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