Long-term trends in Medicare payments in the last year of life.
OBJECTIVE
To update research on Medicare payments in the last year of life.


METHODS
Continuous Medicare History Sample, containing annual summaries of claims data on a 5 percent sample from 1978 to 2006.


METHODS
Analyses were based on elderly beneficiaries in fee for service. For each year, Medicare payments were assigned either to decedents (persons in their last year) or to survivors (all others).


RESULTS
The share of Medicare payments going to persons in their last year of life declined slightly from 28.3 percent in 1978 to 25.1 percent in 2006. After adjustment for age, sex, and death rates, there was no significant trend.


CONCLUSIONS
Despite changes in the delivery of medical care over the last generation, the share of Medicare expenditures going to beneficiaries in their last year has not changed substantially.
Riley
Gerald F
GF
Office of Research Development and Information, Centers for Medicare and Medicaid Services, 7500 Security Blvd., Mail Stop C3-21-28, Baltimore, MD 21244, USA. gerald.riley@cms.hhs.gov
Lubitz
James D
JD
D000368:Aged; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000639:trends*; D006278:Medicare / Q000191:economics*; D009026:Mortality / Q000639:trends; D013727:Terminal Care / Q000191:economics*; D014481:United States / Q000453:epidemiology