TABLE 3.
Cumulative 25-Year Outcomes for Costs, Quality-Adjusted Life-Years (QALYs), and Net Benefits in Model Simulating the US Health System, by Scenario
| Coverage + Quality | Coverage + Quality + Capacity | Coverage + Quality + Capacity + Reimbursement Cut | Coverage + Quality + Capacity + Protection | Capacity + Protection | |
| Baseline parameter settings | |||||
| Change in costsa ($ billions) | +2111d | +1175 | –3240e | +508 | −1178 |
| Change in QALYsb (millions) | +164 | +240 | +115d | +376e | +191 |
| Net benefitc ($ billions) | +10 175d | +16 842 | +11 836 | +27 689e | +15 488 |
| Optimistic parameter settings | |||||
| Change in costsa ($ billions) | +1750d | +515 | –3533e | −1147 | −2368 |
| Change in QALYsb (millions) | +285 | +394 | +285 | +528e | +214d |
| Net benefitc ($ billions) | +19 640 | +29 003 | +24 934 | +40 717e | +18 414d |
| Pessimistic parameter settings | |||||
| Change in costsa ($ billions) | +2196 | +1563 | –3096e | +3330d | +1432 |
| Change in QALYsb (millions) | +92 | +136 | +8d | +266e | +163 |
| Net benefitc ($ billions) | +4704 | +8651 | +3716d | +16 630e | +10 785 |
a
Change in costs equals the change in health care costs plus spending on intervention programs.
b
Change in QALYs equals the change resulting from fewer deaths plus the change resulting from fewer unhealthy days.
c
Net benefit equals (change in QALYs x $75 000) minus change in costs.
d
Worst result among the 5 scenarios.
e
Best result among the 5 scenarios.