DataPoint: Medicare Payment Trends

Medicare paid for 23 percent of the $2.3 trillion worth of personal health care purchased in the U.S. in 2012. Only private health insurance paid a greater proportion (34 percent). Medicaid covered 16 percent while out-of-pocket spending funded 14 percent. In 2012, for-profit nursing homes accounted for 70 percent of all homes, but received 75 percent of all Medicare nursing home payments. In 2011, two thirds of Medicare home health care episodes were NOT preceded by a hospital stay, up from 53 percent in 2001. Community-admitted home health users were more likely to be eligible for both Medicare and Medicaid, had more home health episodes, and had more episodes with a high share of home health aide services compared with post-acute users. This information and much more is contained in a 200-page Medicare data book issued in June by the Medicare Payment Commission (MedPac) and is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841