Strategic Planning & Timelines

Spending on specialty medications is growing by more than 15 percent annually, and it is expected to account for approximately half ($235 billion) of total annual pharmacy spending by 2018. Among the numerous reasons for the high cost of this heterogeneous group of medications are the increasing size of target patient populations, the high cost of drug development, and a complex and uncoordinated delivery system. This article describes the evolution of the specialty market, characterize the current state of specialty medication use, and articulate key challenges and potential solutions.
 

The number of uninsured nonelderly adults fell by an estimated 10.3 million between September 2013 and early March 2014 because of provisions in the Affordable Care Act for private insurance reforms, the establishment of the Health Insurance Marketplace, and Medicaid expansion. Yet the remaining uninsured population is expected to reach 30 million by 2017. While the health care safety net is able to provide care to many of the remaining uninsured, a number of public and private initiatives at the state and local levels have sought to find additional solutions. This fact sheet describes a number of such examples.
 

The Urban Institute’s Health Reform Monitoring Survey (HRMS) has been tracking health insurance coverage among nonelderly adults since the first quarter of 2013.1 The HRMS, which was designed to provide early feedback on implementation of the ACA, found that uninsured rates had declined by 4.0 percentage points among nonelderly adults between September 2013 and June 2014, with larger declines found in states that have expanded Medicaid. Beginning in June 2013, the HRMS added a supplement to track changes in coverage and other outcomes for children under the ACA. This brief examines findings from the HRMS children’s supplement.

This new Evaluation Highlight focuses on how North Carolina and Pennsylvania are testing the success of the Children’s Electronic Health Record Format’s requirements, such as usability and interoperability. The highlight also focuses onhow well these requirements support the provision of primary care to children and how readily they can be incorporated into existing EHRs.
 

The combined effects of the Affordable Care Act’s coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth in 2014 and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015–23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990–2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013–23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023.