A new article in Health Affairs indicates recent annual increases in Medicare spending are the result of outpatient treatment of chronic conditions such as diabetes, arthritis, hypertension and kidney disease.
A recent study analyzed data about disease prevalence and level of – and change in – spending on the 10 most expensive conditions in the Medicare population from 1987, 1997 and 2006.
"Chronic Conditions Account For Rise In Medicare Spending From 1987 To 2006" notes that 20 years ago, most Medicare spending increases were due to inpatient hospital services, especially for heart disease.
Heart disease ranked first in terms of share of growth from 1987 to 1997. However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions – diabetes being the most prevalent – accounted for a significant portion of the increase.
Kenneth E. Thorpe, Lydia L. Ogden and Katya Galactionova of the Rollins School of Public Health at Emory University in Atlanta authored the report. They examined data from the 1987 National Medical Expenditure Survey and the 1997 and 2006 Medical Expenditure Panel Survey.
They suggested that increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.
"The changing mix of medical conditions driving the rise in Medicare spending had consequential effects," they wrote. "More than half of the beneficiaries are treated for five or more chronic conditions each year. System fragmentation means that chronically ill patients receive episodic care from multiple providers who rarely coordinate the care they deliver, and chronic disease management programs are notably absent in traditional fee-for-service Medicare."
The researchers recommend that, as Congress reshapes the U.S. healthcare system, they should address changed health needs through evidence-based preventive care.