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Healthcare Costs

AHRQ Research to Reduce Cost and Improve the Quality of
   Health Care
Currently Funded Studies in Clinical Economics
Employer-Sponsored Health Insurance: Trends in Cost and
   Access
Focus on Cost-Effectiveness Analysis at AHRQ
Health Care Costs: Fact Sheet
Healthcare Cost and Utilization Project (HCUP)
Medical Expenditure Panel Survey (MEPS)
Meeting Medicaid's Cost and Quality Challenges: The Role of
   AHCPR Research
Reducing Costs in the Health Care System
Research Initiative in Clinical Economics (RICE)

 Conferences and Workshops

Can You Minimize Health Care Costs by Improving Patient Safety?
Web Conference, September 20, 30, and October 1, 2002
Causes of and Potential Solutions to the High Cost of Health Care
Web Conference, October 10, 11, and 15, 2002
Health Care Costs: Why Do They Increase? What Can We Do?
Workshop Brief, May 21-23, 2001

Agency Press Releases
9/13/04 Many Chronically Ill Patients Don't Tell Their Doctors That They Limit Use of Prescription Drugs Because of Cost
5/18/04 Significant Increases in Drug Co-Payments May Reduce Patients' Use of Needed Medications

Speeches and Testimony
7/9/03 Testimony on Technology, Innovation, and the Costs of Health Care

Research Findings

Research Activities, May 2004:
Significant increases in drug copayments may reduce patients' use of needed medications
Improved pain management could reduce use of outpatient care and associated costs for patients with HIV disease
Health care costs are lower in Minnesota than in other States due mostly to structural factors, not financial incentives
Increased State Medicaid reimbursement for nursing home care reduces residents' risk of being hospitalized
State governments assumed an increasing role in funding home care after passage of the 1997 Balanced Budget Act
Use of medical care in the Nation is greatest among the wealthy, and income-related inequality in use is highest among seniors

Research Activities, April 2004:
Medicare enrollees in for-profit plans are no less likely to receive high-cost procedures than those in non-profit plans

Research Activities, March 2004:
Screening relatively healthy elderly women for breast cancer every 2 years is cost effective
Hospital costs are higher for elderly Medicare patients with low functional status
Hospitalizations for work-related injuries and illnesses declined from 1997-1999, but charges increased
Medicare's role in financing nursing home care has greatly expanded
Many major teaching hospitals might not be able to offer adequate access to specialty care for uninsured patients
State shifting of Medicaid home care costs to Medicare greatly increases Medicare expenditures for home care

Research Activities, February 2004:
New study estimates potential savings gained by expanding use of beta-blockers in heart failure patients
Asthma symptom days determine annual costs of care for children with mild-to-moderate persistent asthma
Different changes in drug formulary administration and copayments can have very different effects on drug use and spending
Hospital mergers, not consolidation of local hospitals into systems, result in cost savings

Research Activities, January 2004:
British Columbia's reference pricing for a calcium channel blocker may be a model for pharmaceutical cost-containment
Greater deployment of automated external defibrillators at select public locations is likely to be cost effective

Research Activities, December 2003:
Studies focus on diagnosis and treatment of low back pain, as well as related pain and disability
Low-risk deliveries in a collaborative care birth center have outcomes similar to hospital deliveries by obstetricians
Use of coagulometers by home health nurses could reduce costs of monitoring the homebound elderly taking warfarin
Formularies are not likely to control costs for psychotropic drugs as well as they do for some other types of drugs

Research Activities, November 2003:
California HMOs rely on informal evaluations of quality, not hospital report cards, to select hospitals for contracting
Rising health care costs may underlie the decline in employment of people with costly chronic conditions
Researchers report recent findings from the HIV Cost and Services Utilization Study

Research Activities, October 2003:
Injuries in hospitals pose a significant threat to patients and substantially increase health care costs
Costs of care for pneumonia in nursing home residents vary widely and could be reduced
Patients with depressed mood and persistent anxiety use more medical care and have higher costs than other patients
An enhanced MEPS enables national studies of health care coverage, access, costs, and health status of U.S. households

Research Activities, September 2003:
Some States with high Medicaid use of home care may be able to shift some of these visits to Medicare
Hospitals that increase their number of registered nurses increase their operating costs but do not decrease profits
Physicians are likely to remain influential in certain areas of health policy reform

Research Activities, August 2003:
National Emphysema Treatment Trial examines benefits and costs of lung-volume-reduction surgery for severe emphysema
Lengthening postpartum hospital stays to meet minimum Federal standards is cost effective

Research Activities, July 2003:
Half of hospital costs for diabetes patients are linked to the subset of patients with multiple hospitalizations

Research Activities, June 2003:
Heart disease, cancer, and trauma injury top the list of the 15 most costly medical conditions in the United States
Allergic rhinitis care costs have soared in the past decade due to newer antihistamines and other medications

Research Activities, May 2003:
First trimester ultrasound identifies more cases of Down syndrome than second trimester maternal serum screening and is more cost effective

Research Activities, April 2003:
Despite new critical care technologies, the proportion of Medicare spending on end-of-life care is not increasing

Research Activities, March 2003:
Costs associated with genital herpes are expected to rise swiftly over the next 10 years

Research Activities, February 2003:
New report provides an overview of children's insurance coverage, health care use and expenditures, and quality of care

Research Activities, January 2003:
Medicare enrollees who have disabilities are most dissatisfied with not being able to get to a doctor and the high cost of care
Physician retention may depend on preventing their dissatisfaction with pay and community relationships

Research Activities, December 2002:
Managed care's selective contracting with physicians slowed growth in physician fees during the early 1990s

Research Activities, November 2002:
HMO growth during the 1990s was associated with less physician income growth, practice autonomy, and satisfaction
Federal Employees Health Benefit Program uses a capped premium subsidy to help reduce selection

Research Activities, October 2002:
Enrollment in Medicare+Choice plans has increased considerably in recent years but remains quite low in rural areas
Health insurance premiums rose more than 30 percent between 1996 and 2000
AHRQ data show rising hospital charges, falling hospital stays

Research Activities, September 2002:
More elderly patients are receiving eye care, but Medicare costs have remained constant
Changes in Medicaid reimbursement have led to increased ER visits by adults to treat emergency dental problems

Research Activities, August 2002:
Implantable defibrillators reduce cardiac deaths and are as cost effective as many generally accepted therapies
Fewer registered nurses in hospitals linked to more cases of postoperative pneumonia
Researchers examine U.S. dental care expenditures
Researchers examine use of highly active HIV medications and their effects on costs and access to care

Research Activities, July 2002:
Fee-for-service Medicare plans offer better quality care than Medicare HMO plans, but costs are higher

Research Activities, June 2002:
Use of subcutaneous instead of IV erthropoietin for end-stage renal disease patients could reduce Medicare costs
Depression in people with diabetes is associated with increased health care use and higher expenditures
Expanding income eligibility for State Children's Health Insurance Programs would not burden the program
New case study indicates that mental health parity did not raise costs for a large employer who used a managed care arrangement

Research Activities, May 2002:
U.S. drug expenditures are expected to increase by 15 to 19 percent this year
Employees use comparison data on health plans to avoid poorly rated plans and choose plans with lower out-of-pocket costs

Research Activities, April 2002:
Clinical trial participation does not increase the cost of routine care
Employers may be able to lower their costs for health insurance by offering more plans and making employees more price sensitive
Employee characteristics affect the generosity of health plans and the likelihood of employers offering a choice of plans

Research Activities, March 2002:
Insurance type influences medication costs and the choice of brand-name or generic drugs
Providing patients with direct access to specialists does not necessarily increase medical expenditures
Despite health care system changes during the early 1990s, use of care and financial burden for the uninsured changed very little

Research Activities, January 2002:
Hospital emergency departments play a critical role in monitoring the Nation's health care safety net

Research Activities, December 2001:
Use of health care services and costs of care are substantial for children with asthma-related illnesses
Managed care cost-containment policies strengthen continuity of primary care for depressed patients
Medicare fee-for-service patients seem to fare better in areas of higher HMO market penetration
Late middle-aged adults are more likely to decline in overall health when they have no health insurance

Research Activities, September 2001:
Researchers examine hospital costs for CABG surgery
Costs for end-of-life care are only slightly higher for those who die than for survivors with similar characteristics

Research Activities, August 2001:
Costs associated with asthma have increased substantially since the mid-1980s
Healthy, working-age, privately insured consumers currently may be over-insuring for medical care
Proposed antitrust exemption for physicians may alter the balance of power between doctors and health plans

Research Activities, July 2001:
Use of health services in the United States stays fairly constant over 40 years
Hospital mergers may save less than anticipated

Research Activities, May 2001:
Sophisticated imaging tests and specialty care usually are not necessary to evaluate and manage acute low back pain
Costs are about the same for generalists and specialists who treat patients with chronic heart problems

Research Activities, February 2001:
Lowering elevated homocystine levels could result in substantial clinical benefits at a reasonable cost
Mental health visits are cut by one-fourth when providers are paid a fixed rate per patient

Research Activities, January 2001:
Injectable and IV heparin have similar overall care costs and effectiveness for treating deep vein thrombosis
Screening for colorectal cancer every 5 years reduces mortality at costs similar to other cancer screening procedures

Research Activities, December 2000:
Effects of Medicare fee reductions vary by specialty and procedure

Research Activities, October 2000:
Costs are no higher for Medicaid children than for privately insured children in the same HMO

Research Activities, July 2000:
Higher risk of out-of-pocket health care expenses is associated with an increased risk of premature death among the elderly

Research Activities, June 2000:
Payer status appears to have a strong influence on hospital management of patients with heart attack

Research Activities, May 2000:
Cost and cost-effectiveness of clinical interventions are quite different

Research Activities, February 2000:
Turnover of primary care physicians during the last two decades was common and costly

Research Activities, January 2000:
Patients prefer to receive care from doctors who see people from several health plans
Risk-aversion may lead internists to spend more than family physicians to confirm medical diagnoses


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