Health Affairs, 26, no. 3 (2007): 808-816 doi: 10.1377/hlthaff.26.3.808 © 2007 by Project HOPE	New Online   McAllen, TX & Beyond: An Expert Roundtable   Geography & Reform   Medicaid or Insurance Exchange?   Siren Song of New GME   Public Plan Option: Pro & Con

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Health Tracking

TRENDS

Long-Term Trends In The Concentration Of Medicare Spending

Medicare spending is concentrated among a few high-cost beneficiaries who are often targeted by cost-saving interventions. The Continuous Medicare History Sample file was used to analyze trends in the spending concentration over thirty years. Annual expenditures became less concentrated over time, although the year-to-year persistence of person-level high costs remained strong. There was an increase in the prevalence of chronic conditions among high-cost beneficiaries, which supports the rationale for focusing cost-saving interventions on chronic disease management. However, the decrease in concentration may reduce the potential savings from interventions focused on such beneficiaries.

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