Wednesday, June 10, 2015

The Impact of Aging on the HCFA, HHS, and CMS

Older Americans with five or more chronic conditions incurred an average of $5,300 in prescription drug costs in 2008, compared to $1,230 for those with no chronic conditions. MORE STATISTICS

20 percent of total U.S. population  — The population of Americans age 65 and over in 2030 is projected to be 20 percent of the total U.S. population (72 million), compared to 13 percent in 2010.
SOURCE(S): Federal Interagency Forum On Aging Related Statistics

19.2 years of living after age 65  — Under current mortality conditions, people who survive to age 65 can expect to live an average of 19.2 more years, nearly 5 years longer than people age 65 in 1960.

1.3 years of more living   — Under current mortality conditions, white people who survive to age 65 can expect to live an average of 1.3 years longer than black people.
SOURCE(S): Federal Interagency Forum On Aging Related Statistics

45 percent of beneficiaries live with chronic conditions  — Nearly half (45 percent) of the Medicare population is living with three or more chronic conditions.

JUNE 26, 2012
One in four beneficiaries live below the poverty line  — Nearly one in four Medicare beneficiaries were living below the federal poverty line in 2007.

UNE 26, 2012
One in six beneficiaries under 65 qualified for Medicare on the basis of permanent disability  — One in six beneficiaries qualified for Medicare coverage in 2011 before turning 65 on the basis of permanent disability.

21 percent of federal health care spending  — Federal spending for Medicare made up 21 percent of total expenditures in health care in 2010.
SOURCE(S): Congressional Budget Office

80 million people covered by Medicare  — By 2030, 80 million people will be covered by Medicare.
SOURCE(S): 2012 Medicare Trustees Report

65 percent in HMO plans  — Sixty-five percent of Medicare Advantage enrollees are in health maintenance organization (HMO) plans, followed by local preferred provider organizations (PPOs) and regional PPOs, 21 percent and 7 percent, respectively.
SOURCE(S): Kaiser Family Foundation

MAY 31, 2012
17 percent of adults aged 55 to 64 reported having unmet needs or delayed care  — Medicare seniors reported similar rates of unmet needs or delayed care (8%) to adults aged 55 to 64 with private insurance plans (17%).
SOURCE(S): Kaiser Family Foundaion

165 provisions in the Affordable Care Act affect Medicare  — The Affordable Care Act contains roughly 165 provisions that affect the Medicare program.
SOURCE(S): 2010 Medicare Trustees Report

Medicare Fraud Report from the OIG (2012)

While Medicare Fraud is widely publicized,  cases were prosecuted in 2012, the OIGs report elaborates further.


For the first half of FY 2012, we reported expected recoveries of about $1.2 billion consisting of $483.1 million in audit receivables and $748 million in investigative receivables (which includes $136.6 million in non-HHS investigative receivables resulting from our work in areas such as the States’ shares of Medicaid restitution). We reported exclusions of 1,264 individuals and entities from participation in Federal health care programs; 388 criminal actions against individuals or entities that engaged in crimes against HHS programs; and 164 civil actions, which include false claims and unjust-enrichment lawsuits filed in Federal district court, civil monetary penalties (CMP) settlements, and administrative recoveries related to provider self-disclosure matters. Following are highlights of some of the significant problems, abuses, deficiencies, activities, and investigative outcomes that are included in the Semiannual Report for the first half of FY 2012. Health Care Fraud Prevention
About 10 percent of money returned to the Medicare Trust Funds  — About 10 percent of the $20.6 billion obtained from people or organizations that committed Medicare fraud and returned to the Medicare Trust Funds since 1997 was returned in 2011.
SOURCE(S): Department of Health and Human Services

sent roughly 10.4 percent of GDP spending in 2086, resulting in greater strain on the federal budget, economy and Medicare beneficiaries.
SOURCE(S): Medicare Trustees 2012 Report

15 percent of Medicare household budgets  — In 2010, health expenses accounted for nearly 15 percent of household budgets for Medicare beneficiaries, on average – three times more than non-Medicare households.
SOURCE(S): Kaiser Family Foundation

$78,000 average annual cost  — The annual cost of nursing home care averaged about $78,000 nationwide in 2011.
SOURCE(S): Kaiser Family Foundation


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