HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Monday, February 22, 2010

Chronic Care Drives Increases in Medicare Spending

An article published this week by Health Affairs finds that the causes of Medicare spending growth have changed dramatically over the past two decades.

Twenty years ago, most of the increases were due to inpatient hospital services, especially for heart disease, but recent annual increases are the result of outpatient treatment of chronic conditions such as diabetes, arthritis, hypertension, and kidney disease, say Kenneth Thorpe of the Rollins School of Public Health at Emory University and coauthors.

This study analyzed data about disease prevalence and about level of and change in spending on the ten most expensive conditions in the Medicare population from 1987, 1997, and 2006. The data were drawn from the 1987 National Medical Expenditure Survey (NMES), and the 1997 and 2006 Medical Expenditure Panel Survey (MEPS). Among the key findings: heart disease ranked first in terms of share of growth from 1987 to 1997. However, from 1997 to 2006, heart disease fell to tenth, while other medical conditions -- diabetes the most prevalent -- accounted for a significant portion of the rise. Furthermore, the authors postulate that increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.

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