- About 25% of all Medicare spending on beneficiaries 65 and older is for care administered in the last year of life, according to a new report by the Kaiser Family Foundation.
- More than half (55%) of Medicare beneficiaries who died in 2014 were 80 or older, compared with 35% were 65 to 79 and 9% who were under 65.
- In all, 2.6 million people died in the U.S. in 2014. Of those, 2.1 million, or eight in 10, were on Medicare, making it the major insurer of end-of-life care, the report says.
Per capita Medicare spending was nearly four times higher for beneficiaries who died at some point in 2014 than for survivors — $34,529 versus $9,121. But the data also show a drop in the share of spending on end-of-life care over time, from 18.6% in 2000 to 13.5% in 2014.
Other findings include:
- Medicare spent 7 times more on inpatient services for decedents than survivors in 2014;
- Average per capita spending for decedents under 65 outpaced that for 65 and older beneficiaries; and
- Per capita spending for decedents over 65 declined with age, while spending on survivors rose, due to higher spending on post-acute and hospice care.
“These results suggest that providers, patients, and their families may be inclined to be more aggressive in treating younger seniors compared to older seniors, perhaps because there is a greater expectation for positive outcomes among those with a longer life expectancy, even those who are seriously ill,” the report says.
Diseases most prevalent among decedents included hypertension, ischemic heart disease, chronic kidney disease, congestive heart failure, Alzheimer’s disease or dementia, diabetes and cancer. These diseases were also seen at a higher rate in people who died in 2014 than in the Medicare population overall.
KKF limited its analysis to beneficiaries in traditional Medicare, because comparable spending data on Medicare Advantage beneficiaries wasn’t available. While the majority of beneficiaries who died in 2014 were in the traditional program, including Medicare Advantage enrollees would shed light on differences in end-of-life experiences in the two programs, the report says.