Oral

This session addresses health care costs in a variety of settings, both in the United States and internationally. One presentation examines the magnitude of economic disparities in access and use of health care services, particularly preventive services, in an Indian state, Kerala. Two presentations propose either a new form of health care insurance (for seniors in Bermuda) or potential strategies to promote cost containment among regulated health insurance plans (in Rhode Island). The last presentation reports on the results of a comprehensive process involving a variety of stakeholders to prioritize potential cost-containment strategies on the basis of perceived value and feasibility. The systematic inclusion of stakeholder input is critical for the development of effective and acceptable health policy change. The remaining two presentations both analyzed administrative claims data from U.S. private health insurance plans using sophisticated statistical techniques. One examined out-of-pocket costs associated with fibromyalgia, a chronic disease associated with pain and activity limitations. The other investigated the association of participation in employer-sponsored health and wellness programs on employer health care costs over a three year period, with a comparison of the net costs for participation in different program components. The last presentation provides important new information about the return on investment to employers of different types of disease management and wellness promotion programs.

Session Objectives: 1. Describe statistical techniques for the analysis of administrative health insurance claims data to assess the effect of disease and disease management on health care expenditures. 2. Identify at least three different cost-containment strategies in the U.S. health care system and discuss the advantages and limitations of each. 3. Discuss the implications of socioeconomic disparities in health service access and use.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)