Studies from Cambridge Health Alliance in the Area of Managed Care Reported (Century-long Trends In the Financing and Ownership of American Health Care): Managed Care

2023 MAY 31 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Managed Care have been published. According to news reporting from Cambridge, Massachusetts, by NewsRx journalists, research stated, “Policy PointsOver the past century, the tax-financed share of health care spending has risen from 9% in 1923 to 69% in 2020; a large part of this tax financing is now the subsidization of private health insurance.For-profit ownership of health care facilities has also increased in recent decades and now predominates for many health subsectors. A rising share of physicians are now employees.US health care is, increasingly, publicly financed yet investor owned, a trend that has been accompanied by rising medical costs and, in recent years, stagnating or even worsening population health.”

The news correspondents obtained a quote from the research from Cambridge Health Alliance, “A reconsideration of US health care financing and ownership appears warranted. ContextWho pays for health care-and who owns it-determine what care is delivered, who receives it, and who profits from it. We examined trends in health care ownership and financing over a century. MethodsWe used multiple historical and current data sources (including data from the American Medical Association, the American Hospital Association, government publications and surveys, and analyses of Medicare Provider of Services files) to classify health care provider ownership as: public, private (for-profit), and private (not-for-profit). We used US Census data to classify physicians’ employers as public, not-for-profit, or for-profit entities or ‘self-employed.’ We combined estimates from the official National Health Expenditures Accounts with other data sources to determine the public vs. private share of health care spending since 1923; we calculated a ‘comprehensive’ public share metric that accounted for public subsidization of private health expenditures, mostly via the tax exemption for employer-sponsored insurance plans or government purchase of such plans for public employees. FindingsFor-profit ownership of most health care subsectors has risen in recent decades and now predominates in several (including nursing facilities, ambulatory surgical facilities, dialysis facilities, hospices, and home health agencies). However, most community hospitals remain not-for-profit. Additionally, over the past century, a growing share of physicians identify as employees. Meanwhile, the comprehensive taxpayer-financed share of health care spending has increased dramatically from 9% in 1923 to 69% in 2020, with taxpayer-financed subsidies to private expenditures accounting for much of the recent growth. ConclusionsAmerican health care is increasingly publicly financed yet investor owned, a trend accompanied by rising costs and, recently, worsening population health.”

According to the news reporters, the research concluded: “A reassessment of the US mode of health care financing and ownership appears warranted.”

This research has been peer-reviewed.

For more information on this research see: Century-long Trends In the Financing and Ownership of American Health Care. The Milbank Quarterly, 2023. The Milbank Quarterly can be contacted at: Wiley, 111 River St, Hoboken 07030-5774, NJ, USA.

Our news journalists report that additional information may be obtained by contacting A. Gaffney, Cambridge Health Alliance, Cambridge, MA 02139, United States. Additional authors for this research include S. Woolhandler and D. U. Himmelstein.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1111/1468-0009.12647. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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