Trends in out-of-pocket healthcare costs among older community-dwelling Medicare beneficiaries.
OBJECTIVE
To describe trends in out-of-pocket healthcare costs, including insurance premiums, for older Medicare beneficiaries living in the community.


METHODS
Medicare Current Beneficiary Survey data were analyzed for community-dwelling beneficiaries 65 years or older between 1992 and 2004.


METHODS
The primary focus of the analysis was out-of-pocket healthcare costs and out-of-pocket costs as a percentage of income. Descriptive statistics are presented for 1992, 1996, 2000, and 2004.


RESULTS
Inflation-adjusted median out-of-pocket costs were stable between 1992 and 2000 and then rose by 21.7% between 2000 and 2004. Median costs as a percentage of income declined between 1992 and 1996 but increased from 12.6% in 2000 to 15.5% in 2004. Between 1992 and 2004, out-of-pocket costs increased fastest at the upper percentiles of the distribution. High out-of-pocket costs tended to persist from year to year, exacerbating the financial burden for some beneficiaries.


CONCLUSIONS
Following a period of declining burden between 1992 and 1996, out-of-pocket healthcare costs rose significantly between 2000 and 2004, increasing the financial burden for many older Medicare beneficiaries. These data provide a baseline for evaluating Medicare reform proposals that affect beneficiary spending.
Office of Research, Development, and Information, Centers for Medicare & Medicaid Services, Baltimore, MD 21244, USA. gerald.riley@cms.hhs.gov
Gerald F
GF
Riley
D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D003365:Costs and Cost Analysis / Q000639:trends; D005260:Female; D005382:Financing, Personal / Q000191:economics* / Q000639:trends; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D006278:Medicare / Q000191:economics*; D014481:United States