TUESDAY, Oct. 17, 2017 (HealthDay News) — Much of the total potentially preventable spending for Medicare beneficiaries is concentrated among frail elderly individuals, according to a study published online Oct. 16 in the Annals of Internal Medicine.
Jose F. Figueroa, M.D., M.P.H., from the Harvard T.H. Chan School of Public Health in Boston, and colleagues examined the proportion of total spending that is potentially preventable among subpopulations of high-cost Medicare beneficiaries. Using a claims-based algorithm, they defined six subpopulations: nonelderly disabled, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy. Potentially preventable spending was calculated as costs for avoidable emergency department visits plus inpatient and associated 30-day post-acute costs for ambulatory care-sensitive conditions.
The researchers found that 4.8 percent of Medicare spending in 2012 was potentially preventable, of which 73.8 percent was incurred by high-cost patients in the highest 10 percent of total standardized individual spending. High-cost frail elderly individuals made up 4 percent of the Medicare population and accounted for 43.9 percent of total potentially preventable spending ($6,593 per person). High-cost nonelderly disabled individuals and the major complex chronic group accounted for 14.8 and 11.2 percent of potentially preventable spending, respectively ($3,421 and $3,327 per person, respectively).
“Potentially preventable spending varied across Medicare subpopulations, with the majority concentrated among frail elderly persons,” the authors write.
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