Publications

Our research is used by government agencies, foundations, and others to advance better health policies and programs.

TOPICS

Behavioral Health Children Economics Equity Health Care Value Medicaid and Medicare Military and Veterans

December 2018 Health Sector Economic Indicators Briefs

December 14, 2018 | Economic Indicators

See the latest data on health spending, price, and labor growth.

Sustainable U.S. Health Spending: Serious Issues—Sound Policy Solutions

December 12, 2018 | Report

Monograph of Altarum's 8th annual sustainable health spending symposium, which took place on July 12, 2018 in Washington DC.

Collateral Damage of the Opioid Crisis

December 12, 2018 | Research Brief

This survey reveals the needs of grandparents raising grandchildren displaced by the opioid crisis, and offers recommendations for supporting them.

November 2018 Health Sector Economic Indicators Briefs

November 15, 2018 | Economic Indicators

See the latest data on health spending, price, and labor growth.

October 2018 Health Sector Economic Indicators Briefs

October 16, 2018 | Economic Indicators

See the latest data on health spending, price, and labor growth.

Health Sector Trend Report, September 2018

October 05, 2018 | Trend Reports

This quarterly report examines current trends in US health care spending, prices, utilization, and employment.

Family Planning Confidential: A Qualitative Research Study on the Implications of the ACA

September 27, 2018 | Online Article

Despite additional revenue sources that have emerged since the passage of the ACA, Title X funding may remain critical for clients who need safe, affordable, and confidential care.

September 2018 Health Sector Economic Indicators Briefs

September 14, 2018 | Economic Indicators

This month's Health Sector Economic Indicator Briefs show modest growth in national health care spending and annual health care prices.

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Background

The opioid crisis has resulted in a dramatic uptick in the number of children being removed from the custody of their parents. Many of these children end up in the care of relatives. Currently around 7.8 million children reside in grandparent-led households. While evidence-based treatment for substance use disorder is capturing national attention, less focus has been given to the many families grappling with the collateral damage of their loved one’s struggle with addiction. This has begun to change with the passage of the bipartisan “Supporting Grandparents Raising Grandchildren Act” in July.

To better inform future policies aimed at providing services and support to grandparents raising grandchildren, Altarum funded data collection about grandfamilies both in Michigan and nationally. Led by social psychologist Christine Stanik, PhD, the resulting report focuses on grandparents raising grandchildren—identifying their perceived needs and barriers to obtaining services, exploring the possible burden of the opioid crisis in this population, and offering recommendations to support and improve outcomes for underserved grandfamilies.

Methods

Primary data collection began during the summer of 2018. The first phase of this study sought to shed light on the lived experience of grandfamilies though in-depth interviews with 20 grandmothers living across the state of Michigan. The second phase explored emerging themes from the interviews with a broader sample through an online survey of 1,015 grandparents raising grandchildren nationwide.

Key findings

Grandfamilies deal with complex mental and behavioral health needs of children who have experienced severe psychological and physical trauma.
Grandparents must cope with their own grief and emotional distress while parenting grandchildren with complex emotional needs.
Raising a second family places grandparents in a financially perilous situation and contributes to the number of children and elderly living in poverty.
The road to custody is complicated. Grandparents are ill-prepared to deal with the legal system.
The foster care system, as it currently exists, may not be the best option to meet grandparents’ needs.
Grandparents subvert their own needs to provide support for their grandchildren.
Grandparent peer groups are an important source of knowledge and strength.

Recommendations

Sort out the provision of subsidies to connect grandparents with existing resources.
Enhance the foster care system to better serve kinship caregivers.
Develop and implement continuing education and mental health interventions at health system points of contact for both grandparents and grandchildren.
Clarify legal rights to help grandparents navigate the family court system.
Develop and implement peer support trainings and peer-led programs to meet the unique challenges of grandfamilies.

Read the full report.

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Background

Methods

Key findings

Grandfamilies deal with complex mental and behavioral health needs of children who have experienced severe psychological and physical trauma.
Grandparents must cope with their own grief and emotional distress while parenting grandchildren with complex emotional needs.
Raising a second family places grandparents in a financially perilous situation and contributes to the number of children and elderly living in poverty.
The road to custody is complicated. Grandparents are ill-prepared to deal with the legal system.
The foster care system, as it currently exists, may not be the best option to meet grandparents’ needs.
Grandparents subvert their own needs to provide support for their grandchildren.
Grandparent peer groups are an important source of knowledge and strength.

Recommendations

Sort out the provision of subsidies to connect grandparents with existing resources.
Enhance the foster care system to better serve kinship caregivers.
Develop and implement continuing education and mental health interventions at health system points of contact for both grandparents and grandchildren.
Clarify legal rights to help grandparents navigate the family court system.
Develop and implement peer support trainings and peer-led programs to meet the unique challenges of grandfamilies.

Read the full report.

These monthly briefs analyze the most recent data available on health sector employment, spending, prices, and utilization—helping to fill gaps in the official government data.

Below are highlights from this month's report:

At $3.70 trillion (seasonally adjusted annual rate), national health spending in September 2018 was 4.8% higher than it was in September 2017.
Health care added 35,600 new jobs in October 2018, above the 12-month average of 26,900.
Health care prices in September 2018 rose 1.7% above September 2017, the same as the August 2018 rate.

[summary] => [format] => full_html [safe_value] =>

These monthly briefs analyze the most recent data available on health sector employment, spending, prices, and utilization—helping to fill gaps in the official government data.

Below are highlights from this month's report:

At $3.70 trillion (seasonally adjusted annual rate), national health spending in September 2018 was 4.8% higher than it was in September 2017.
Health care added 35,600 new jobs in October 2018, above the 12-month average of 26,900.
Health care prices in September 2018 rose 1.7% above September 2017, the same as the August 2018 rate.

These monthly briefs analyze the most recent data available on health sector employment, spending, prices, and utilization—helping to fill gaps in the official government data.

Below are highlights from this month's report:

At $2.68 trillion (seasonally adjusted annual rate), national health spending in August 2018 was 4.8% higher than it was in August 2017.
Health care added 25,700 new jobs in September 2018, in line with the 12-month average of 25,100.
Health care prices in September 2018 rose 1.7% above September 2017, the same as the August 2018 rate.

[summary] => [format] => full_html [safe_value] =>

These monthly briefs analyze the most recent data available on health sector employment, spending, prices, and utilization—helping to fill gaps in the official government data.

Below are highlights from this month's report:

At $2.68 trillion (seasonally adjusted annual rate), national health spending in August 2018 was 4.8% higher than it was in August 2017.
Health care added 25,700 new jobs in September 2018, in line with the 12-month average of 25,100.
Health care prices in September 2018 rose 1.7% above September 2017, the same as the August 2018 rate.

This quarterly report examines current trends in U.S. health care spending, prices, utilization, and employment. Highlights include:

In Q2 2018, US health spending was 5.0% higher than in Q2 2017, bringing the growth rate for the first half of 2018 to 4.8%, year over year.
Health spending by private payers has grown faster than public payers since 2016.
Removing the effects of enrollment growth, especially in Medicaid, reveals an even larger divergence between private and public payer health spending growth rates.
Health care price growth remains below 2.0%, and below economy-wide inflation.
Health sector job growth has stabilized at around 2.0% since Q2 2017.

About Altarum's Quarterly Health Sector Trend Reports

With funding from the Robert Wood Johnson Foundation, Altarum provides a quarterly analysis of key trends in health care spending, prices, utilization, and employment. These reports make direct use of the Quarterly Services Survey (QSS), the timeliest source of detailed, survey-based spending information for health care services, which account for more than 70% of national health spending. Each quarter, when new QSS data are released (March, June, September, and December), we publish this report.

These trend reports are related to, but distinct from, Altarum's Health Sector Economic Indicators briefs, which are issued every month.

[summary] => [format] => full_html [safe_value] =>

This quarterly report examines current trends in U.S. health care spending, prices, utilization, and employment. Highlights include:

In Q2 2018, US health spending was 5.0% higher than in Q2 2017, bringing the growth rate for the first half of 2018 to 4.8%, year over year.
Health spending by private payers has grown faster than public payers since 2016.
Removing the effects of enrollment growth, especially in Medicaid, reveals an even larger divergence between private and public payer health spending growth rates.
Health care price growth remains below 2.0%, and below economy-wide inflation.
Health sector job growth has stabilized at around 2.0% since Q2 2017.

About Altarum's Quarterly Health Sector Trend Reports

These trend reports are related to, but distinct from, Altarum's Health Sector Economic Indicators briefs, which are issued every month.

Abstract

Purpose: A cornerstone of the Title X program is guaranteed access to confidential family planning services regardless of patients’ ability to pay. This is particularly important for adolescents and young adults. The Patient Protection and Affordable Care Act (ACA) expanded health insurance access for thousands of individuals. But, billing third-party payers for family planning services can result in the generation of explanations of benefits and other communications to the policy holder that may compromise confidentiality for covered dependents.

Methods: The research team facilitated 12 focus groups with 62 Title X clients in 5 states and conducted interviews with 91 health center key informants in 10 states. Transcripts were coded using NVivo version 10.0. Researchers used deductive coding and grounded theory to search for themes. Results Clients expressed confusion about the difference between confidential services from their health center versus confidential communications from their health insurance plan. Health center staff also highlighted confidentiality issues that may arise from ACA insurance expansion and revealed that clients overall do not understand how health insurance works, particularly younger clients and those that were newly covered under the ACA.

Conclusions: Many Title X supported health centers will continue not to bill insurance if there are concerns regarding confidentiality, especially with their adolescent and young adult clients. Despite additional revenue sources that have emerged since the passage of the ACA, Title X funding may remain critical for clients who need safe, affordable, and confidential care.

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Abstract

This month's Health Sector Economic Indicator Briefs show modest growth in national health care spending and annual health care prices. Meanwhile, the health care share of total employment increased to a new all-time high, bringing hiring in the second half of 2018 back in line with previous 5 quarters.

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