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Lecture Health economics - Chapter 14: Medicare

Lecture Health economics - Chapter 14: Medicare. This chapter presents the following content: The medicare program, coverage, financing, case study, medicare costs, medicare financing, patient cost sharing, physician prospective payment system,. | Medicare Professor Vivian Ho Health Economics Fall 2009 Topics Coverage Financing Case Study The Medicare Program Target population - individuals 65+, certain disabled people, and people with kidney failure Part A - Hospital Insurance program (compulsory) Inpatient hospital services Skilled nursing care Home health care Hospice care 19.1m enrollees in 1966; 44.9m in 2008 *Source: www.cms.hhs.gov Source: http://www.cms.hhs.gov/publications/trusteesreport/tr2005.pdf Source: http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf Part B - Supplemental Medical Insurance program (voluntary) Physician services Outpatient care Emergency room services 17.7m enrollees in 1966, 41.7m in 2008 *Source: www.cms.hhs.gov Source: http://www.cms.hhs.gov/publications/trusteesreport/tr2005.pdf Source: http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf 1966 1.8 1980 37.2 1990 109.5 1995 182.4 2000 225.2 2003 283.8 2006 408.3 2008 468.0 Medicare Costs Total Expenditures ($ billions) Source: http://www.cms.hhs.gov/publications/trusteesreport/tr2005.pdf Source: http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf Medicare Financing - Part A Funding Sources 2.9% payroll tax shared equally by employers and employees Federal Hospital Insurance Trust Fund Enrollee deductibles and copayments 1. Income taxes on Social Security for high-income beneficiaries. 2. Premiums for certain persons not otherwise eligible and who enroll voluntarily. 3. General reimbursements for certain uninsured individuals. 4. Interest earnings on invested assets of trust fund. Part A Trust Fund ($ millions) 1967 $ 3,089 1975 12,568 1980 25,415 1985 50,933 1990 79,563 1995 114,847 2000 159,681 2005 196,921 2008 230,815 2,597 1,343 10,612 9,870 24,288 14,490 48,654 21,277 66,687 95,631 114,883 129,520 130,284 168,084 184,142 277,723 235,556 321,270 Year Income Disbursements Balance Balance = Receipts - Expenditures + Previous year’s balance Right now, Part A in surplus. | Medicare Professor Vivian Ho Health Economics Fall 2009 Topics Coverage Financing Case Study The Medicare Program Target population - individuals 65+, certain disabled people, and people with kidney failure Part A - Hospital Insurance program (compulsory) Inpatient hospital services Skilled nursing care Home health care Hospice care 19.1m enrollees in 1966; 44.9m in 2008 *Source: www.cms.hhs.gov Source: http://www.cms.hhs.gov/publications/trusteesreport/tr2005.pdf Source: http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf Part B - Supplemental Medical Insurance program (voluntary) Physician services Outpatient care Emergency room services 17.7m enrollees in 1966, 41.7m in 2008 *Source: www.cms.hhs.gov Source: http://www.cms.hhs.gov/publications/trusteesreport/tr2005.pdf Source: http://www.cms.hhs.gov/ReportsTrustFunds/downloads/tr2009.pdf 1966 1.8 1980 37.2 1990 109.5 1995 182.4 2000 225.2 2003 283.8 2006 408.3 2008 468.0 Medicare Costs Total Expenditures ($ .