Medicare & Medicaid
Cost Analysis
Overview
In the U.S. the Medicare and Medicaid programs pay for about 40% of national health expenditures. We have developed capabilities in analyzing Medicare and Medicaid data to determine attributable costs, expected reimbursements, cost and utilization trends, and costs of illness in these respective populations. In addition, in litigation matters, Medicare and Medicaid payment rates can serve as a “lower bound” in reasonable fair market value calculations.
Types Of Engagements
- Calculation of costs of illness in the Medicare population
- Expected Medicare reimbursement in litigation matters
- Economic modelling of cost impact of a medical device or diagnostic in the Medicare population.
Key Staff
- John Schneider, PhD
- Cara Scheibling, MBA
- Anthony LoSasso, PhD
- Robert Ohsfeldt, PhD
- Ryan Bresnahan, MS
Related Markets & Industries
- Insurance & third-party payers
- Attorneys & law firms
- Medical services
- Hospitals & health systems
- Utilities
- Construction
- Transportation
Related Publications
- A Cost-Offset Analysis of the Roxadustat Incident Dialysis-Dependent Global Phase 3 Program: A US Healthcare Perspective. 2021
- The Economics of Reasonable Value and the Valuation of Medical Losses. 2019
- What is the Reasonable Value of Future Medical Care? 2019
- Economic evaluation of passive monitoring technology for seniors. 2019
- Cost impact of unexpected disposition after orthopedic ambulatory surgery associated with category of anesthesia provider. 2016
- Hospital Expenditure at the End-of-Life: What Are the Impacts of Health Status and Health Risks? 2015
- In-office magnetic resonance imaging (MRI) equipment ownership and MRI volume among Medicare patients in orthopedic practices. 2015
- Organizational boundaries of medical practice: the case of physician ownership of ancillary services. 2012
- Converting to critical access status: how does it affect rural hospitals’ financial performance? 2009
- Factors associated with Iowa rural hospitals’ decision to convert to critical access hospital status. 2009
- Effects of specialty hospitals on the financial performance of general hospitals, 1997-2004. 2007
- Effect of critical access hospital conversion on patient safety. 2007
Related Issue Briefs
- What are “Hedonic Damages,” and Should They Matter in Litigation? (Issue Brief No. 56)
- The Rise of Litigation Funding and Medical Funding in Personal Injury and Product Liability Lawsuits (Issue Brief No. 54)
- Electronic Medical Records: Potential Issues in Litigation and Biomedical Research (Issue Brief No. 48)
- What is the Reasonable Value of Future Medical Care? (Issue Brief No. 44)
- Will Changes in the Affordable Care Act Result in Organizational Changes in U.S. Medical Care? Implications for Economic Evaluation of Drugs & Devices (Issue Brief No. 36)
- Value-Based Payment for Oncology Services (Issue Brief No. 34)
- Paying for Specialty Pharmaceuticals: The Case of Injectable Oncology Drugs (Issue Brief No. 26)
- Value-Based Purchasing for Hospital Services in the U.S. (Issue Brief No. 11)
- How Big a Problem is Health Care Fraud and Abuse, and How Can We Detect It? (Issue Brief No. 9)
- U.S. Health Care Costs: Disentangling Underlying Trends from the Effects of the Affordable Care Act (Issue Brief No. 8)
- Health Care Costs and Value: An International Perspective (Issue Brief No.6)
- Nobody Pays Retail: A Primer on Valuing Medical Care Bills (Issue Brief No. 2)
- Using Publicly Available Health Care Databases to Value & Price Medical Care Services (Issue Brief No. 1)