title: Supplemental coverage associated with more rapid spending growth for Medicare beneficiaries.
abstract: Lowering both Medicare spending and the rate of Medicare spending growth is important for the nation's fiscal health. Policy makers in search of ways to achieve these reductions have looked at the role that supplemental coverage for Medicare beneficiaries plays in Medicare spending. Supplemental coverage makes health care more affordable for beneficiaries but also makes beneficiaries insensitive to the cost of their care, thereby increasing the demand for care. Ours is the first empirical study to investigate whether supplemental Medicare coverage is associated with higher rates of spending growth over time. We found that supplemental insurance coverage was associated with significantly higher rates of overall spending growth. Specifically, employer-sponsored and self-purchased supplemental coverage were associated with annual total spending growth rates of 7.17 percent and 7.18 percent, respectively, compared to 6.08 percent annual growth for beneficiaries without supplemental coverage. Results for Medicare program spending were more equivocal, however. Our results are consistent with the belief that current trends away from generous employer-sponsored supplemental coverage and efforts to restrict the generosity of supplemental coverage may slow spending growth.
authors: Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA. egolber@umn.edu
authors: Ezra
authors: E
authors: Golberstein
authors: Kayo
authors: K
authors: Walsh
authors: Yulei
authors: Y
authors: He
authors: Michael E
authors: ME
authors: Chernew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003669:Deductibles and Coinsurance / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D017054:Insurance, Medigap / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000191:economics*; D018803:Models, Economic; D014481:United States
keywords: Health Spending; Medicare
references: Health Aff (Millwood). 1992 Spring;11(1):194-207
references: 1577375
references: Health Aff (Millwood). 2009 Sep-Oct;28(5):1327-35
references: 19738248
references: N Engl J Med. 2010 Jan 7;362(1):1-3
references: 20007553
references: Med Care Res Rev. 2001 Jun;58(2):131-61
references: 11398644
references: Health Care Financ Rev. 1996 Fall;18(1):157-74
references: 10165030
references: Health Aff (Millwood). 2002 Jul-Dec;Suppl Web Exclusives:W127-38
references: 12703569
references: Health Aff (Millwood). 2007 May-Jun;26(3):808-16
references: 17485760
references: J Health Econ. 1997 Oct;16(5):543-62
references: 10175630
references: Health Aff (Millwood). 2006 Nov-Dec;25(6):1507-16
references: 17102173
references: Health Aff (Millwood). 2005;24 Suppl 2:W5R42-52
references: 16186150