior to the intervention. Our analysis found that the intervention consistently had little or no effect across the entire sample, but was associated with a statistically significant decrease in spending when the analysis concentrated on the sample that fully participated in the program. Overall, our analysis finds that total annual Medicare costs for the participating sample were 15.7% lower in 2007 (

The Rising Prevalence Of Treated Disease: Effects On Private Health Insurance Spending

3240) than for the control group, controlling for age, sex, race, and baseline risk. On balance, our analysis supports a conclusion that the program did successfully reduce costs for its target population. We find that Medicare expenditures were lower among enrollees in the program than they would have been without the intervention. This article shows that significant cost reductions among high-cost, chronically ill Medicare beneficiaries are possible.