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Why Hospitals Want Patients to Pay UpfrontBy John Tozzi Septem.docx
- 1. Why Hospitals Want Patients to Pay Upfront By John Tozzi September 25, 2014 Tozzi is a reporter for Bloomberg Businessweek in New York. URL: http://www.businessweek.com/articles/2014-09-25/why- hospitals-want-patients-to-pay-upfront Melody Rempe spends much of her day telling people who are about to go into the hospital how much they’ll have to pay. As a patient financial counselor at Nebraska Methodist Health System, she calls patients about a week before they go in for procedures with estimates of their bills and what portion insurance will cover. Although many are grateful, some cry or yell. “Sometimes you’re talking to them about the biggest thing in their life,” she says. Rempe says most calls end well when she walks patients through the hospital’s payment-plan options or other financial assistance. Hospitals have good reason to be concerned about their patients’ finances: Even people with insurance are increasingly responsible for a big portion of their medical bills. Among Americans who get health coverage at work, 41 percent have deductibles of at least $1,000 they must meet before insurance starts paying. That’s up from 10 percent in 2006, according to the Kaiser Family Foundation. Those with employer coverage are joined by 7 million new enrollees in Obamacare plans, which typically make patients share a large chunk of costs. The average deductible in the most popular “silver” tier of coverage is $2,267, according to an analysis by the Robert Wood Johnson Foundation. Raising deductibles helps employers and insurers limit premium hikes. It also shifts more of the risk onto individuals. That in turn boosts the chances that doctors and hospitals won’t get paid. If a patient has a $2,900 deductible, “it’s far more difficult to get that $2,900 from an individual patient than it is from the Medicare program or from Blue Cross Blue Shield,”
- 2. says Richard Gundling, vice president of the Healthcare Financial Management Association, a trade group. A March report on hospitals from Moody’s (MCO), the credit-rating firm, was blunt: “Today’s high deductibles are tomorrow’s bad debt.” Hospitals’ total cost of uncompensated care reached $46 billion in 2012, equal to about 6 percent of their expenses, the American Hospital Association says. Large for-profit chains such as LifePoint Hospitals (LPNT), which operates more than 60 medical centers in 20 states, have felt the impact of rising deductibles. LifePoint’s bad debt related to copays and deductibles is running at $25 million per quarter this year, up from $15 million per quarter in 2013, Leif Murphy, the company’s chief financial officer, said on an earnings call in July. He blamed the increase in part on the growing prevalence of high-deductible plans. As the mechanics of insurance policies become more complicated, Americans are having a harder time understanding how their plan choices will affect their finances. Only 14 percent of insured adults correctly understand insurance jargon such as deductibles, coinsurance, copays, and out-of- pocket maximums, according to a 2013 study published in the Journal of Health Economics. Many Americans aren’t prepared for a medical emergency. Dr. Marilyn Peitso, a pediatrician in St. Cloud, Minn., says parents often can’t afford $300 to $400 for antibiotics to treat an ear infection. “For young working families, this can get to be a real financial burden, and it can make them less likely to seek needed care,” she says. About 44 percent of households have less than three months of savings, according to an analysis by the Corporation for Enterprise Development, an antipoverty group. “Tell me what 28-year-old is going to be able to provide, especially in this economy, $6,000 of their own money?” says Jan Grigsby, chief financial officer at Springhill Medical Center in Mobile, Ala. Like Nebraska Methodist, Springhill reaches out to patients before scheduled procedures with an estimate of what they’ll
- 3. owe, Grigsby says. For those who can’t pay immediately, the hospital works with lenders to arrange no-interest payment plans of as long as two years. Staff members also check whether patients are eligible for charity care from the hospital or if they qualify for Medicaid. Many hospitals try to get patients to pay upfront 30 percent to 50 percent of what they’ll owe and some offer discounts for paying early, says Yaro Voloshin of health-care consultant MedAssets (MDAS). One reason is that they want to avoid the damage to their reputations that accompanies aggressive debt collection practices. “Over the years there’s been some stigma about collecting from patients,” says Zac Stillerman, an executive with the Advisory Board, which sells software and consulting services to hospitals. “It’s a bit of a third rail.” Managers at Nebraska Methodist noticed payment problems getting worse about seven years ago, when a large employer in the Omaha area introduced a plan with a $5,000 deductible. “We would bill a procedure for a patient; the entire amount would be applied to the deductible,” says Bob Wagner, the hospital’s director for revenue cycle. “We actually got no money.” Now any patient scheduling a procedure expected to cost more than $500 out of pocket gets a call from Rempe or another of Nebraska Methodist’s five financial counselors. The hospital tries to get some payment in advance, but it doesn’t turn away those who can’t pay. Even simply identifying the indigent can help, says Gundling of the Healthcare Financial Management Association. “For both the patient and the facility,” he says, “trying to collect a debt that can’t be paid just wastes everybody’s time.” The bottom line: Some of the 17 million U.S. residents covered by high-deductible health plans are racking up medical debt. Questions With this case, you are provided a sample of patient data for your analyses. The provided link in Blackboard to the Excel
- 4. workbook contains data on patients in a particular hospital. The dataset contains the following variables: Income: Patient's annual household income Past Due Amount: Amount of debt or money owed by the patient to the hospital. Insurance: Type (if any) of medical insurance. Years since last visit: Number of years since the patient's last appointment. Year born: The year in which the patient was born Gender: Patient's gender Hospitalizations: Lifetime hospitalizations of the patient Ethnicity: Patient's Race Marital Status: Patient's Marital Status Hospitals are concerned about patients’ ability to pay their medical bills. It is suggested that there a relationship between type of medical insurance and medical debt. Write a concise report answering questions 1-6. Using past due amount as the dependent variable and all other variables as predictors (independent variables), run appropriate statistical analyses in Excel to mine the data. Label sections of your report to correspond to the questions. Insert tables and graphs from Excel in your report as appropriate. 1. Summarize the issue(s) and/or problems from the case in your own words. Support your answer(s). 2. Identify strategies for solving the problem. 3. Propose one or more solutions/hypotheses which address the problem(s). 4. Evaluate potential solutions to the problem(s). Analyze own and others’ assumptions. What inferences can you make from your dataset? Some suggestions are listed below; however, conduct additional analyses as deemed appropriate. a. Create a frequency table of insurance types.
- 5. b. Construct a bar chart, a pie chart, and a Pareto diagram of insurance types. c. Which graphical method do you think is best to portray these data? d. Based on this data, what conclusions can you make about the insurance status of the patients? 5. Choose a solution. 6. Evaluate outcomes by reviewing the results relative to the problem(s) defined. 1 7-32. SeaFair Fashions relies on its sales force of 220 to do an initial screening of all new fashion. The company is currently bringing out a new line of swimwear and has invited 40 salespeople to its Orlando home office. An issue of constant concern to the SeaFair sales office is the volume of orders generated by each salesperson. Last year, the overall company average was $417,330 with a standard deviation of $45,285. (Hint: The finite population correction factor, Equation 7.5, is required.) a. Determine the probability the sample of 40 will have a sales average less than $400,000. b. What shape do you think the distribution of all possible sample means of 40 will have? Discuss. c. Determine the scale of the standard deviation of the distribution of the sample mean of all possible samples of size 40. d. How would the answers to parts a, b and c change if the home office brought 60 salespeople to Orlando? Provide the respective answers for this sample size.
- 6. e. Each year SeaFair invites the sales personnel with sales above the 85th percentile to enjoy a complementary vacation in Hawaii. Determine the smallest average salary for the sales personnel that were in Hawaii last year. (Assume the distribution of sales was normally distributed last year.) 7-54. United Manufacturing and Supply makes sprinkler valves for use in residential sprinkler systems. United supplies these valves to major companies such as Rain Bird and Nelson, who in turn sell sprinkler products to retailers. United recently entered into a contract to supply 40,000 sprinkler valves. The contract called for at least 97% of the valves to be free of defects. Before shipping the valves, United managers tested 200 randomly selected valves and found 190 defect-free valves in the sample. The managers wish to know the probability of finding 190 or fewer defect-free valves if in fact the population of 40,000 valves is 97% defect-free. Discuss how they could use this information to determine whether to ship the valves to the customer. 8-12. Allante Pizza delivers pizzas throughout its local market area at no charge to the customer. However, customers often tip the driver. The owner is interested in estimating the mean tip income per delivery. To do this, she has selected a simple random sample of 12 deliveries and has recorded the tips that were received by the drivers. These data are $2.25 $2.50 $2.25 $2.00 $2.00 $1.50 $0.00 $2.00 $1.50 $2.00 $3.00 $1.50 a. Based on these sample data, what is the best point estimate to use as an estimate to use as an estimate of the true mean tip per
- 7. delivery? b. Suppose the owner is interested in developing a 90% confidence interval estimate. Given the fact that the population standard deviation is unknown, what distribution will be used to obtain the critical value? c. Referring to part b, what assumption is required to use the specifies distribution to obtain the critical value? Develop a box and whisker plot to illustrate whether this assumption seems to be reasonably satisfied. d. Referring to parts b and c, construct and interpret the 90% confidence interval estimate for the population mean. 8-38. The Northwest Pacific Phone Company wishes to estimate the average number of minutes its customers spend on long-distance calls per month. The company wants the estimate made with 99% confidence and a margin of error of no more than 5 minutes. a. A previous study indicated that the standard deviation for long-distance calls is 21 minutes per month. What should the sample size be? b. Determine the required sample size if the confidence level were changed from 99% to 90%. c. What would the required sample size be if the confidence level was 95% and the margin of error was 8 minutes? 8-56. As the automobile accident rate increases, insurers are forced to
- 8. increase their premium rates. Companies such as Allstate have recently been running a campaign they hope will result in fewer accidents by their policyholders. For each six-month period that a customer goes without an accident, Allstate will reduce the customer’s premium rate by a certain percentage. Companies like Allstate have reason to be concerned about driving habits, based on a survey conducted by Drive for Life, a safety group sponsored by Volvo of North America, in which 1,100 drivers were surveyed. Among those surveyed, 74% said that careless or aggressive driving was the biggest threat on the road. One-third of the respondents said that cell phone usage by other drivers was the driving behavior that annoyed them the most. Based on these data, assuming that the sample was a simple random sample, construct and interpret a 95% confidence interval estimate for the true proportion in the population of all drivers who are annoyed by cell phone users. Patient DataIncomePast Due AmountInsuranceYears Since Last VisitYear BornGenderHospitalizationsEthnicityMarital Status92680Medicaid01955Female1CaucasianMarried120990Me dicare11934Male8CaucasianMarried963970Private01973Female 2CaucasianMarried63027327Private11958Female6HispanicDivo rced2732450Private01963Female3CaucasianMarried587560Priv ate01975Male2CaucasianMarried1398320Private31992Male1Ca ucasianMarried199300Medicare01945Female6HispanicMarried3 7615149Medicaid21969Female4AsianWidowed76863616Private 11989Male2CaucasianMarried24125197Private01947Male0Cauc asianMarried2865058Medicaid21968Male1AsianDivorced15340 0Private11956Female5CaucasianMarried202744506Private2195 2Male5HispanicMarried202490Medicare11938Male7African AmericanMarried33959171Private31978Male3HispanicDivorced 177266267Private01989Female2AsianDivorced25020266Medica id21957Female1CaucasianDivorced163109168Private01979Mal e3CaucasianDivorced166501544Medicaid01980Female1Caucasi anDivorced25664155Medicaid11981Male2CaucasianDivorced14
- 9. 896428Medicaid21970Female1African AmericanMarried760080Private01970Female2CaucasianMarried 174119307Private01962Male4CaucasianMarried29516324Privat e01981Male2CaucasianSeparated416140Private11967Male0Cau casianDivorced70161277Medicaid01989Female1African AmericanMarried295860Medicaid21985Male2CaucasianMarried 21671346Medicaid01959Female5CaucasianMarried1704210Priv ate11987Female2CaucasianMarried1149480Medicare01940Fem ale2CaucasianMarried9267137Private01965Male0CaucasianDiv orced1449200Private31985Male2AsianDivorced689260Private0 1983Male2AsianMarried1248730Private11989Female1Caucasia nSeparated1293580Medicare01942Female9CaucasianMarried18 6134145Medicare01941Male2CaucasianMarried89260Private01 965Male5CaucasianDivorced84411174None21991Female1Cauc asianDivorced202140Private + Medicare01933Female4HispanicDivorced43988410Private01971 Female2CaucasianSingle1724940Private01985Male1AsianDivor ced2895430Private01956Female0CaucasianDivorced51294360P rivate11967Male1CaucasianMarried29621960Medicaid11987Ma le2CaucasianDivorced1927630Private01948Male6HispanicMarri ed77959173Private01986Female3AsianMarried8859368Private3 1980Female0CaucasianSeparated256103208Private01984Male1 CaucasianWidowed48289475Private01965Male5AsianMarried1 110480Medicare21939Male1CaucasianMarried1927463None219 47Female1OtherMarried256290Private + Medicare21943Female6HispanicDivorced129400Private + Medicare01946Male1CaucasianMarried102797500Medicare019 34Male9CaucasianDivorced91530Private01947Male4African AmericanMarried268840Medicare11942Male6CaucasianMarried 580160Private11988Female2CaucasianMarried7519429Private3 1976Female2OtherDivorced25948484Medicare11939Male8Cauc asianMarried14711659Private01979Female1African AmericanMarried1758269Private11947Female4CaucasianMarrie d29101364Medicare01935Male11HispanicMarried258920Medic aid01968Male1HispanicDivorced641460Private01979Male0Afri can AmericanMarried696880Private +
- 10. Medicare31934Male8CaucasianDivorced127391452Medicaid01 983Male1AsianMarried2215740Private01963Male5HispanicWid owed891510Private21963Female2CaucasianDivorced21651332 Medicaid11969Male3HispanicMarried499881802Private31969M ale4CaucasianMarried58244360Private21978Female3HispanicS eparated60040Private11955Male3CaucasianDivorced9402278M edicaid01975Male4African AmericanMarried1000880None01955Female6CaucasianMarried 1154200None01963Female0HispanicMarried153210Medicare01 939Female10CaucasianMarried218481291Private41975Male3Ca ucasianMarried2212170Medicare01938Female11AsianMarried2 152480Private01988Female2CaucasianMarried1357720Private0 1992Male0CaucasianDivorced814990Private31950Male0Caucas ianDivorced1386470Private01964Male1African AmericanDivorced124764239Private01953Male3AsianMarried7 8631168Private41988Female1CaucasianMarried232340Private + Medicare01933Male12HispanicSingle1088790Private01982Fem ale2AsianDivorced192620Private31980Female1AsianSingle217 470Private01986Male1CaucasianMarried2005360Medicare1193 8Male4CaucasianMarried21973154Medicaid01977Male3Caucasi anMarried99000Private01960Female2CaucasianDivorced997020 91Private01982Male2OtherDivorced81040Private + Medicare11937Female10HispanicMarried159693192Private0198 2Female1CaucasianMarried196730Medicaid21966Male1AsianM arried215640Medicaid01989Male0AsianSingle687610Private01 962Female1CaucasianDivorced34456371Medicare21939Male6A sianDivorced1321280Private31973Female0CaucasianMarried22 7130Private01977Male3AsianMarried1490930Medicare31942M ale7CaucasianDivorced881500Private01970Female3CaucasianM arried51086183Private31974Male3CaucasianSeparated166010M edicaid31984Female0CaucasianSingle772320Private + Medicare01932Male10CaucasianDivorced211570395Private219 90Male2CaucasianMarried196150Medicare11942Female6Africa n AmericanMarried247860Medicaid11992Male1CaucasianMarried 181985162None31988Male1AsianMarried95531344Medicaid11
- 11. 973Female0CaucasianMarried220141462Medicaid01984Female 2African AmericanMarried704810Private01971Male0CaucasianDivorced 543520Private31992Male1African AmericanDivorced271803800Private31990Female2CaucasianSe parated168600174None01953Male5CaucasianDivorced2484330 Private01957Male5CaucasianSeparated44458155Private21962Fe male4CaucasianDivorced78190Private11987Female2AsianDivor ced14566071Private11988Female2CaucasianDivorced1189220P rivate01965Male4CaucasianMarried179674383Private21956Fem ale4AsianMarried44338478Medicare01936Male2CaucasianMarr ied99980Private41977Female0CaucasianDivorced7662620Privat e01958Male1HispanicDivorced1597520Private + Medicare01933Male14CaucasianMarried292650Private31979Fe male3OtherDivorced598610Private31973Male4CaucasianWidow ed595600Private01966Female3CaucasianDivorced69323924Med icaid01950Male2CaucasianMarried66328359Private + Medicare11937Male10AsianMarried74820Medicaid01955Male5 African AmericanDivorced1479250Private01973Female2CaucasianSingl e73072250Private01950Female6CaucasianMarried599540Privat e01951Male4OtherMarried15800308Medicaid11979Male2Other Married298860Private01950Female1CaucasianMarried1895920 Private + Medicare01936Female7HispanicSeparated213141631Private019 55Female3CaucasianDivorced1403120Private01971Female4Afri can AmericanDivorced12298420Medicaid21988Male1African AmericanMarried91180Medicare11946Female3CaucasianSingle 2578360None01961Female5HispanicDivorced104002120Private + Medicare01946Male2AsianDivorced1462380Medicare01932Fem ale13OtherMarried19238089Private31974Female4HispanicMarri ed821610Medicare11943Male1HispanicMarried331530Medicaid 01965Female2HispanicMarried252024715Private + Medicare01933Male8CaucasianMarried1118430Private01963Ma le1African
- 13. AmericanDivorced362160Medicaid11950Female0CaucasianDiv orced323341183Private01952Female5OtherMarried277673171P rivate01968Female3CaucasianMarried1361340Private11992Fem ale0HispanicMarried128492127Private + Medicare01944Male1CaucasianDivorced2441000Private01978F emale3CaucasianMarried587700Private01956Female0Caucasian Married864280Private + Medicare01936Male2CaucasianMarried434790Private01986Mal e2CaucasianMarried926290Private01960Female4AsianSeparate d14789156Medicaid21947Female7CaucasianDivorced1632930P rivate01989Female1AsianDivorced128733331Private01959Fema le5HispanicMarried1687780Private11986Male1CaucasianSepara ted836240None01969Female4HispanicMarried566470Private01 962Male1CaucasianSeparated86360Private01985Female1Caucas ianMarried2594980Private11954Male4African AmericanDivorced152832343Private31947Female6CaucasianDi vorced121720Private01954Female4African AmericanDivorced200485173Private21949Male2CaucasianMarr ied1355070Private01980Male1CaucasianSeparated636750Privat e31972Female4CaucasianMarried98233122Private21970Female 2CaucasianDivorced2373070Medicare31933Female11Caucasian Married588520Private01977Female2CaucasianSeparated108110 Medicare01945Female3CaucasianSeparated6269426Private + Medicare01946Female3CaucasianMarried201800Medicaid01966 Female4CaucasianWidowed285820Private + Medicare01942Female7AsianMarried857589Private11965Male2 CaucasianSingle100163070Medicaid01966Male0CaucasianMarr ied98440Medicare21942Male3CaucasianDivorced867810Private 11947Male1CaucasianDivorced620860Medicare01945Male7Cau casianMarried982140Private01979Male3HispanicSeparated1043 580Private21982Female1CaucasianMarried1828630Private0199 0Female2CaucasianDivorced14795290Medicare01942Male5Cau casianMarried1343937Private + Medicare01944Male5CaucasianMarried274150Private31972Fem ale3OtherDivorced2498090Private01964Male5HispanicDivorce d1191040None01948Female5African
- 14. AmericanMarried31529176Medicaid01954Female6CaucasianWi dowed1379640None01962Female5OtherMarried1893430Private 01953Female4CaucasianMarried126007328Private01969Male2C aucasianWidowed856110Private01976Female4CaucasianMarrie d8047134Medicaid21969Male2CaucasianMarried10925147Medi caid01969Male1OtherDivorced143201354Private01950Male4Ca ucasianDivorced168640Private31986Female0African AmericanMarried127945398Medicaid01974Male0HispanicSingl e1968770Private01950Male4CaucasianDivorced684310Private + Medicare01936Female10CaucasianSingle126555966Private + Medicare21940Female2HispanicMarried136290Private + Medicare01941Male5AsianMarried184340Medicare21938Male7 CaucasianMarried266850Private + Medicare01937Female6CaucasianSingle1006980Private01951M ale5CaucasianDivorced1632620Private01973Male4CaucasianDi vorced503190Private31958Male3AsianDivorced132416215None 01952Female5CaucasianSingle189660Medicaid01983Female3C aucasianSeparated810010Private01963Male3CaucasianWidowed 317740Medicaid01961Female0African AmericanSingle86550421Private21977Female0CaucasianDivorc ed1947888Private11972Female1CaucasianSeparated270170Priv ate31968Male2HispanicMarried686010Private01967Female4Ca ucasianDivorced2570016Medicaid11985Male2African AmericanDivorced90570Private01987Female1CaucasianSeparat ed105691428Medicaid31981Male1CaucasianMarried84234059P rivate01953Male4African AmericanMarried839710Medicare11942Male3AsianDivorced26 91570Private11977Male1AsianDivorced198600Medicaid01960 Male5CaucasianWidowed485590Private01966Male2African AmericanMarried1945120Medicare11937Female3CaucasianWid owed47906308Private21985Male1HispanicDivorced275330Med icare01932Male17African AmericanMarried1160610Private01961Female2HispanicMarried 435120Private31953Female6African AmericanMarried1358440Medicare01946Male2African AmericanMarried69192316Private01953Male2AsianDivorced10
- 15. 68500Private01992Male2CaucasianSingle451942609Private019 82Male1AsianWidowed7684359Private11954Male5CaucasianW idowed1806170Private31987Male1HispanicMarried264180Medi caid01950Male1CaucasianWidowed336113400Private01984Mal e1CaucasianSingle29742194Private11965Female4CaucasianMar ried290290Private01989Male0CaucasianMarried110198422Priv ate + Medicare01935Male2CaucasianMarried79670Medicare11939Fe male11AsianMarried118943309Medicare01940Male8HispanicSi ngle586830Medicare01936Female7CaucasianSeparated7312141 3None01957Male6AsianMarried136053198Private01982Male0C aucasianMarried287920Medicaid21947Male5HispanicDivorced1 4768484None01966Female2HispanicDivorced272421780Private + Medicare01934Female11AsianMarried84760Medicaid01991Fem ale1CaucasianSingle251040Private01986Male1OtherDivorced28 577321Medicaid31975Male2HispanicDivorced2228240Private3 1980Male2CaucasianMarried11487912None01954Male6Caucasi anMarried223163659Medicaid11970Male2CaucasianWidowed8 08940None11972Female2CaucasianMarried205820Medicaid019 67Male4African AmericanSingle2002400None01954Male5CaucasianSeparated89 287306Private01960Male1African AmericanDivorced980390Private01980Male2CaucasianDivorce d363750Private + Medicare01940Male6CaucasianWidowed1658291806Private219 90Male2CaucasianMarried2649050Private01953Female6Caucasi anMarried1536330Private01956Female2CaucasianMarried82960 0Private31985Male0CaucasianMarried62923369Medicare01936 Female4HispanicDivorced882040Private01986Female2Caucasia nMarried2343540Private21952Female2AsianMarried1415150Pri vate + Medicare11936Male5CaucasianMarried1978180Private31976Fe male4CaucasianDivorced1567780Private01949Male5Caucasian Widowed231880Medicaid11968Male4CaucasianMarried691390 Medicare01943Female2CaucasianDivorced1933160Medicare019
- 17. male15OtherSeparated33551348Medicaid01963Female0African AmericanMarried11721634Private01969Male2CaucasianDivorc ed60861211Medicare11946Male0AsianDivorced1454290Medica re11941Male2African AmericanDivorced139431972None01985Male0AsianSeparated1 0834345None01976Male1CaucasianDivorced34417406Private01 972Female2African AmericanMarried247460Medicaid31976Female3HispanicWidow ed171924218Private01965Male1AsianDivorced136470Private + Medicare01938Female7CaucasianMarried16999310Medicaid219 68Male4CaucasianMarried588730Private01977Male1Caucasian Married2513952029Private11991Male1CaucasianMarried22440 70Private01965Male1CaucasianDivorced72728392Private + Medicare01943Female1CaucasianDivorced197285148Private11 977Male3CaucasianSeparated9768465Private01983Male1Cauca sianMarried163419396None11967Female1HispanicMarried5815 60Private + Medicare01932Female10CaucasianSeparated287240Medicare21 933Female5CaucasianDivorced71620Medicare01945Female3Ca ucasianDivorced116580Private + Medicare31944Female4HispanicMarried17714351Private01981 Male3African AmericanSingle135780Medicaid21978Male3HispanicMarried80 062838Private + Medicare21934Male8CaucasianDivorced7308156Private01978F emale0CaucasianDivorced1609730None11961Female3Hispanic Divorced277080Private01967Male1CaucasianDivorced2110540 Private31973Male2CaucasianMarried1427580Private01953Male 2CaucasianSingle2570510Medicare01941Male5CaucasianMarrie d9200114Medicaid01990Female2CaucasianWidowed287940Priv ate21971Female2CaucasianMarried194210Medicaid01962Femal e2CaucasianSeparated14800410Medicaid21978Male3Caucasian Widowed1084180Private01974Male2HispanicMarried31573962 Private21987Male1HispanicMarried95290Medicaid21958Male3 CaucasianDivorced213950Private01988Male2CaucasianMarried 85330Private01983Female2CaucasianDivorced217790Private31
- 18. 992Female0HispanicSeparated21019739Private01966Female4Af rican AmericanMarried107420459Private11992Male2CaucasianMarri ed103350237Private01948Male2CaucasianDivorced6040406Priv ate31961Male5African AmericanMarried1601221990Private11947Male3CaucasianSepa rated3084380Private11988Female0AsianMarried9161382None3 1965Male3African AmericanSeparated292040None21952Female5African AmericanWidowed94150221Medicare11935Male9CaucasianMar ried889980Medicare01941Female7CaucasianDivorced973964M edicare31946Male5CaucasianMarried8599989Private11950Fema le0CaucasianMarried594080Private01953Female5HispanicDivor ced147091178Private + Medicare01939Female8African AmericanWidowed168130Private01976Female3CaucasianDivor ced3611132Medicaid01963Female5CaucasianMarried1574860Pr ivate21947Male6CaucasianMarried1333740Private01975Male0 CaucasianMarried141540Private01972Female1AsianMarried113 200None31987Male0HispanicDivorced532630Private01972Fem ale3CaucasianSeparated29362410Private01948Male1African AmericanDivorced142680Medicare01939Male9CaucasianMarrie d155100Medicaid31983Male2CaucasianSingle325956276Private 01958Male5CaucasianMarried170814297Medicaid31970Female 3HispanicDivorced74181124Medicare01946Male1CaucasianWi dowed645890Private01979Male3African AmericanMarried177590Medicare01934Female5African AmericanSeparated1559530Private + Medicare01941Female8African AmericanDivorced700880Private01986Female2CaucasianMarrie d74119151Private01956Male3HispanicMarried472640Medicare 31933Female7CaucasianMarried2507387Private01980Male2His panicMarried176293143Medicaid21963Male0CaucasianDivorce d1377860Private01980Male1CaucasianDivorced567270Private4 1969Female1HispanicMarried91050Private31974Female2Hispan icDivorced196960Medicaid01948Male3HispanicDivorced12738 1417Private31986Male3CaucasianMarried5395257Private01990
- 19. Male0OtherSingle794710Private01955Female5CaucasianWidow ed18545208Medicaid11984Male0CaucasianMarried9099200Priv ate01986Male0CaucasianMarried706420Private11960Female5Ot herSingle1566430Private01951Female6CaucasianMarried14617 7441Private01986Male2CaucasianDivorced359970Medicare019 44Male4CaucasianMarried26425129None31984Female3Caucasi anDivorced1966990Private41975Female0AsianDivorced173540 Medicare01932Female6African AmericanMarried1579030Private01968Male0HispanicDivorced2 5999380Medicaid01961Male5CaucasianMarried174417147Priva te21979Male1CaucasianMarried245036499Private31980Male1C aucasianMarried2005370Medicare11940Female9African AmericanMarried9006272Medicare01946Male2HispanicMarried 367650Private21991Male0HispanicSeparated171970Medicare01 946Male7HispanicDivorced77540Medicaid01978Male1Caucasia nMarried95002436Private21976Female0CaucasianMarried23525 0Medicare11944Female1CaucasianMarried160968300Private + Medicare21945Male5AsianMarried144110Medicare21946Male1 African AmericanDivorced1115950Private + Medicare21937Female2HispanicSeparated277820Medicaid0198 8Female2HispanicDivorced212680Private + Medicare01935Male7African AmericanDivorced109494359None11956Male1OtherDivorced14 17050Private31948Male3CaucasianMarried11531271Private + Medicare01933Male5African AmericanMarried768560Medicare01941Female8CaucasianMarri ed441300Private + Medicare01945Female8CaucasianMarried85804920Private0196 3Female2AsianDivorced347300Medicaid11949Female0Caucasia nMarried176021208Medicaid21988Female1CaucasianDivorced1 4959310Private01976Female1CaucasianMarried1032630Private 01953Female4CaucasianSingle72044483Medicare21941Male6C aucasianDivorced127070Medicare11939Female2CaucasianSepar ated2013790Private01954Female2CaucasianDivorced80800Med icare01942Male4CaucasianMarried857380Private01971Male2Ca ucasianMarried1271220Private01949Female5HispanicMarried13
- 21. 2CaucasianDivorced202196263Medicare01937Male3Caucasian Married1332300Private31968Male1CaucasianMarried1375320Pr ivate31982Female1CaucasianMarried1289550Private01972Male 1CaucasianDivorced9560845Private21971Male1CaucasianDivor ced95842153Private31979Female2HispanicWidowed972300Priv ate01970Male1CaucasianDivorced11157202Medicare01939Male 4CaucasianWidowed81331464Medicaid41970Male2CaucasianM arried21867221Medicare21938Female12CaucasianMarried2155 270Private01964Male2HispanicDivorced277540Medicaid01962 Male5African AmericanMarried164426293None01947Female7HispanicMarrie d886010Private + Medicare01944Male4CaucasianMarried1301890Private31951Fe male1CaucasianMarried77040Private01964Female3CaucasianSe parated934750Private11967Female0CaucasianWidowed219420P rivate + Medicare11934Male11AsianMarried2407070Private01961Male4 AsianMarried77560Medicare01934Female7African AmericanWidowed1415750Private01990Female2CaucasianMarr ied280820Private01982Female0CaucasianMarried583290Private + Medicare01941Female6HispanicMarried186313544Medicaid019 55Male5CaucasianDivorced80410Private21967Female2Caucasia nSeparated297187251Private11953Male2CaucasianMarried1524 00Medicare01936Female5HispanicWidowed1337030Private + Medicare21941Female4OtherSingle81843481Medicare01940Ma le6African AmericanDivorced586700Private21958Male5CaucasianMarried 347900Medicare01937Female7CaucasianSeparated336062693M edicaid31961Male4CaucasianDivorced37699190Medicare01941 Male9AsianMarried2037020Private11970Female1African AmericanMarried2769916Medicaid01964Male4CaucasianMarrie d32447472Medicaid01988Male1CaucasianMarried2142180Medi care01943Male3AsianMarried130310Private01947Female5Afric an AmericanDivorced2455490Medicare01941Female3CaucasianWi
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- 24. 01985Female1CaucasianMarried1341580Private + Medicare21933Female7HispanicSingle655990Private11970Fem ale0HispanicMarried431990Private01947Female2CaucasianMar ried224630Medicaid01956Female1OtherWidowed15926173Priv ate01950Female1HispanicDivorced93570Medicare21944Male5 HispanicMarried2677330Private + Medicare01943Female3OtherDivorced400720Private + Medicare01935Female8HispanicDivorced27394426Medicare119 40Female8CaucasianMarried293621433Private41992Female1Hi spanicMarried380370Medicaid01966Female3CaucasianMarried1 16398335Private11978Male1CaucasianMarried155123258Medic aid31990Female2AsianMarried466141287Private01973Female1 CaucasianMarried344040Private01949Male1CaucasianDivorced 185880Private41991Male2AsianDivorced299760Private + Medicare01946Female4CaucasianDivorced273430Medicaid1195 6Male2CaucasianDivorced207060Medicare01939Female1Africa n AmericanMarried1939100Private + Medicare01943Female3CaucasianWidowed699860Private + Medicare01936Female5CaucasianSingle1968570Medicare21943 Male6CaucasianSeparated741570Private31960Male2CaucasianD ivorced188913253Private01987Female2African AmericanWidowed1788320Private41992Female1CaucasianDivo rced80901575Medicaid01985Male2HispanicDivorced791054Me dicaid01950Female3CaucasianMarried278960Private + Medicare01941Male1CaucasianMarried176960Private + Medicare31933Female7CaucasianMarried844870Private01973F emale1African AmericanSeparated273650Medicaid01962Female4CaucasianWi dowed71731255Private01970Female2CaucasianDivorced148512 0Private01972Male0CaucasianSingle926970Medicare01945Fem ale1CaucasianDivorced448230Private01950Male7African AmericanMarried22469466None01969Female3CaucasianDivorc ed187200Private01958Female2OtherMarried2506080Private219 83Male2African AmericanSeparated151060Medicaid21963Male0CaucasianSepar ated743940Medicare01937Female6CaucasianMarried2061950Pr
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- 27. Medicare01933Female10HispanicMarried2259060Private01983 Female1AsianWidowed15839411Private + Medicare01941Male3CaucasianMarried2749710Private01964Fe male5CaucasianMarried1765576Private + Medicare01939Female7CaucasianMarried71090Private01975Fe male4HispanicMarried2099930Private01956Female3OtherMarri ed120473183Medicaid01958Female4African AmericanMarried99431226Medicare01937Female10CaucasianS eparated1172400Medicare01933Female9CaucasianMarried1224 1334Medicaid21963Female5CaucasianDivorced220420Medicaid 31980Male1African AmericanDivorced184342159Private31983Male2HispanicMarrie d1745630Private11955Male5CaucasianSingle2180570None1198 4Female3AsianMarried121021232Private21960Male4Caucasian Separated892440Private01955Male4HispanicMarried260000Non e01954Male4CaucasianMarried28909832Private + Medicare01936Male8AsianDivorced296500Private01961Female 1CaucasianDivorced229220Private01974Male3CaucasianSepara ted130149224Private01950Female5CaucasianMarried179310Me dicare01935Male10African AmericanMarried85139470Private01955Male5CaucasianMarrie d148520Medicare31936Female2CaucasianMarried1748380Priva te11986Male2CaucasianMarried99413383Medicaid01991Male1 CaucasianMarried81773123Private + Medicare01932Male4HispanicDivorced93573111Private21988F emale2HispanicDivorced435650Private01989Female1HispanicS ingle80120Medicaid21963Male4AsianDivorced24774573Medica id01976Male0CaucasianDivorced124792897Private31970Femal e5CaucasianMarried68825135Medicaid01955Female6Caucasian Separated19845124None31971Male2HispanicMarried402840Pri vate31950Male3AsianDivorced202130Private + Medicare01936Female8African AmericanMarried99410Medicaid01968Female3CaucasianMarrie d1276780Medicare01935Female3CaucasianMarried7376290Non e31987Male2HispanicMarried1428070Private31952Female3Cau casianDivorced1298860Private01966Male4CaucasianMarried15
- 28. 82500Private21981Male1CaucasianMarried27405326Private + Medicare31943Female6CaucasianMarried966950Private + Medicare01934Male14AsianDivorced20341583Private01967Mal e2CaucasianDivorced29638489Private21974Male2CaucasianDiv orced88172482None41970Male3CaucasianMarried461712012Pr ivate01963Female1African AmericanMarried257380Medicaid11965Female4CaucasianMarri ed342870Private01982Female1AsianMarried348680Medicaid01 953Male6CaucasianMarried182810Private01956Male5African AmericanWidowed69589167Private41987Male2CaucasianMarri ed870760Private11980Female0CaucasianMarried71519253Priva te + Medicare21944Female8OtherMarried984060Private01955Femal e4CaucasianSingle642790Medicare01943Female4OtherMarried1 06370298Private01986Male1CaucasianMarried1332110Private1 1949Male3CaucasianMarried45010257None11964Male3Caucasi anMarried78846466Private41985Female2CaucasianDivorced870 04281Medicaid41988Male2CaucasianSeparated153550296Medi care21933Male9CaucasianMarried1904000Private11976Female1 CaucasianMarried1257030Medicare01933Female15CaucasianSe parated174260None01990Male1AsianWidowed154299429Privat e01956Male5HispanicDivorced178981268Private01983Male0Hi spanicDivorced1316320Private21964Male5CaucasianSingle159 9340Private01977Female3CaucasianSeparated222516157Private 21989Male1CaucasianMarried234430Private01971Female1Afric an AmericanDivorced1803280Private + Medicare01940Female7African AmericanMarried1810280Private01970Male4African AmericanMarried358722589Medicaid01967Female4CaucasianD ivorced29030515Private21964Female1CaucasianMarried239880 Private11949Male7CaucasianMarried78910Private11974Female 1African AmericanMarried45127138Medicare01933Male9HispanicMarrie d82560Medicaid31967Female1CaucasianMarried137960Private + Medicare01933Female6CaucasianDivorced1704130Private2197
- 29. 5Female4CaucasianWidowed279110Medicaid11986Male2Cauca sianDivorced192660Private01991Female2OtherDivorced114033 0Private + Medicare21940Male4CaucasianDivorced22869666Medicaid219 92Male0CaucasianDivorced352920Private01974Female4Hispani cWidowed2253280Private01989Male2CaucasianMarried255710 Medicaid01981Female3CaucasianDivorced7092753Private0195 3Female1African AmericanDivorced218473450Private01976Male0CaucasianMarr ied95470Private21971Male4African AmericanSeparated1869690Medicare11934Male4CaucasianMarr ied132360Medicaid01966Male2CaucasianMarried192770448Pri vate01978Male1CaucasianMarried193283714Private31986Fema le1CaucasianDivorced247160Medicare11943Female0African AmericanDivorced3061640Private01983Female0HispanicSingle 112969473Medicare01939Male9CaucasianDivorced22946352Pri vate21980Female1CaucasianDivorced793830Medicare01939Mal e6CaucasianSingle3174680Medicare01937Male10African AmericanSeparated1868960Private31966Male5CaucasianMarrie d138923192Private01951Male5CaucasianMarried8217264Medic are01941Female9CaucasianMarried9912347Private + Medicare01944Male7African AmericanDivorced96701490Medicare21935Male13CaucasianMa rried881680Private21986Female2CaucasianMarried829070Priva te + Medicare01938Male5CaucasianMarried1150600Private01955Ma le1CaucasianDivorced92031923Medicaid01947Male5Caucasian Divorced146070Medicare01944Female2CaucasianDivorced1023 43374Private11957Female0OtherMarried21741109Private + Medicare01936Female12CaucasianDivorced712970Medicare019 37Female1AsianMarried1652230Private21986Male2CaucasianM arried142060Private01959Female3African AmericanMarried106024244Private01947Male1CaucasianSepar ated1440730Private31976Male3AsianDivorced24068603Private 01960Female5HispanicSingle82670Medicare01942Female6Asia nMarried246210Medicaid31953Female2African
- 30. AmericanWidowed1004050Private01990Female0CaucasianDivo rced18788457Medicaid21984Female2CaucasianMarried1066551 04Private11966Male1HispanicMarried120940224Private31982 Male2AsianWidowed209210Medicare01941Male2CaucasianMar ried134728225Private01990Male2CaucasianDivorced1123240Pr ivate01960Male2CaucasianSeparated1349080Private + Medicare01944Female9CaucasianSingle968910Private11985Mal e0CaucasianMarried272750Medicaid01979Female1HispanicWid owed915330Private31973Male3HispanicMarried143921354Priv ate01977Female0HispanicDivorced1172570Private11953Male0 CaucasianMarried65480Medicaid31966Female2African AmericanDivorced991760Private01953Male3HispanicMarried25 7560Private31975Female3African AmericanSingle419870Private21967Male1CaucasianSeparated2 68286368Private01973Female1HispanicMarried46649412Privat e11952Female3HispanicMarried11905884Private + Medicare01932Female5CaucasianMarried875780Medicare01933 Male3CaucasianMarried102144459Private01961Female2African AmericanMarried9948401Private01961Female1CaucasianMarrie d62882494Private01983Female1CaucasianMarried151467231Pri vate01984Male0CaucasianMarried20437109Private + Medicare21937Female8AsianDivorced2215980Private21991Fem ale1HispanicDivorced78080Private01947Female2HispanicWido wed64544112Private + Medicare21934Male1African AmericanDivorced686740Private21959Female3CaucasianMarrie d82462935Private21961Female4OtherDivorced1958682212Priv ate01983Male1CaucasianMarried875300Private01991Female2C aucasianMarried1384700Private01990Male0HispanicMarried15 953196Private + Medicare11938Male10CaucasianDivorced1828320Private41981 Female1AsianDivorced1252392Private01964Female3HispanicM arried18866486Private01961Male5African AmericanWidowed1104580Private01977Male1AsianDivorced90 650Medicare01933Male2CaucasianMarried1685700Medicare01 933Female13HispanicMarried1817510Private21950Male0Hispa nicWidowed1756890Private01950Female6OtherDivorced165994
- 32. nMarried2231030Medicare11945Male6CaucasianMarried205402 0Private01957Male6CaucasianMarried115365286Private + Medicare21944Female6CaucasianWidowed219521258Private21 961Male3AsianMarried226677123Private11986Male1Caucasian Married9948283Private01968Male2AsianMarried303370Medica re01941Female7AsianDivorced55632336Private01976Male3Afri can AmericanMarried2880070Private41989Female2CaucasianDivorc ed877660Private01971Female0CaucasianMarried86421775Priva te + Medicare01945Male1HispanicDivorced81571407Private01957F emale4CaucasianMarried517750Private31973Female1Caucasian Single264770Medicare01941Female5HispanicMarried44965162 Private21954Female6CaucasianMarried892090Private01950Fem ale6African AmericanMarried26451264Medicaid01991Female0African AmericanDivorced154296300Private21982Female3African AmericanSingle321260Medicaid31965Female5HispanicSingle26 596242Medicaid21958Male0CaucasianMarried1059710Private1 1960Female5HispanicMarried172147203Private41992Female1O therMarried17257286Private01989Female2CaucasianWidowed5 31120Private01973Male1CaucasianMarried101800Private11979 Male1CaucasianSingle786920Private01977Male1CaucasianSepa rated431960Medicare01943Female5CaucasianWidowed933350P rivate + Medicare01936Female12HispanicSingle150074575Private31950 Female5HispanicDivorced922420Private01976Female2African AmericanMarried16860270Medicaid31982Male2CaucasianDivo rced676922896Private01972Female4CaucasianDivorced505620 Private21989Female1OtherDivorced78035344Medicaid21983Ma le0CaucasianWidowed167420Private01977Female1HispanicSin gle17920479Medicaid01985Female2CaucasianMarried286740M edicaid01959Female2CaucasianMarried1741710Private01950Fe male2HispanicSingle117520Medicaid01962Male1CaucasianWid owed1019200Private + Medicare21934Male12HispanicMarried649320Medicare01939M