10.03.11 Medicare Doshi - HCMG 101 Jalpa Doshi October 3,...

Info iconThis preview shows pages 1–12. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: HCMG 101 Jalpa Doshi October 3, 2010 Medicare is only for the elderly Medicare is run by the federal government Medicare does not cover prescription drugs Doctors must participate in Medicare Private insurers play a small role in Medicare History and Enrollment Trends Medicare Financing The Four Parts of Medicare Part A: Hospital Insurance Part B: Supplemental Medical Insurance Part C: Medicare Advantage / Medicare+Choice Part D: Outpatient Prescription Drug Benefit Potential Reform Efforts / Hot Topics History of Medicare President Johnson signing Medicare Bill, 1965 President Bush signing Medicare Modernization Act, 2003 1965: Medicare bill signed Elderly (age 65+) and disabled under age 65 End-stage renal disease (kidney dialysis) eligible in 1973 Part A (hospital) & Part B (supplemental medical) 1980s-mid 1990s: Payment Reforms Hospitals: DRGs (diagnosis-related groups) in 1983 Physicians: RBRVS (resource based relative value scale) in 1992 1997: Balanced Budget Act (BBA) Cut provider payments by limiting growth rate in Medicare fees Medicare+Choice Part C introduced 2003: Medicare Modernization Act (MMA) Prescription Drug Benefit: Part D Medicare Advantage (renamed & modified Medicare+Choice) Source : statehealthfacts.org, Kaiser Family Foundation Data for Eligibility as of 2006, for Source as of 2008 Source of Eligibility Beneficiaries = 43.3 million Source of Coverage Disabled & ESRD 16% Elderly 84% Medicare Fee-for-Service 79.1% Medicare Advantage Part C 20.9% Beneficiaries = 44.8 million 25.5 31.0 34.1 38.6 52.2 68.2 20.4 8.6 8.7 7.3 5.4 3.3 3.0 10 20 30 40 50 60 70 80 1970 1980 1990 2000 2010 2020 2030 Calendar Year Disabled & ESRD Elderly * Numbers may not sum due to rounding. Source : CMS, Office of the Actuary. The number of people Medicare serves will nearly DOUBLE by 2030. 20.4 28.4* 34.3 39.6* 45.9 61.0* 76.8 Medicare Enrollment (millions) Actual Projected Note: Overall spending includes benefit dollars, administrative costs, and program integrity costs. Represents Federal spending only. Source : CMS, Office of the Actuary. Overall Medicare spending grew from $4.1 billion in 1965 to nearly $193.7 billion in 2005. Dollars in Billions 300 200 100 0 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010* 2014* 4.1 7.3 13 24.6 42.7 70 99 131 193.7 275.4 358.6 90% 37% 10% 63% Total Number of Beneficiaries, 2005: 37.5 million Total Medicare Spending, 2005: $265 billion Ten Percent of Medicare Beneficiaries Account for Nearly Two-Thirds of Medicare Spending, 2005 Average per capita Medicare spending among top 10%: $44,220 Average per capita Medicare spending among bottom 90%: $2,934 SOURCE: Kaiser Family Foundation analysis of CMS Medicare Current Beneficiary Survey Cost & Use file, 2005 22% 18% 20% 21% 28% 41% Total Services* Nursing Home Care Physician Services Prescription Drugs Hospital Services Home Health Care Expenditures in Billions...
View Full Document

Page1 / 56

10.03.11 Medicare Doshi - HCMG 101 Jalpa Doshi October 3,...

This preview shows document pages 1 - 12. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online