HOUSE_OVERSIGHT_020991.jpg
1.83 MB
Extraction Summary
1
People
6
Organizations
1
Locations
0
Events
1
Relationships
4
Quotes
Document Information
Type:
Presentation slides / business report
File Size:
1.83 MB
Summary
This document contains two slides from a KPCB 'USA Inc.' presentation regarding the economic factors of restructuring Medicare and Medicaid. The first slide analyzes cost growth contribution by spending type (projected 2019), noting that political sensitivity makes reform difficult. The second slide argues that healthcare providers are already underpaid by the government, showing negative profit margins for Medicare (-9%) and Medicaid (-12%) patients based on 2007/2009 data, while employer-sponsored insurance subsidizes the industry. The document bears a 'HOUSE_OVERSIGHT' Bates stamp.
People (1)
| Name | Role | Context |
|---|---|---|
| Doug Simpson | Researcher |
Cited in the footer as part of Morgan Stanley Healthcare Research, providing data for the charts.
|
Organizations (6)
| Name | Type | Context |
|---|---|---|
| KPCB |
Kleiner Perkins Caufield & Byers; appearing in the footer as the creator of the presentation (USA Inc.).
|
|
| Morgan Stanley Healthcare Research |
Cited as a source for the healthcare data.
|
|
| CMS |
Centers for Medicare & Medicaid Services; cited as a data source.
|
|
| Avalere Health |
Cited as a source for the analysis of hospital survey data.
|
|
| American Hospital Association |
Cited as the source of survey data used in the analysis.
|
|
| House Oversight Committee |
Implied by the Bates stamp 'HOUSE_OVERSIGHT', suggesting this document was part of a congressional investigation.
|
Locations (1)
| Location | Context |
|---|---|
|
Subject of the report 'USA Inc.' and scope of the healthcare data.
|
Relationships (1)
Footer citation: 'Doug Simpson, Morgan Stanley Healthcare Research'
Key Quotes (4)
"Reimbursement Reform Is Easier Said than Done Owing to Political Sensitivity..."Source
HOUSE_OVERSIGHT_020991.jpg
Quote #1
"Healthcare Service Providers are Already 'Underpaid' by Government"Source
HOUSE_OVERSIGHT_020991.jpg
Quote #2
"Many hospitals are struggling financially."Source
HOUSE_OVERSIGHT_020991.jpg
Quote #3
"Profit margins from patients with employer sponsored insurance are sufficient to leave hospital industry with positive overall margin, despite being only 36% of inpatient discharges."Source
HOUSE_OVERSIGHT_020991.jpg
Quote #4
Full Extracted Text
Complete text extracted from the document (1,872 characters)
Restructure Medicare & Medicaid: Economic Factors—
Reimbursement Reform Is Easier Said than Done Owing to Political Sensitivity...
Reimbursement Reform Is Easier Said than Done Owing to Political Sensitivity...
Percentage Contribution to Medicare
Medical Cost Growth Rate
by Spending Type, 2019E
Medical Cost Growth Rate
by Spending Type, 2019E
Nursing Home &
Home Health
9.3%
Home Health
9.3%
All Other
9.9%
9.9%
Rx Drugs
16.2%
16.2%
Physician
& Clinical
Services
20.1%
& Clinical
Services
20.1%
Hospital
Care
44.5%
Care
44.5%
Key Issues:
- Consumers understandably do not
like constraints on their care
location.
- Doctors, nurses and hospitals are
fulfilling a difficult task at the core of
the healthcare delivery system.
- Care providers are very important
to local communities.
- Local hospitals are large
employers.
- Many hospitals are struggling
financially.
- Consumers understandably do not
like constraints on their care
location.
- Doctors, nurses and hospitals are
fulfilling a difficult task at the core of
the healthcare delivery system.
- Care providers are very important
to local communities.
- Local hospitals are large
employers.
- Many hospitals are struggling
financially.
Source: Data per CMS' National Health Expenditure database, Doug Simpson, Morgan Stanley Healthcare Research.
KPCB www.kpcb.com
USA Inc. | What Might a Turnaround Expert Consider? 299
KPCB www.kpcb.com
USA Inc. | What Might a Turnaround Expert Consider? 299
Restructure Medicare & Medicaid: Economic Factors—
Healthcare Service Providers are Already “Underpaid” by Government
Healthcare Service Providers are Already “Underpaid” by Government
USA Community Hospital Profit Margins & Inpatient Discharges by Payor Class
Profit margins by
payor class (%),
2007
32%
-9%
-12%
-45%
4.5%
payor class (%),
2007
32%
-9%
-12%
-45%
4.5%
Percent of total
inpatient
discharges, by
payor class
(%), February
2009
36%
42%
17%
5%
100%
inpatient
discharges, by
payor class
(%), February
2009
36%
42%
17%
5%
100%
Employer
Sponsored
Insurance
Medicare
Medicaid
Self-Pay
Total
Sponsored
Insurance
Medicare
Medicaid
Self-Pay
Total
Profit margins from patients
with employer sponsored
insurance are sufficient to
leave hospital industry with
positive overall margin,
despite being only 36% of
inpatient discharges.
with employer sponsored
insurance are sufficient to
leave hospital industry with
positive overall margin,
despite being only 36% of
inpatient discharges.
Reimbursement cuts to
Medicare and/or Medicaid
would pose significant
challenges, as hospitals
already realize negative
margins from those payor
classes.
Medicare and/or Medicaid
would pose significant
challenges, as hospitals
already realize negative
margins from those payor
classes.
Source: Avalere Health analysis of American Hospital Association Annual Survey data, 2007, for community hospitals. Morgan Stanley Healthcare Research.
KPCB www.kpcb.com
USA Inc. | What Might a Turnaround Expert Consider? 300
KPCB www.kpcb.com
USA Inc. | What Might a Turnaround Expert Consider? 300
HOUSE_OVERSIGHT_020991
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