Health Affairs

Health Affairs, doi: 10.1377/hlthaff.28.5.w978 (Published online September 1, 2009) © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Using Clinical Information To Project Federal Health Care Spending

Elbert S. Huang ¹, Anirban Basu ², Michael J. O'Grady ^3*, James C. Capretta ⁴

¹ Elbert Huang is an assistant professor of medicine in the Section of General Internal Medicine, University of Chicago (Illinois) School of Medicine.
² Anirban Basu is an assistant professor of medicine in the Section of General Internal Medicine, University of Chicago (Illinois) School of Medicine.
³ Michael O'Grady is a senior fellow at NORC in Bethesda, Maryland, and principal of O'GradyHealth Policy LLC in Chevy Chase, Maryland.
⁴ James Capretta is a principal of Civic Enterprises LLC in Washington, D.C.

^*Corresponding author.

Abstract

Complications from chronic illnesses often do not emerge for many years. Current federal cost projection methods are constrained by ten-year cost estimates, which capture increases in near-term intervention costs but not changes in long-term costs. Current methods also cannot easily capture the cost implications of changes in disease progression. Type 2 diabetes is a prime example of a chronic illness with long-term health and cost consequences. We present results from an epidemiologically based model that projects federal costs for diabetes under alternative policies, and we discuss the potential changes in the federal budget process needed to capture the full impact of these interventions. [Health Aff (Millwood). 2009;28(5):w978-90 (published online 1 September 2009; 10.1377/hlthaff.28.5.w978)]

Key Words: Chronic Care, Health Reform, Legal/Regulatory Issues, Health Spending, Politics

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