title: Cumulative expenditures under the DI, SSI, Medicare, and Medicaid programs for a cohort of disabled working-age adults.
abstract: OBJECTIVE
  To estimate cumulative DI, SSI, Medicare, and Medicaid expenditures from initial disability benefit award to death or age 65.
  
  
  METHODS
  Administrative records for a cohort of new CY2000 DI and SSI awardees aged 18-64.
  
  
  METHODS
  Actual expenditures were obtained for 2000-2006/7. Subsequent expenditures were simulated using a regression-adjusted Markov process to assign individuals to annual disability benefit coverage states. Program expenditures were simulated conditional on assigned benefit coverage status. Estimates reflect present value of expenditures at initial award in 2000 and are expressed in constant 2012 dollars. Expenditure estimates were also updated to reflect benefit levels and characteristics of new awardees in 2012.
  
  
  METHODS
  We matched records for a 10 percent nationally representative sample.
  
  
  RESULTS
  Overall average cumulative expenditures are $292,401 through death or age 65, with 51.4 percent for cash benefits and 48.6 percent for health care. Expenditures are about twice the average for individuals first awarded benefits at age 18-30. Overall average expenditures increased by 10 percent when updated for a simulated 2012 cohort.
  
  
  CONCLUSIONS
  Data on cumulative expenditures, especially combined across programs, are useful for evaluating the long-term payoff of investments designed to modify entry to and exit from the disability rolls.
authors.affiliation: Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD.
authors.forename: Gerald F
authors.initials: GF
authors.lastname: Riley
authors.forename: Kalman
authors.initials: K
authors.lastname: Rupp
mesh_terms: D000293:Adolescent; D000328:Adult; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D018868:Insurance, Disability / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D006278:Medicare / Q000706:statistics & numerical data*; D008875:Middle Aged; D012943:Social Security / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult
keywords: Disability; Medicaid; Medicare; Social Security Disability Insurance; Supplemental Security Income
references.citation: Disabil Health J. 2013 Apr;6(2):95-9
references.pmid: 23507159
references.citation: Soc Secur Bull. 1995 Spring;58(1):29-47
references.pmid: 7644968
references.citation: J Health Econ. 2005 May;24(3):465-88
references.pmid: 15811539
references.citation: Health Aff (Millwood). 2011 Sep;30(9):1664-72
references.pmid: 21900656
references.citation: Soc Secur Bull. 1989 Sep;52(9):2-41
references.pmid: 2814747
references.citation: Soc Secur Bull. 2012;72(3):19-35
references.pmid: 23113427
references.citation: Soc Secur Bull. 1991 Apr;54(4):2-23
references.pmid: 1858001