We generally consider living a long life an important goal, and it certainly does beat the alternative. But one side effect of getting older is that, as we age, we typically acquire additional acute and chronic medical conditions, and the prevalence of many common chronic medical conditions increases significantly. Age/gender rating is an area in which actuarial considerations are often in direct tension with social or public policy considerations: there is a natural tension between the policy goals of making coverage more affordable for older people (with higher average costs) and the goal of encouraging younger people (with lower average costs) to purchase health insurance coverage.
In an article first published in the magazine The Actuary, Milliman consultants Doug Norris, Hans Leida, Erica Rode, and Travis (T.J.) Gray explore how age and gender affect costs and premiums in commercial healthcare.
The cost of hospitalization for acute coronary syndrome (ACS) is expensive and continues to rise. In terms of direct medical expenditures, ACS costs Americans more than $150 billion annually, with approximately 60% to 75% of these costs related to hospital admission and readmission. No prior studies have addressed the cost of inpatient mortality during an ACS admission. This article, co-authored by Milliman’s Jill Van Den Bos and Travis Gray, compares ACS-related length of stay, total admission cost, and total admission cost by day of discharge/death for patients who died during an inpatient admission with a matched cohort discharged alive following an ACS-related inpatient stay.
This article was published by PubMed.
A new article published by Dovepress Journal examines the impact of patient cost sharing for antihypertensive medications on adherence, utilization, and expenditures. The trend has been for managed care organizations and employers to require patients to bear a greater out-of-pocket burden for healthcare resources consumed. This study illustrates the potential adverse effects of higher patient cost sharing among patients with hypertension stratified by different risk levels. A decrease in the proportion of days covered was predictive of higher resource utilization and healthcare costs, which should be of interest to payors and employers alike.
Read the article here.