Chronic diseases drive up Medicare costs, study shows

A new study by Emory University public health researchers finds that outpatient treatment for chronic diseases such as diabetes, hypertension and kidney disease are to blame for the recent rise in Medicare spending. Kenneth Thorpe, PhD, chair, Health Policy and Management, Rollins School of Public Health, presented study findings today at a briefing of the National Press Club in Washington, DC.

The report, “Chronic Conditions Account for Rise in Medicare Spending from 1987 to 2006,” was published Feb. 18 by the journal Health Affairs.

Kenneth E. Thorpe, PhD

Thorpe and colleagues analyzed data about disease prevalence and about level of and change in spending on the 10 most expensive conditions in the Medicare population from 1987, 1997 and 2006.

Among key study findings:

  • Heart disease ranked first in terms of share of growth from 1987 to 1997.  However, from 1997 to 2006, heart disease fell to 10th, while other medical conditions – diabetes the most prevalent – accounted for a significant portion of the rise.
  • Increased spending on diabetes and some other conditions results from rising incidence of these diseases, not increased screening and diagnoses.

“The changing mix of medical conditions driving the rise in Medicare spending had consequential effects,” say the study authors. “More than half of the beneficiaries are treated for five or more chronic conditions each year. System fragmentation means that chronically ill patients receive episodic care from multiple providers who rarely coordinate the care they deliver, and chronic disease management programs are notably absent in traditional fee-for-service Medicare.

“As Congress, the administration, providers, insurers and consumers debate reshaping the U.S. health system, they must address these changed health needs through evidence-based preventive care,” the authors say.

Learn more about Thorpe’s studies at NPR, Big Think and Huffington Post.

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