Characteristics of Medicare Beneficiaries with Chronic Conditions Centers for Medicare & Medicaid Services
Ronnie Tan
June 4, 2007
Data Source and Methodology
• • • • • •
Chronic Condition Warehouse (CCW) 5% Sample for 2004 (aged, disabled, ESRD) No HMO (managed care) enrollment in 2004 Enrolled in Part A and Part B for the entire year Includes deaths in 2004 Accretes out
21 Chronic Conditions
• Acute Myocardial Infarction • Alzheimer’s Disease • Alzheimer’s Disease and Related Disorders • Atrial Fibrillation • Cancer, Colorectal • Cancer, Endometrial • Cancer, Female Breast • Cancer, Lung • Cancer, Prostate • Cataract • Chronic Kidney Disease • Chronic Obstructive Pulmonary Disease • Congestive Heart Failure • Diabetes • Glaucoma • Hip/Pelvic Fracture • Ischemic Heart Disease • Major Depression • Osteoporosis • Rheumatoid Arthritis/Osteoarthritis • Stroke / Transient Ischemic Attack
Percentage of Medicare Beneficiaries with Chronic Conditions
0 19%
2 or more 60%
1 21%
Percentage of Medicare Beneficiaries with Chronic Conditions
5 or more 15% 4 10% 0 19%
3 15% 2 20%
1 21%
Per Capita Medicare Spending for Medicare Beneficiaries with Chronic Conditions
$25,000 $22,000 $20,000 $15,000 $10,000 $7,200 $5,000 $2,800 $0 0 $1,100 1 2 3 4 5 or more $4,600 $11,000
# of Chronic Conditions
Percent of Population and Spending by number of Chronic Conditions
100%
15%
5 or more
80%
10%
46%
15%
60%
20% 16%
40%
21% 15%
20%
19%
13% 8% 3%
0%
% of Beneficiaries
% of Spending
Most Common Chronic Conditions for Medicare Beneficiaries
% of Beneficiaries
0% Ischemic Heart Disease Cataract Diabetes Arthritis Congestive Heart Failure Osteoporosis Major Depression COPD Glaucoma Alzheimer’s & Related Disorders 5% 10% 15% 20% 25% 30% 35% 40%
Chronic Condition: Diabetes
24% of Medicare beneficiaries have diabetes Beneficiaries with diabetes account for 40% of Medicare spending Medicare spends on average $11,800 per beneficiary with diabetes annually 89% of those with diabetes have at least 1 other chronic condition
Common Comorbid Conditions Associated with Diabetes
% of Beneficiaries with Diabetes 0% Ischemic Heart Disease Congestive Heart Failure Cataract Arthritis Chronic Kidney Disease 10% 20% 30% 40% 50% 60%
Per Capita Medicare Spending for Diabetes plus Comorbid Conditions
$14,000 $12,000 $10,000 $8,000 $6,000 $4,000 $2,000 $0 Diabetes Only + IHD +CHF + IHD + CHF + CKD $2,000 $4,000 $4,400 $6,700 $11,000
$13,600
+ IHD + CKD
Chronic Condition: Congestive Heart Failure (CHF)
20% of Medicare Beneficiaries have CHF Beneficiaries with CHF account for 48% of Medicare Spending Medicare spends on average $17,700 per beneficiary with CHF annually 98% of those with CHF have at least 1 other chronic condition
Common Comorbid Conditions Associated with CHF
% of Beneficiaries with CHF 0% Ischemic Heart Disease Diabetes Cataract RA_OA COPD 10% 20% 30% 40% 50% 60% 70% 80%
Per Capita Medicare Spending for Medicare Beneficiaries with CHF
$25,000 $23,100 $20,000 $17,700 $15,000 $12,900 $10,000 $5,000 $0 Just CHF 1 2 3 4 5
# of Chronic Conditions along with CHF
$8,900 $6,000 $3,600
Summary
High Prevalence of Chronic Conditions in the Medicare population Further analysis needed CCW and ResDAC booths CCW Database, for more information www.ccwdata.org and www.resdac.umn.edu