Medical Expenditure Panel Survey (MEPS), Health Care Expenditures for the Elderly with Chronic Conditions in 2012 Jeffrey Rhoades

Presenter Disclosure The following personal, professional, or financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Jeffrey Rhoades No relationships to disclose 2

MEPS – Household Component  Annual survey of 14,000 households  Sub-sample of respondents from the previous year’s National Health Interview Survey (NHIS)  Representative of the civilian non-institutionalized population of the U.S.  Collects data for 2 years of healthcare usage  5 in-person interviews over 2 ½ year period using Computer Assisted Personal Interview (CAPI)  Typically one respondent per household 3

Health Care Expenditures  Collected at the event level  Represent payments to providers of the health care  Payments are reported by source (e.g., out- of-pocket, private insurance, public insurance)  Total expenditure is the sum of payments across all sources of payment 4

Source of Payment Categories  Out-of-Pocket  Private Insurance  Medicare  Medicaid  VA  TRICARE  Other Federal Government  State or Local Government  Worker’s Comp  Other Insurance 5

Medical Conditions  Event types  Inpatient Stay  Outpatient Visit  Emergency Room Visit  Office Based Visit  Home Health  Following question asked about each event:  What conditions were discovered or led person to make this visit?  Prescribed Medicine Purchases  What health problem is medicine prescribed for? 6

Selected Chronic Conditions  Cancer  Cerebrovascular disease  Degenerative nervous system conditions  Dementia  Diabetes  Heart disease  Liver disease  Renal disease  Respiratory disease 7

Civilian Non-institutionalized Population, age 65 or older, 2012  No chronic conditions, n=1,537  One chronic condition, n=1,326  Two or more chronic conditions, n=1,241 8

Percentage of Individuals with Medical Event by Type of Service and Number of Chronic Conditions, Age 65+, Significantly different from each of the other groups p<0.05 Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012 Percentage

Mean Health Care Expenditures by Number of Chronic Conditions, Age 65+, Dollars

Mean Health Care Expenditures by Type of Service and Number of Chronic Conditions, Age 65+, Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012 Dollars

Distribution of Total Expenditures by Type of Service, Persons Age 65+ by Number of Chronic Conditions, Significantly different p<0.05 Ambulatory Care* (Outpatient, Emergency Room, Office Based Visits) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Percentage

Distribution of Total Expenditures by Source of Payment, Persons Age 65+ by Number of Chronic Conditions, Significantly different p<0.05 Other* (VA, Tricare, Other Federal Government, State or Local Government, Worker’s Comp, Other Insurance) Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, Percentage

Financial Burden of Chronic Conditions, Age 65+, 2012 Out-of-Pocket Payments (OOP)/Family Income 14 +Significantly different from each of the other groups p<0.05 Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 2012 OOP as a Proportion of Family Income

Summary The percent of individuals 65 and older with any medical event increases as the number of chronic conditions increases (ambulatory care, inpatient stay, prescribed medicines, and/or home health). For each type of medical event, expenditures for the treatment of chronic conditions increases relative to total expenditures as the number of chronic conditions increases. As the number of chronic conditions increases the proportion of total expenditures spent for ambulatory care declines and increases for home health. 15

Summary Individuals 65 and older with no chronic conditions pay a greater proportion of total expenditures out-of-pocket as compared to those with chronic conditions. For individuals 65 and older with two or more chronic conditions Medicaid pays a greater proportion of total expenditures compared to those with no chronic conditions. Almost 20% of individuals 65 and older with two or more chronic conditions spend 5% or more of family income for health care. 16