Tag Archives: Medical Expenditure Panel Survey (MEPS)

41% of healthcare spending attributed to 12% of Americans, study finds

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http://www.beckershospitalreview.com/finance/41-of-healthcare-spending-attributed-to-12-of-americans-study-finds.html

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U.S. adults with five or more chronic conditions spend 14 times more on health services on average than those with no chronic conditions, according to a new RAND Health report prepared for the Partnership to Fight Chronic Disease.

For the study, researchers analyzed the Medical Expenditure Panel Survey from Agency for Healthcare Research and Quality. MEPS is a nationally representative sample of the noninstitutionalized U.S. adult population.

The study revealed 60 percent of U.S. adults had at least one chronic condition in 2014, the most recent year data is available. Forty-two percent of U.S. adults had more than one chronic condition, according to the study.

The study showed people with more chronic conditions require more healthcare services. For example, the study revealed people with five or more chronic conditions average 20 physician visits per year, while those with three or four chronic conditions average 12 physician visits annually.

The study also showed spending on healthcare services rises with the number of chronic conditions a person has. U.S. adults with one or two chronic conditions make up 31 percent of the population and 23 percent of total healthcare spending. Those with five or more chronic conditions make up 12 percent of the population but account for 41 percent of total healthcare spending, according to the study.

For the study, researchers defined healthcare spending as the amount spent on all inpatient and outpatient care across all payers, including out-of-pocket payments.

Private vs. public prices

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http://www.academyhealth.org/blog/2017-01/private-vs-public-prices

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You probably knew that the prices private health insurers pay hospitals are higher than those of Medicare and Medicaid. But you may not have known that the gap between private and public payers used to be a lot smaller and has grown tremendously in recent years.

Using Medical Expenditure Panel Survey (MEPS) data, by payer (private health insurance, Medicare, and Medicaid) and over time (1996-2012), the chart shows average hospital payment rates (in constant dollars), adjusted for age, sex, race/ethnicity, geography, income, health conditions, charges, length-of-stay, and whether or not a surgical procedure was performed. To produce figures for the chart, the authors used this model to predict hospital payment per stay for each MEPS observation, as if they were covered by private insurance, Medicare, or Medicaid, in turn.

As is clear from the chart, adjusted, average private pay rates have always been above public rates, but were closest in 1996-2000. Back then, private rates were no more than 10% above Medicare rates. Perhaps this was the effect of managed care, which kept growth in private rates down. Those rates began to grow during the managed care backlash, until 2005. From 2005-2009, adjusted, average private hospital rates—while considerably above Medicare and Medicaid rates—held steady. Then, in 2009, they took off again. In 2012, adjusted, average private rates were about 75% higher than Medicare rates.*

Medicaid payments were about 90% of Medicare’s in most study years.