Health Affairs, doi: 10.1377/hlthaff.25.w378 (Published online August 22, 2006) © 2006 by Project HOPE	New Online   Obama's Success & Next Steps   3 Health Policy Options for President Obama   A Hybrid Proposal   Bipartisan Compromise

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The Rise In Spending Among Medicare Beneficiaries: The Role Of Chronic Disease Prevalence And Changes In Treatment Intensity

¹ Ken Thorpe is the Robert W. Woodruff Professor and chair of the Department of Health Policy and Management, Rollins School of Public Health, Emory University, in Atlanta, Georgia.
² David Howard is an assistant professor in that department.

^*Corresponding author.

Abstract

We examine the impact of the rise in treated disease prevalence on the growth in Medicare beneficiaries' health care spending. Virtually all of this spending growth is associated with patients who are under medical management for five or more conditions. This is traced to both a rise in true disease prevalence and changes in clinical treatment thresholds. Using the metabolic syndrome as a case study, we find that the share of patients treated with medications has increased 11.5 percentage points in less than ten years. This raises important questions about the "fit" of how Medicare pays for services for complex medical management. [Health Affairs 25 (2006): w378-w388; 10.1377/hlthaff.25.w378]

Key Words: Chronic Care, Consumer Issues, Demography, Elderly, Health Promotion/Disease Prevention, Medicare, Health Spending

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