title: Long-term trends in the concentration of Medicare spending.
abstract: Medicare spending is concentrated among a few high-cost beneficiaries who are often targeted by cost-saving interventions. The Continuous Medicare History Sample file was used to analyze trends in the spending concentration over thirty years. Annual expenditures became less concentrated over time, although the year-to-year persistence of person-level high costs remained strong. There was an increase in the prevalence of chronic conditions among high-cost beneficiaries, which supports the rationale for focusing cost-saving interventions on chronic disease management. However, the decrease in concentration may reduce the potential savings from interventions focused on such beneficiaries.
authors.affiliation: Office of Research, Development, and Information, Centers for Medicare and Medicaid Services, Baltimore, Maryland, USA. Gerald.riley@cms.hhs.gov
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Riley
mesh_terms: D017677:Age Distribution; D002908:Chronic Disease; D019538:Health Care Surveys; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D006278:Medicare / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends*; D009026:Mortality; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology