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With the United States and other developed nations spending as much as 14 percent of their GDP on medical care, economists and policy analysts are asking what these countries are getting in return. Yet it remains frustrating and difficult to measure the productivity of the medical care service industries. This volume takes aim at that problem, while taking stock of where we are in our attempts to solve it. Much of this analysis focuses on the capacity to measure the value of technological change and other health care innovations. A key finding suggests that growth in health care spending has coincided with an increase in products and services that together reduce mortality rates and promote additional health gains. Concerns over the apparent increase in unit prices of medical care may thus understate positive impacts on consumer welfare. When appropriately adjusted for such quality improvements, health care prices may actually have fallen. Provocative and compelling, this volume not only clarifies one of the more nebulous issues in health care analysis, but in so doing addresses an area of pressing public policy concern.

Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that \"this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences\". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.

Developing credible short-term and long-term projections of Medicare health care costs is critical for public- and private-sector policy planning, but faces challenges and uncertainties. There is uncertainty not only in the underlying economic and demographic assumptions used in projection models, but also in what a policy modeler assumes about future changes in the health status of the population and the factors affecting health status , the extent and pace of scientific and technological breakthroughs in medical care, the preferences of the population for particular kinds of care, the likelihood that policy makers will alter current law and regulations, and how each of these factors relates to health care costs for the elderly population. Given the substantial growth in the Medicare population and the continued increases in Medicare, Medicaid, and private health insurance spending, the availability of well-specified models and analyses that can provide useful information on the likely cost implications of health care policy alternatives is essential. It is therefore timely to review the capabilities and limitations of extant health care cost models and to identify areas for research that offer the most promise to improve modeling, not only of current U.S. health care programs, but also of policy alternatives that may be considered in the coming years. The National Research Council conducted a public workshop focusing on areas of research needed to improve health care cost projections for the Medicare population, and on the strengths and weaknesses of competing frameworks for projecting health care expenditures for the elderly. The workshop considered major classes of projection and simulation models that are currently used and the underlying data sources and research inputs for these models. It also explored areas in which additional research and data are needed to inform model development and health care policy analysis more broadly. The workshop, summarized in this volume, drew people from a wide variety of disciplines and perspectives, including federal agencies, academia, and nongovernmental organizations.

Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementia-often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop.

Health care quality and its affordability have become very pressing issues in the United States. All sectors of the country are attempting to push forward initiatives that will improve the health care system as well as the health of the American population in general. Despite the economical dedication to health care, about 1/5, the system remains uneven and fragmented, patient harm is quite common, care is often uncoordinated, and many more mishaps occur. There exists many obstacles to improve the nation's health care system; these include the capacity to reliably and consistently measure progress. In 2006 the Institute of Medicine (IOM) established the Roundtable on Value & Science-Driven Health Care which has since accelerated the development of a learning health system- one in which science, informatics, incentives, and culture are aligned to create a continuous learning loop. This learning loop would thus help make the health care system better. In response, the IOM organized a 2-day workshop to explore in depth the core measurement needs for population health, health care quality, and health care costs. The workshop hoped to gain a full understanding of how to improve the nation's measurement capacity to track progress in the health care system. Having this knowledge would help the nation get one step closer to the creation of an efficient learning loop. The workshop was divided into a series of sessions that focused on different aspects of measurement . Core Measurement Needs for Better Care, Better Health, and Lower Costs: Counting What Counts: Workshop Summary includes explanations and key details for these sessions: Vision, Current Measurement Capabilities, Specifying the Shape of a Core Metric Set, and Implementation. The report also features common themes within these areas, the workshop agenda, and information about those involved.

One of the most well-established relationships in the economics of aging is that between health and wealth. Yet this relationship is also changing in conjunction with a rapidly aging population as well as a broad evolution in how people live later in life. Building on findings from earlier editions in this National Bureau of Economic Research series, Investigations in the Economics of Aging focuses on the changing financial circumstances of the elderly and the relationship of these circumstances to health and health care. Among the topics addressed are the significance of out-of-pocket health care costs, the effects of inflation on social security, and the impact of the recent financial crisis on Americans' well-being. Encompassing new data and advances in research methodology, the developments presented in this volume will have important implications for economies worldwide.

Analyses in the Economics of Aging summarizes a massive amount of new research on several popular and less-examined topics pertaining to the relationship between economics and aging. Among the many themes explored in this volume, considerable attention is given to new research on retirement savings, the cost and efficiency of medical resources, and the predictors of health events. The volume begins with a discussion of the risks and merits of 401(k) plans. Subsequent chapters present recent analysis of the growth of Medicare costs; the different aspects of disability; and the evolution of health, wealth, and living arrangements over the life course. Keeping with the global tradition of previous volumes, Analyses in the Economics of Aging also includes comparative studies on savings behavior in Italy, the Netherlands, and the United States; an examination of household savings among different age groups in Germany; and a chapter devoted to population aging and the plight of widows in India. Carefully compiled and containing some of the most cutting-edge research and analysis available, this volume should be of interest to any specialist or policymaker concerned with ongoing changes in savings and retirement behaviors.

Analyses in the Economics of Aging summarizes a massive amount of new research on several popular and less-examined topics pertaining to the relationship between economics and aging. Among the many themes explored in this volume, considerable attention is given to new research on retirement savings, the cost and efficiency of medical resources, and the predictors of health events. The volume begins with a discussion of the risks and merits of 401(k) plans. Subsequent chapters present recent analysis of the growth of Medicare costs; the different aspects of disability; and the evolution of health, wealth, and living arrangements over the life course. Keeping with the global tradition of previous volumes, Analyses in the Economics of Aging also includes comparative studies on savings behavior in Italy, the Netherlands, and the United States; an examination of household savings among different age groups in Germany; and a chapter devoted to population aging and the plight of widows in India. Carefully compiled and containing some of the most cutting-edge research and analysis available, this volume should be of interest to any specialist or policymaker concerned with ongoing changes in savings and retirement behaviors.