Medical Expenditure Panel Survey (MEPS),Health Care Expenditures for the Elderly with Chronic

Conditions in 2012

Jeffrey Rhoades

Presenter Disclosure

The following personal, professional, or financial relationships with commercial interests relevant to this presentation existed during the past 12 months:

Jeffrey Rhoades

No relationships to disclose

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MEPS – Household Component

Annual survey of 14,000 households Sub-sample of respondents from the previous year’s

National Health Interview Survey (NHIS)

Representative of the civilian non-institutionalized population of the U.S.

Collects data for 2 years of healthcare usage

5 in-person interviews over 2 ½ year period using Computer Assisted Personal Interview (CAPI)

Typically one respondent per household3

Health Care Expenditures

Collected at the event level

Represent payments to providers of the health care

Payments are reported by source (e.g., out-of-pocket, private insurance, public insurance)

Total expenditure is the sum of payments across all sources of payment

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Source of Payment Categories

Out-of-Pocket Private Insurance Medicare Medicaid

VA TRICARE Other Federal

Government State or Local

Government Worker’s Comp Other Insurance

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Medical Conditions

Event types Inpatient Stay Outpatient Visit Emergency Room Visit Office Based Visit Home Health

Following question asked about each event: What conditions were discovered or led person to make this visit?

Prescribed Medicine PurchasesWhat health problem is medicine prescribed for?

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Selected Chronic Conditions

Cancer Cerebrovascular disease Degenerative nervous system conditions Dementia Diabetes Heart disease Liver disease Renal disease Respiratory disease

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Civilian Non-institutionalized Population, age 65 or older, 2012

No chronic conditions, n=1,537

One chronic condition, n=1,326

Two or more chronic conditions, n=1,241

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Percentage of Individuals with Medical Event by Type of Serviceand Number of Chronic Conditions, Age 65+, 2012

Ambulatory Care* Inpatient Stay Prescribed Medicines Home Health0%

20%

40%

60%

80%

100%

84.8%+

7.4%+

81.0%+

3.6%+

95.5%+

16.3%+

96.7%+

8.3%+

98.1%+

26.8%+

98.7%+

18.8%+

No Chronic Conditions One Chronic Condition Two or more Chronic Conditions

9+Significantly different from each of the other groups p<0.05Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

Per

cen

tag

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Mean Health Care Expenditures byNumber of Chronic Conditions, Age 65+, 2012

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No Chronic Conditions One Chronic Condition Two or more Chronic Conditions$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$2,946

$7,463

$6,059

$7,741

Treatment of Chronic Condition(s) Treatment of other Conditions

$9,005

$3,411

$15,205

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

Dol

lars

Mean Health Care Expenditures by Type of Service and Number of Chronic Conditions, Age 65+, 2012

11Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits)Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

No Chronic

Conditions

One Chronic

Condition

Two or more

Chronic Conditions

No Chronic

Conditions

One Chronic

Condition

Two or more

Chronic Conditions

No Chronic

Conditions

One Chronic

Condition

Two or more

Chronic Conditions

No Chronic

Conditions

One Chronic

Condition

Two or more

Chronic Conditions

Ambulatory Care* Inpatient Stay Prescribed Medicines Home Health

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$1,529$2,135

$2,324

$918

$2,372

$2,860

$874$1,358

$1,961

$90$194

$588

$881

$1,814

$1,049

$2,693

$679

$1,445

$337

$1,520

Treatment of Chronic Condition(s) Treatment of other Conditions

$3,016

$4,138

$3,421

$5,553

$2,037

$3,406

$531

$2,108

Dol

lars

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Distribution of Total Expenditures by Type of Service, Persons Age 65+ by Number of Chronic Conditions, 2012

No Chronic Conditions One Chronic Condition Two or more Chronic Conditions0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

44.8

35.5 27.2

26.9

38.0

36.5

25.6 22.6

22.4

2.7 5.913.9

Ambulatory Care* Inpatient Stay Prescribed Medicines Home Health

+

+ +

+

++

+Significantly different p<0.05Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

+

Per

cen

tag

e

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Distribution of Total Expenditures by Source of Payment, Persons Age 65+ by Number of Chronic Conditions, 2012

No Chronic Conditions One Chronic Condition Two or more Chronic Conditions0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

12.5 8.8 8.6

17.415.9 14.4

63.765.9

64.2

1.7 4.05.0

4.8 5.5 7.8

Out-of-Pocket Private Insurance Medicare Medicaid Other*

+

+Significantly different p<0.05Other* (VA, Tricare, Other Federal Government, State or Local Government, Worker’s Comp, Other Insurance) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

+

+

Per

cen

tag

e

Financial Burden of Chronic Conditions, Age 65+, 2012Out-of-Pocket Payments (OOP)/Family Income

OOP >= 5% of Family Income OOP >= 10% of Family Income OOP >= 20% of Family Income0%

5%

10%

15%

20%

5.3%+

2.0%+1.2%+

11.0%+

4.3%+

1.5%

18.3%+

7.5%+

3.0%+

No Chronic Conditions One Chronic Condition Two or more Chronic Conditions

14+Significantly different from each of the other groups p<0.05Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012

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P a

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Pro

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Summary

• The percent of individuals 65 and older with any medical event increases as the number of chronic conditions increases (ambulatory care, inpatient stay, prescribed medicines, and/or home health).

• For each type of medical event, expenditures for the treatment of chronic conditions increases relative to total expenditures as the number of chronic conditions increases.

• As the number of chronic conditions increases the proportion of total expenditures spent for ambulatory care declines and increases for home health.

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Summary

• Individuals 65 and older with no chronic conditions pay a greater proportion of total expenditures out-of-pocket as compared to those with chronic conditions.

• For individuals 65 and older with two or more chronic conditions Medicaid pays a greater proportion of total expenditures compared to those with no chronic conditions.

• Almost 20% of individuals 65 and older with two or more chronic conditions spend 5% or more of family income for health care.

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