State Health Care Expenditures

"Experience from 2005: State Health Care Expenditures." Deborah Chollet and Eric Schone (contributing authors), February 2007. This overview from the Maryland Health Care Commission shows that health care expenditures in the state for 2005 grew 7 percent from 2004 to 2005, more slowly than the trend since 2001. In addition, per capita health care expenditures continue to be less than the national average, although Maryland’s expenditure growth has mirrored the national average. From 2004 to 2005, per capita health care expenditures grew 6 percent, compared to the longer-term trend of 7 percent per year since 2001. The report notes that hospital inpatient and outpatient care together represent the largest single category of health care expenditures, accounting for more than one-third of the total. In 2005, private insurance financed 40 percent of all health care expenditures; 17 percent were paid out of pocket. Government programs financed the balance—Medicare, 21 percent; Medicaid, 18 percent; and other programs, 4 percent. (The authors oversaw the design and development of the report and estimated private insurance and out-of-pocket expenditures by service type.)

Medicare Advantage

"Private Plans in Medicare: A 2007 Update." Marsha Gold, March 2007. In 2006, the Medicare prescription drug benefit gave beneficiaries a choice of remaining in traditional Medicare and receiving the benefit through a freestanding prescription drug plan or enrolling in one of several types of Medicare Advantage (MA) plans that integrate all Medicare benefits and typically provide supplemental coverage. This issue brief examines how the marketplace has evolved since the change went into effect and how beneficiaries responded. It includes national and state-specific data on MA availability by type of plan in 2007, along with similar information on MA enrollment in November 2006. In addition, the brief looks at market dynamics to identify which firms dominate and are driving the market and how they and others are positioning themselves in 2007. The results profile a very active and expanding Medicare market for private plans, but one in which some products hold more industry and beneficiary appeal than others. The question for policymakers is whether the Medicare program will be stronger due to these recent change.

View a related webcast with Marsha Gold and others.

Special Care for Special Kids

"Impact on Family and Work." Quality Care for Special Kids: Profiles of Children with Chronic Conditions and Disabilities, Update #5. February 2007, Shanna Shulman, Henry Ireys, and Stephanie Peterson. This brief, the fifth in a series on critical issues involved in caring for children with special health care needs, notes that about 60 percent of all children have health insurance through a parent's employer, but coverage of services for children with special health care needs varies. Furthermore, the more comprehensive the benefit package, the larger the share of costs assumed by employees. Because children with special health care needs use more services and see providers more often than other children do, their parents may be under greater financial stress, which can be exacerbated if they need to forgo working to manage their child's care. The brief suggests steps that plans can take to address these issues.