By Cheryl Schraeder, Paul Shelton(eds.)
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Additional resources for Comprehensive Care Coordination for Chronically III Adults
Medicare is the largest single purchaser of health care in the United States, and accounted for 23% of total spending in 2006 (MedPAC 2010b). The rest of health care spending came from private insurance payers (35%) and from out-of-pocket spending. All public programs, including Medicare, Medicaid, the State Children’s Health Insurance Program, and other programs, accounted for 47% of total spending. Medicare spending presents a more complex picture than beneficiary demographics and their health status.
Inadequate capital for purchasing and maintaining the EHR system are often cited as the main reason for transition delays (DePhillips 2007). Little is known about how to create and successfully implement a comprehensive HIT system that will positively impact comprehensive care coordination for patients with complex chronic illnesses. In a systematic literature review, Dorr and colleagues (2007) identified HIT components important in supporting this concept. Components of an HIT P1: KAE/UKS BLBS085-02 P2: KAE BLBS085-Schraeder June 28, 2011 11:37 Trim: 244mm×172mm Overview 33 system that were closely correlated with positive outcomes included a connection of an electronic medical record, computerized prompts, population management, including reports and feedback, specialized decision support, electronic scheduling, and personal health records.
In 2008 Medicare accounted for 29% of all national spending on hospital care, 21% of physician and clinical services, 41% of home care services, 19% of nursing home care, 30% of durable medical equipment, and 22% of prescription drugs (MedPAC 2010b). According to 2009 data, inpatient hospital services accounted for 27% of Medicare expenditures, 13% for physician services, and 12% for prescription drugs under Part D. Total Medicare expenditures in any given calendar year are spent among a very small number of beneficiaries.