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Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
Medicare's Role and Future Challenges, JAMA, November 28, 2012
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Medicare's Role and Future Challenges, JAMA, November 28, 2012

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  • 1. Percent of total Medicare population:NOTE: ADL is activity of daily living.SOURCES: Income and savings data from Urban Institute/Kaiser Family Foundation analysis, 2011. All other data from Kaiser FamilyFoundation analysis of the Centers for Medicare & Medicaid Services Medicare Current Beneficiary 2009 Cost and Use file.Characteristics of the Medicare Population5%13%15%17%23%27%40%50%50%Per Capita AnnualIncome below $22,000Per Capita Savingsbelow $53,0003+ Chronic ConditionsFair/Poor HealthCognitive/MentalImpairmentUnder-65 Disabled2+ ADL LimitationsAge 85+Long-term CareFacility Resident
  • 2. Distribution of Traditional MedicareBeneficiaries and Medicare Spending, 200990%43%10%57%Total Number ofTraditional MedicareBeneficiaries: 35.4 millionTotal TraditionalMedicareSpending: $343 billionAverage per capitaTraditional Medicarespending: $9,702Average per capitaTraditional Medicarespending amongtop 10%: $55,763NOTES: Excludes Medicare Advantage enrollees. Includes noninstitutionalized and institutionalized beneficiaries.SOURCE: Kaiser Family Foundation analysis of the CMS Medicare Current Beneficiary Survey Cost and Use File, 2009.Average per capitaTraditional Medicarespending amongbottom 90%:$4,584
  • 3. Percent of total Medicare population:SOURCES: Kaiser Family Foundation analysis of the Centers for Medicare & Medicaid Services Medicare Current Beneficiary 2009 Costand Use file.Medicare Beneficiaries’ Utilization of SelectedMedical and Long-Term Care Services, 20092%5%9%19%28%77%Physician Office VisitEmergency Room VisitInpatient Hospital StayHome HealthVisitSkilled NursingFacility StayHospice Visits
  • 4. Medicare Benefit Payments By Type of Service,2012Skilled NursingFacilitiesHospitalInpatientServicesPhysicianPaymentsHospitalOutpatientServicesHome HealthOther Services*MedicareAdvantageOutpatientPrescriptionDrugsTotal Benefit Payments = $556 billionNOTE: Does not sum to 100% due to rounding. Excludes administrative expenses and is net of recoveries. *Includes hospice, durablemedical equipment, Part B drugs, outpatient dialysis, ambulance, lab services, and other services.SOURCE: Congressional Budget Office, Medicare Baseline, March 2012.14%13%4%6%26%11%22%6%Part APart BPart A and BPart CPart D
  • 5. Part B and Part D Out-of-Pocket Spending asa Share of Average Social Security BenefitNOTE: SMI is Supplementary Medical Insurance. Out-of-pocket spending includes SMI (Part B and Part D) premiums and out-of-pocketcost-sharing expenses for SMI covered services.SOURCE: Kaiser Family Foundation analysis based on data from 2012 Annual Report of the Boards of Trustees of the Federal HospitalInsurance and Federal Supplementary Medical Insurance Trust Funds.Averageout-of-pocketspending onSMIpremiumsAverageout-of-pocketspending onSMI costsharingTotal SMIout-of-pocketspending2000 2010 2020Average Monthly Social Securitybenefit payment$1,001 $1,151 $1,242Average monthly out-of-pocketspending on Part B and Part D$136 $299 $3392000: 14%2010: 26%2020: 27%
  • 6. Medicare as a Share of the Federal Budget,1980 - 2020$591$1,253$1,789$3,456$4,932$107 $216$520$889$341980 1990 2000 2010 2020Federal spending (in billions)Medicare spending (in billions)Medicare as a share of the federal budget5.8% 8.5% 12.1% 15.1% 18.0%SOURCE: Historical spending for 1980 – 2010 from Congressional Budget Office (CBO) Budget and Economic Outlook: Historical BudgetData (January 2011); projected spending for 2020 from CBO Update to the Budget and Economic Outlook: Fiscal Years 2012 to 2022(August 2012).
  • 7. Average Annual Growth in Medicare SpendingCompared with Economic Benchmarks, 2011 –20203.1%4.9%3.7%1.9%Medicare+SGR(fee freeze)Private healthinsuranceGDP CPINOTE: SGR is sustainable growth rate; GDP is gross domestic product; CPI is consumer price index.SOURCES: Kaiser Family Foundation analysis of data from Medicare Trustees, Office of Management and Budget, Congressional Budget Office,Centers for Medicare & Medicaid Services, U.S. Census Bureau.
  • 8. Medicare Enrollment, 1970 - 2030Number in millions:SOURCE: 2012 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical InsuranceTrust Funds.Historical Projected
  • 9. Solvency Projections of the Medicare Part A TrustFund under current law and with repeal of healthreform lawCurrent lawWith ACArepealSolvency projections of the Part A trust fund:Source: Part A solvency projection for current law from 2012 Annual Report of the Boards of Trustees of the Federal HospitalInsurance and Federal Supplementary Medical Insurance Trust Funds; solvency projection with ACA repeal from Centers for Medicareand Medicaid Services (CMS) Press Release, “Medicare Stable, but Requires Strengthening,” released April 23, 2012.Year

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