Newly published research in the journal Health Affairs used a new methodology to analyze administrative claims data for older Medicare enrollees during their entire last year of life rather than just the last few months.
- The analysis uncovered four specific spending patterns for those patients who died during the 2012 study period.
- The researchers concluded patients' healthcare spending patterns are established long before their last months -- an insight that could help drive better strategies for containing end-of-life spending.
The stakes for controlling spending during beneficiaries' last year are high considering that Medicare spends an average of $40,000–$50,000 per person in their final year vs. $7,000 per year for others.
The study, led by Matthew Allen Davis of the University of Michigan School of Nursing, found that among decedents in their last year:
- 48.7% had high persistent spending;
- 29.0% had moderate persistent spending;
- 10.2% had progressive spending; and
- 12.1% had late rise spending.
While it has often been assumed that a steep spending increase at the end of life is to be expected, this paper calls out that fact that high spending during the entire year before death was exhibited by nearly half the decedents. It shows that patterm to be associated with the patients having had multiple chronic conditions, but not with any specific conditions.
"Therefore, future strategies directed at meeting the care needs of older adults with multiple chronic conditions—not necessarily of those with a poor immediate prognosis—could have the largest impact on national spending," the researchers wrote.