How can system outcomes be measured? Where do we do better

System outcomes can be measured using the Peterson-Kaiser Health
System Tracker and how much we are spending, what is driving growth,
and what we are getting for what we spend.

U.S. compared to OECD nations: spending, outcomes

Cpmpared to OECD nations, the U.S. spends approximately 42% or more
per capita.e
however we have higher mortality rates and lower life expectancy

U.S. System trends; advantages and disadvantages over international comparisons

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Different measures/indicators of health system performance;

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What do we need to take into consideratuon when comparing infant
mortality rates (and other measures) across nations?

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Mortality amenable to health care: definition, how used, how U.S.
compares to other countries; U.S. trend over time; what if we improved
preventable deaths up to rate of top performing nations--how many
lives saved?

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Factors outside of the health system that contribute to health status
and affect access

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Three common types of health care systems often found in other
countries (be sure to be able to identify examples of countries for
each of the types)

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Medicare: history, effects of provider accomodation, changes in type
of Medicare reimbursement over time over time (hospital (1980s)) and
physician payment reform (1990s)--why and components of system

see slides on medicare history

Medicare Modernization act of 2003, what is the donut hole?e

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Medicare advantage plan enrollment trends--is enrollment decreasing
or projected to increase

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Macra: impact on sustainable growth rate, effect on physician
payment, effect on part B premiums; Who is affected by the quality
payment program? What are the two tracks of the quality payment program?

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Structure: What do parts A, B, C, D cover? sources of revenue for
parts A,B, C, D

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Spending (both program and beneficiary), beneficiary spending
compared to non-medicare households; factors that affect medicare
program spending.

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Benefits and gaps, Medigap coverage

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ACA procisions

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Be able to distinguish among blended payments, Medicare ACOs, and,
bundled payments

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Hospital Readmission Reduction program: What is it? What are the
ongoing policy issues?

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factors that affect spending now and in the future; future financing
challenges; Five major challenges that will define future debates over
medicare policy factors that affect solvency of the part A trust fund

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What is a defined benefit vs a defined contribution program?

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Dual eligible: Who are they? characteristics, health status, and
health care spending compared to other beneficiaries

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