CDC: Medicare Costs for Heart Disease Vary Widely Across US

Larry Hand

December 30, 2016

ATLANTA, GA — Incremental costs for treating Medicare beneficiaries with heart disease, compared with Medicare beneficiaries without heart disease, vary by geographic region and county, according to new research[1] .

Rita Wakim and colleagues at the Centers for Disease Control and Prevention analyzed 2012 data on fee-for-service Medicare claims and compared costs for beneficiaries with and without heart disease and costs by type of service. They reported the results in an article published online December 29, 2016 in Preventing Chronic Disease.

Researchers summed total costs of Medicare payments, beneficiary payments, and third-party payments for inpatient, outpatient, postacute, hospice, physician, imaging, and other types of care. They calculated the absolute difference in costs for beneficiaries with heart disease above beneficiaries without heart disease, as well as the relative difference by dividing the cost per beneficiary with heart disease by the cost per beneficiary without heart disease.

Researchers found the total costs for beneficiaries with heart disease to be about $96 billion in 2012. They found the absolute difference between beneficiaries with and without heart disease to be $10,345 and the relative incremental costs of heart disease per beneficiary to be 2.6 per capita.

They also found:

  • Highest mean absolute incremental costs in the South ($11,581 per capita).

  • Highest mean incremental inpatient costs in the South ($4101 per capita).

  • Highest mean outpatient costs in the Midwest ($2225 per capita).

Counties with incremental total costs in the highest range ($12,443–$28,001) were concentrated in the South and Appalachia, while the highest incremental inpatient costs ($4648–$19,329) were in the South, Appalachia, and Northeast. The highest incremental outpatient costs ($2363–$7798) were in the West and Midwest.

They found that regions with the highest total incremental costs also had the highest prevalence of heart disease and highest incremental inpatient costs.

"Geographic variation in the incremental costs of care for beneficiaries with heart disease and geographic differences in use of services suggest a nonuniform use of resources to prevent and treat heart disease," the researchers write.

The authors reported no external funding or relevant financial relationships.

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