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Lec14_Medicare_handout - Medicare Medicare Professor Vivian...

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Medicare Medicare Professor Vivian Ho Health Economics Fall 2009
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Topics Topics Coverage Financing Case Study
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The Medicare Program The Medicare Program Target population - individuals 65+, certain disabled people, and people with kidney failure Part A - Hospital Insurance program (compulsory) Inpatient hospital services Skilled nursing care Home health care Hospice care 19.1m enrollees in 1966; 44.9m in 2008 *Source: www.cms.hhs.gov
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Part B - Supplemental Medical Insurance program (voluntary) Physician services Outpatient care Emergency room services 17.7m enrollees in 1966, 41.7m in 2008 *Source: www.cms.hhs.gov
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1966 1.8 1980 37.2 1990 109.5 1995 182.4 2000 225.2 2003 283.8 2006 408.3 2008 468.0 Medicare Costs Medicare Costs Total Expenditures ($ billions)
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Medicare Financing - Part A Medicare Financing - Part A Funding Sources 2.9% payroll tax shared equally by employers and employees Federal Hospital Insurance Trust Fund Enrollee deductibles and copayments
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Part A Trust Fund Part A Trust Fund ($ millions) ($ millions) 1967 $ 3,089 1975 12,568 1980 25,415 1985 50,933 1990 79,563 1995 114,847 2000 159,681 2005 196,921 2008 230,815 2,597 1,343 10,612 9,870 24,288 14,490 48,654 21,277 66,687 95,631 114,883 129,520 130,284 168,084 184,142 277,723 235,556 321,270 Year Income Disbursements Balance
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Part A Patient Cost Sharing Part A Patient Cost Sharing No hospital inpatient coverage after 90 days Except for 60-day lifetime reserve Medicare offers no coverage in “catastrophic circumstances.”
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Part A Patient Costs Part A Patient Costs 1966 $ 40 1975 92 1980 180 1985 400 1990 592 1995 716 2000 776 2005 912 2009 1068 10 --- 23 46 45 90 100 200 148 296 179 358 194 388 228 456 267 534 Year Days 1-60 Days 61-90 After 90 Days Deductible Daily Coinsurance
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Medicare Part B Financing Medicare Part B Financing Funding sources Monthly premium payments Contributions from general revenue of the U.S. Treasury
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Part B Trust Fund Part B Trust Fund 1967 $ 1,285 1975 4,322 1980 10,275 1985 24,577 1990 46,138 1995 58,169 2000 89,239 2005 151,307 2008 200,623 799 486 4,170 1,424 10,737 4,532 22,730 10,646 43,022 14,527 65,213 13,874 88,992 45,896 151,536 16,885 183,303 59,382 Year Income Disbursements Balance
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Part B Patient Costs Part B Patient Costs 1966 $ 50 1975 60 1980 60 1985 75 1990 75 1995 100 2000 100 2005
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