The answer: No, but the Medicre bureaucracy statistics hide hospital (and doctor usage) for Medicare Part C users, lumping it altogether as "managed care." As I've posted about here and here, the 2012 MedPAC Medicare Data Book is out. And these are just some of the maybe important/maybe trivial snips of information available in the book directly or through implication.
Here's some highlights of the first section. There are 11 sections so there's plenty of fodder to fill up by blog for the rest of the Northern Hemisphere's summer. The chart above, which I drew from Data Book data, shows how spending patterns changed over the last decade.A chart from the actual document puts Medicare in perspective with all healthcare spending in the United States specifically in 2010 (most of the Data Book data is two to four years old).
Overall findings include:
- "The slowing in aggregate (Medicare FFS) spending from 2005 to 2007 is partially attributable to a decline in the number of Medicare FFS beneficiaries as the number of Medicare Part C (Advantage) beneficiaries increased."
- Hospital in-patient per-capita spending went down in 2010 but post-acute care spending per-capita went up by the same amount. A wash? No because the federal statisticians didn't thing that was worth commenting on. What's really happening is that Medicare Part C data hides both hospital and doctor-office spending. This is a real flaw in the view provided by the Medicare bureaucracy.
- Other snippets:
- Out of pocket (OOP) spending is said to make up 14% and Medicare is said to make up 23% of the $2.2 trillion U.S. health care spending in 2010 but that is not net of premiums paid by Medicare beneficiaries. To truly reflect government spending you need to knock Medicare down a few percent and bump up OOP by a few percent.
- It would be interesting to break down Medicare futher among not only share paid for by beneficiary premiums (mostly "regular" Part B premiums) but also share paid for by Medicare payroll taxes and share paid for by general tax revenue
- Presumably reflecting PPACA's cuts to Medicare, the MedPAC 2012 Medicare Data Book shows total health care spending in the U.S. rising steeply during the rest of this decade but Medicare spending flat (both as a percent of GDP); this impression could be caused by rounding (or even by a flaw in the chart-drawing software) because MedPAC says the actuals are 18% of GDP to 20% for total and 3.6% of GDP to 4% for Medicare, which are both about 10% increases
-- Dennis Byron