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Table 1: Amount and Distribution of Medicare Per Capita Spending Overall and By Type of Service for Traditional Medicare Beneficiaries Under Age 65 and Over Age 65, 2014
Type of service Part of Medicare  covering service Under age 65 Over age 651
Amount Percent of total Amount Percent of total
Total    $13,098 100.0%  $9,972 100.0%
Part D drugs D 3,817 29.1% 1,159 11.6%
Acute inpatient hospital A 3,141 24.0% 2,722 27.3%
Outpatient hospital A 2,203 16.8% 1,448 14.5%
Other inpatient hospital A 640 4.9% 369 3.7%
Evaluation & management B 503 3.8% 459 4.6%
Other Part B procedures B 370 2.8% 524 5.3%
Skilled nursing facility A 366 2.8% 826 8.3%
Physician office services B 365 2.8% 416 4.2%
Home health A or B2 324 2.5% 499 5.0%
Part B drugs B 287 2.2% 360 3.6%
Tests B 271 2.1% 239 2.4%
Durable medical equipment B 225 1.7% 132 1.3%
Other Part B services B 211 1.6% 164 1.6%
Imaging B 130 1.0% 171 1.7%
Hospice A 85 0.6% 333 3.3%
Dialysis B 59 0.5% 13 0.1%
Anesthesia B 52 0.4% 53 0.5%
Ambulatory surgery center B 50 0.4% 86 0.9%
NOTE: Analysis excludes beneficiaries in Medicare Advantage. 165-year olds are excluded because these beneficiaries are enrolled for less than a full year. 2Home health services can be covered under Part A or Part B depending on whether or not the services follow a hospital stay.
SOURCE: Kaiser Family Foundation analysis of a five percent sample of Medicare claims from the CMS Chronic Conditions Data Warehouse, 2014.
Table 2: Amount and Distribution of Out-of-Pocket Spending Overall and By Type of Service for Traditional Medicare Beneficiaries
Under Age 65 and Age 65 or Older, 2012
Type Under age 65 Age 65 or older
Amount Percent of total Percent of
non-premium
spending
Amount Percent of total Percent of
non-premium
spending
Total out-of-pocket spending  $3,706 100% n/a $6,146 100% n/a
  Premium out-of-pocket spending1 1,383 37% n/a 2,979 48% n/a
  Non-premium out-of-pocket spending 2,324 63% 100% 3,167 52% 100%
     Medical providers 671 18% 29% 767 12% 24%
     Prescription drugs 605 16% 26% 548 9% 17%
     Long-term care facility 464 13% 20% 995 16% 31%
     Dental 203 5% 9% 359 6% 11%
     Inpatient 149 4% 6% 103 2% 3%
     Outpatient 140 4% 6% 156 3% 5%
     Skilled nursing facility 87 2% 4% 110 2% 3%
     Home health 4 <1% <1% 129 2% 4%
NOTE: Analysis excludes beneficiaries in Medicare Advantage. 1Missing out of pocket premium amounts were imputed following a hotdecking approach, stratified by categories of supplemental coverage.
SOURCE: Kaiser Family Foundation analysis of Medicare Current Beneficiary Survey 2012 Cost & Use file.
Table 3: Utilization of Service by Traditional Medicare Beneficiaries
Under Age 65 and Age 65 or Older, 2012
Type of service Under age 65 Age 65 or older
Percent using service Percent using service
Prescription drugs 88% 90%
Office visit 66% 77%
Outpatient visit 64% 64%
Dental 35% 49%
Emergency department (ED) visit 19% 14%
  2+ ED visits 7% 3%
Any inpatient stay 18% 18%
  2+ inpatient stay 7% 6%
Home health visit 5% 10%
Skilled nursing facility (SNF) stay 2% 6%
  2+ SNF stays <1% 2%
Hospice 1% 3%
NOTE: Analysis excludes beneficiaries in Medicare Advantage.
SOURCE: Kaiser Family Foundation analysis of Medicare Current Beneficiary Survey 2012 Cost & Use file.

 

 

 

 

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