BACKGROUND Medicare spending after age 65 years may be higher for previously uninsured adults if suboptimal care before this age leads to irreversible complications, persistently elevated clinical risks, or delay of costly elective procedures. OBJECTIVE To compare Medicare spending for previously uninsured and insured adults by using Medicare claims data. DESIGN Longitudinal survey data and...

CONTEXT Treatment for depression can be expensive and depression can affect the use of other medical services, yet there is little information on how depression affects the prevalence of cost-related medication nonadherence (CRN) in elderly patients and patients with disabilities. OBJECTIVE To quantify the presence of CRN in depressed and nondepressed elderly Medicare beneficiaries and noneld...

BACKGROUND More than half of veterans who use Veterans Health Administration (VA) care are also eligible for Medicare via disability or age, but no prior studies have examined variation in use of outpatient services by Medicare-eligible veterans across health system, type of care or time. OBJECTIVES To examine differences in use of VA and Medicare outpatient services by disability-eligible or...

CONTEXT Cost-sharing in US prescription drug coverage plans for elderly persons varies widely. Evaluation of prescription drug use among elderly persons by type of health insurance could provide useful information for designing a Medicare drug program. OBJECTIVE To determine use of effective cardiovascular drugs among elderly persons with coronary heart disease (CHD) by type of health insuran...

Medicare payment disproportionately impacts rural physicians compared to urban. For example, 51% of rural physicians, compared to 44% of urban physicians, receive at least 38% of their payments from Medicare.1 Thus, the Medicare physician payment system is of significant rural interest. In this policy brief, we present the effects of the Medicare Prescription Drug, Improvement, and Modernizatio...

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in trad...

BACKGROUND A previous study revealed that patients perceived physician reimbursement to be much higher than current Medicare schedules for hip and knee replacement. The purpose of this study was to evaluate patient perception of surgeon reimbursement for total shoulder replacement (TSA) and rotator cuff repair (RCR). METHODS The study surveyed 250 patients. Patients were asked what they belie...

59 The Medicare Current Beneficiary Sur­ vey (MCBS) is a continuous panel survey of a nationally­representative sample of Medi care enrollees. The survey collects a variety of information on these Medicare beneficiaries with a focus on the social, economic, and demographic character istics of the Medicare population, bene ficiaries’ health status, and their health care serv ices, cost, and sour...