Technological Innovation in Health Care and the Long-Term Fiscal Outlook

医疗保健技术创新和长期财政前景

基本信息

批准号：
8750769
负责人：
DANA P GOLDMAN
金额：
$ 39.97万
依托单位：
UNIVERSITY OF SOUTHERN CALIFORNIA
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-15 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8750769
关键词：
Accounting Age Aging American Behavioral Behavioral Model Budgets Caring Complement Disease Economic Models Economics Elderly Equilibrium Evolution Feedback Future Generations Government Growth Health Health Care Costs Health Policy Healthcare Heart Income Insurance Knowledge Labor Forces Life Literature Longevity Maps Medical Medical Technology Medicare Medicare/Medicaid Modeling Outcome Past Trends Pharmacologic Substance Policies Population Population Growth Price Production Research Role Running Scientific Advances and Accomplishments Social Values Social Welfare Stream Technology Time United States United States Centers for Medicare and Medicaid Services aged aging population base cost economic outcome falls functional status innovation models and simulation mortality population health programs public health relevance simulation technological innovation trend

项目摘要

DESCRIPTION (provided by applicant): Over the past 50 years, longevity has risen at a steady pace. Functional status of the elderly has also witnessed important improvements, although gains have leveled off recently. These improvements do not come without costs. The United States has devoted an increasing share of its income to health care over that same period. In part because of the projected increase of health costs, the long-term fiscal outlook of the U.S. presents important challenges. Fiscal forecasts from the Congressional Budget Office and the Centers for Medicare & Medicaid Services (CMS) are dire, with Medicare spending alone projected to more than double as a share of national income, from 3.7% today to 7.3% in 2050. However, these forecasts take the driver of health care costs-technology-as exogenous, or fixed. This is unrealistic. We know innovators maximize the expected value of a future profit stream, and they will take into account the demand for their innovations in the future. The proposed research will marry two distinct but complementary approaches from the health policy and macroeconomic fields. First, we will incorporate technological change, and its determinants, into existing models projecting the long- term fiscal outlook of the U.S. Our engine will be an economic-demographic microsimulation that covers the population aged 25 and older, the Future Americans Model (FAM). This approach will examine granular technological change to understand consequences for spending and population health. Second, we will build a macroeconomic growth model to understand endogenous innovation and health care spending in overlapping generations (OLG) that incorporates the projections of our economic-demographic simulation. Such OLG models have proven very useful for understanding long-run economic outcomes and their effects on government debt. Results from the OLG model will complement the results of the FAM by revealing the fiscal paths consistent with a balanced government budget when taking behavioral and macroeconomic changes into account. There are four principal outcomes of this project. First, we will quantify the fiscal consequences of various innovation scenarios. Second, the research will identify scenarios under which new innovations will impact health by effectively treating one disease while simultaneously impacting innovation for other diseases. Third, the project will identify scenarios under which health spending would rise or fall in future years as a result of technological change and how health spending can be financed with minimum welfare consequences using the FAM-calibrated OLG model. Fourth, by combining behavioral models with simulation models such as the Future Americans Model, this project will advance the state of knowledge on the possibilities of combining different approaches to make long-term fiscal forecasts.

描述（由申请人提供）：在过去的50年中，寿命的增长稳定。尽管收益逐渐升级，但老年人的功能状况也见证了重要的改进。这些改进并非没有成本。在同一时期，美国将其收入的份额越来越多。在某种程度上，由于预计健康成本的增加，美国的长期财政前景提出了重要的挑战。国会预算办公室和Medicare＆Medicaid服务中心（CMS）的财政预测非常严重，仅医疗保险支出预计将占国民收入的一部分，从今天的3.7％到2050年的7.3％。这是不现实的。我们知道创新者最大程度地提高了未来利润流的预期价值，他们将考虑到未来对创新的需求。拟议的研究将嫁给卫生政策和宏观经济领域的两种不同但互补的方法。首先，我们将将技术变革及其决定因素纳入现有的模型，这些模型投射了美国的长期财政前景，我们的发动机将是一个经济数字显微仿真，涵盖了25岁及以上的人口，即未来的美国人模型（FAM）。这种方法将检查颗粒状技术变化，以了解支出和人口健康的后果。其次，我们将建立一个宏观经济增长模型，以了解重叠世代（OLG）的内源性创新和医疗保健支出，并结合了我们经济数字模拟的预测。事实证明，这样的OLG模型对于理解长期经济成果及其对政府债务的影响非常有用。 OLG模型的结果将通过在考虑行为和宏观经济变化时揭示与平衡的政府预算一致的财政道路来补充FAM的结果。该项目有四个主要结果。首先，我们将量化各种创新方案的财政后果。其次，该研究将确定新的创新将通过有效治疗一种疾病的同时影响其他疾病创新的情况，从而确定新的创新将影响健康。第三，该项目将确定由于技术变革而在未来几年中将增加或下降的情况，以及如何使用FAM校准的OLG模型以最低限度的福利后果来融资健康支出。第四，通过将行为模型与诸如未来美国人模型之类的仿真模型相结合，该项目将促进有关结合不同方法进行长期财政预测的可能性的知识状态。