Long-term Trends in Medicare Payments in the Last Year of Life

Overview

Journal Health Serv Res

Specialty Health Services

Date 2010 Feb 13

PMID 20148984

Citations 156

Authors

Gerald F Riley

James D Lubitz

Affiliations

Soon will be listed here.

Abstract

Objective: To update research on Medicare payments in the last year of life.

Data Sources: Continuous Medicare History Sample, containing annual summaries of claims data on a 5 percent sample from 1978 to 2006.

Study Design: Analyses were based on elderly beneficiaries in fee for service. For each year, Medicare payments were assigned either to decedents (persons in their last year) or to survivors (all others).

Results: The share of Medicare payments going to persons in their last year of life declined slightly from 28.3 percent in 1978 to 25.1 percent in 2006. After adjustment for age, sex, and death rates, there was no significant trend.

Conclusions: Despite changes in the delivery of medical care over the last generation, the share of Medicare expenditures going to beneficiaries in their last year has not changed substantially.

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References

LEVINSKY N, Yu W, Ash A, Moskowitz M, Gazelle G, Saynina O . Influence of age on Medicare expenditures and medical care in the last year of life. JAMA. 2001; 286(11):1349-55. DOI: 10.1001/jama.286.11.1349. View

Barnato A, McClellan M, Kagay C, Garber A . Trends in inpatient treatment intensity among Medicare beneficiaries at the end of life. Health Serv Res. 2004; 39(2):363-75. PMC: 1361012. DOI: 10.1111/j.1475-6773.2004.00232.x. View

Kronman A, Ash A, Freund K, Hanchate A, Emanuel E . Can primary care visits reduce hospital utilization among Medicare beneficiaries at the end of life?. J Gen Intern Med. 2008; 23(9):1330-5. PMC: 2518010. DOI: 10.1007/s11606-008-0638-5. View

Stooker T, van Acht J, van Barneveld E, van Vliet R, van Hout B, Hessing D . Costs in the last year of life in The Netherlands. Inquiry. 2001; 38(1):73-80. DOI: 10.5034/inquiryjrnl_38.1.73. View

Lubitz J, Riley G . Trends in Medicare payments in the last year of life. N Engl J Med. 1993; 328(15):1092-6. DOI: 10.1056/NEJM199304153281506. View

Wilensky G . Reforming Medicare's physician payment system. N Engl J Med. 2009; 360(7):653-5. DOI: 10.1056/NEJMp0808003. View

Shipman C, Gysels M, White P, Worth A, Murray S, Barclay S . Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups. BMJ. 2008; 337:a1720. PMC: 2659492. DOI: 10.1136/bmj.a1720. View

Liu K, Wiener J, Niefeld M . End of life Medicare and Medicaid expenditures for dually eligible beneficiaries. Health Care Financ Rev. 2007; 27(4):95-110. PMC: 4194964. View

Scitovsky A . "The high cost of dying" revisited. Milbank Q. 1994; 72(4):561-91. View

10.

Lubitz J, Prihoda R . The use and costs of Medicare services in the last 2 years of life. Health Care Financ Rev. 1985; 5(3):117-31. PMC: 4191360. View

11.

Bach P, Schrag D, Begg C . Resurrecting treatment histories of dead patients: a study design that should be laid to rest. JAMA. 2004; 292(22):2765-70. DOI: 10.1001/jama.292.22.2765. View

12.

Spillman B, Lubitz J . The effect of longevity on spending for acute and long-term care. N Engl J Med. 2000; 342(19):1409-15. DOI: 10.1056/NEJM200005113421906. View

13.

Hogan C, Lunney J, Gabel J, Lynn J . Medicare beneficiaries' costs of care in the last year of life. Health Aff (Millwood). 2001; 20(4):188-95. DOI: 10.1377/hlthaff.20.4.188. View

14.

Hanratty B, Burstrom B, Walander A, Whitehead M . Inequality in the face of death? Public expenditure on health care for different socioeconomic groups in the last year of life. J Health Serv Res Policy. 2007; 12(2):90-4. DOI: 10.1258/135581907780279585. View

15.

Chernew M, Goldman D, Pan F, Shang B . Disability and health care spending among medicare beneficiaries. Health Aff (Millwood). 2005; 24 Suppl 2:W5R42-52. PMC: 6824714. DOI: 10.1377/hlthaff.w5.r42. View

16.

Earle C, Neville B, Landrum M, Ayanian J, Block S, Weeks J . Trends in the aggressiveness of cancer care near the end of life. J Clin Oncol. 2004; 22(2):315-21. DOI: 10.1200/JCO.2004.08.136. View

17.

Lynn J, Schall M, Milne C, Nolan K, Kabcenell A . Quality improvements in end of life care: insights from two collaboratives. Jt Comm J Qual Improv. 2008; 26(5):254-67. DOI: 10.1016/s1070-3241(00)26020-3. View

18.

Thorpe K, Howard D . The rise in spending among Medicare beneficiaries: the role of chronic disease prevalence and changes in treatment intensity. Health Aff (Millwood). 2006; 25(5):w378-88. DOI: 10.1377/hlthaff.25.w378. View

19.

Hoover D, Crystal S, Kumar R, Sambamoorthi U, Cantor J . Medical expenditures during the last year of life: findings from the 1992-1996 Medicare current beneficiary survey. Health Serv Res. 2003; 37(6):1625-42. PMC: 1464043. DOI: 10.1111/1475-6773.01113. View

20.

Teno J, Clarridge B, Casey V, Welch L, Wetle T, Shield R . Family perspectives on end-of-life care at the last place of care. JAMA. 2004; 291(1):88-93. DOI: 10.1001/jama.291.1.88. View