Similar but Not the Same: How Medicare Per Capita Spending Compares for Younger and Older Beneficiaries
| Table 1: Amount and Distribution of Medicare Per Capita Spending Overall and By Type of Service for Traditional Medicare Beneficiaries Under Age 65 and Over Age 65, 2014 | |||||
| Type of service | Part of Medicare covering service |
Under age 65 | Over age 651 | ||
| Amount | Percent of total | Amount | Percent of total | ||
| Total | $13,098 | 100.0% | $9,972 | 100.0% | |
| Part D drugs | D | 3,817 | 29.1% | 1,159 | 11.6% |
| Acute inpatient hospital | A | 3,141 | 24.0% | 2,722 | 27.3% |
| Outpatient hospital | A | 2,203 | 16.8% | 1,448 | 14.5% |
| Other inpatient hospital | A | 640 | 4.9% | 369 | 3.7% |
| Evaluation & management | B | 503 | 3.8% | 459 | 4.6% |
| Other Part B procedures | B | 370 | 2.8% | 524 | 5.3% |
| Skilled nursing facility | A | 366 | 2.8% | 826 | 8.3% |
| Physician office services | B | 365 | 2.8% | 416 | 4.2% |
| Home health | A or B2 | 324 | 2.5% | 499 | 5.0% |
| Part B drugs | B | 287 | 2.2% | 360 | 3.6% |
| Tests | B | 271 | 2.1% | 239 | 2.4% |
| Durable medical equipment | B | 225 | 1.7% | 132 | 1.3% |
| Other Part B services | B | 211 | 1.6% | 164 | 1.6% |
| Imaging | B | 130 | 1.0% | 171 | 1.7% |
| Hospice | A | 85 | 0.6% | 333 | 3.3% |
| Dialysis | B | 59 | 0.5% | 13 | 0.1% |
| Anesthesia | B | 52 | 0.4% | 53 | 0.5% |
| Ambulatory surgery center | B | 50 | 0.4% | 86 | 0.9% |
| NOTE: Analysis excludes beneficiaries in Medicare Advantage. 165-year olds are excluded because these beneficiaries are enrolled for less than a full year. 2Home health services can be covered under Part A or Part B depending on whether or not the services follow a hospital stay. SOURCE: Kaiser Family Foundation analysis of a five percent sample of Medicare claims from the CMS Chronic Conditions Data Warehouse, 2014. |
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| Table 2: Amount and Distribution of Medicare Per Capita Spending Overall and By Type of Service for Traditional Medicare Beneficiaries Under Age 65, by Year of Age, 2014 |
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| TOTAL PER CAPITA | Part D prescription drugs | Inpatient hospital | Outpatient hospital | Part B providers/ services/ supplies/drugs | Skilled nursing facility | Hospice | Home health | |||||||||
| AGE | Amount | % of total | Amount | % of total | Amount | % of total | Amount | % of total | Amount | % of total | Amount | % of total | Amount | % of total | Amount | % of total |
| All <65 | $13,098 | 100% | $3,817 | 29.1% | $3,781 | 28.9% | $2,203 | 16.8% | $2,523 | 19.3% | $366 | 2.8% | $85 | 0.6% | $324 | 2.5% |
| 25 | 7,918 | 100 | 2,185 | 27.6% | 2,730 | 34.5% | 1,464 | 18.5% | 1,403 | 17.7% | 43 | 0.5% | 21 | 0.3% | 71 | 0.9% |
| 26 | 8,282 | 100 | 2,676 | 32.3% | 2,497 | 30.1% | 1,455 | 17.6% | 1,527 | 18.4% | 29 | 0.4% | 0 | 0.0% | 99 | 1.2% |
| 27 | 9,199 | 100 | 2,836 | 30.8% | 2,690 | 29.2% | 1,697 | 18.4% | 1,817 | 19.8% | 55 | 0.6% | 4 | 0.0% | 101 | 1.1% |
| 28 | 9,623 | 100 | 2,846 | 29.6% | 2,827 | 29.4% | 2,046 | 21.3% | 1,727 | 18.0% | 37 | 0.4% | 5 | 0.0% | 134 | 1.4% |
| 29 | 10,578 | 100 | 2,943 | 27.8% | 3,246 | 30.7% | 1,925 | 18.2% | 2,324 | 22.0% | 41 | 0.4% | 7 | 0.1% | 92 | 0.9% |
| 30 | 9,144 | 100 | 2,964 | 32.4% | 2,675 | 29.3% | 1,632 | 17.8% | 1,711 | 18.7% | 61 | 0.7% | 8 | 0.1% | 93 | 1.0% |
| 31 | 10,408 | 100 | 3,455 | 33.2% | 3,147 | 30.2% | 1,729 | 16.6% | 1,857 | 17.8% | 97 | 0.9% | 24 | 0.2% | 100 | 1.0% |
| 32 | 11,117 | 100 | 3,570 | 32.1% | 3,216 | 28.9% | 2,067 | 18.6% | 2,002 | 18.0% | 101 | 0.9% | 28 | 0.2% | 134 | 1.2% |
| 33 | 11,150 | 100 | 3,793 | 34.0% | 2,854 | 25.6% | 2,084 | 18.7% | 2,116 | 19.0% | 103 | 0.9% | 28 | 0.3% | 171 | 1.5% |
| 34 | 11,474 | 100 | 3,582 | 31.2% | 3,456 | 30.1% | 2,119 | 18.5% | 2,020 | 17.6% | 136 | 1.2% | 31 | 0.3% | 131 | 1.1% |
| 35 | 11,834 | 100 | 3,757 | 31.7% | 3,596 | 30.4% | 2,080 | 17.6% | 2,133 | 18.0% | 66 | 0.6% | 35 | 0.3% | 167 | 1.4% |
| 36 | 12,301 | 100 | 4,358 | 35.4% | 3,292 | 26.8% | 2,266 | 18.4% | 2,064 | 16.8% | 139 | 1.1% | 16 | 0.1% | 165 | 1.3% |
| 37 | 11,876 | 100 | 4,097 | 34.5% | 3,033 | 25.5% | 2,256 | 19.0% | 2,184 | 18.4% | 99 | 0.8% | 28 | 0.2% | 178 | 1.5% |
| 38 | 11,549 | 100 | 4,049 | 35.1% | 3,030 | 26.2% | 2,129 | 18.4% | 2,041 | 17.7% | 86 | 0.7% | 12 | 0.1% | 202 | 1.7% |
| 39 | 13,079 | 100 | 4,323 | 33.1% | 3,829 | 29.3% | 2,268 | 17.3% | 2,181 | 16.7% | 184 | 1.4% | 53 | 0.4% | 241 | 1.8% |
| 40 | 12,555 | 100 | 4,162 | 33.1% | 3,021 | 24.1% | 2,462 | 19.6% | 2,501 | 19.9% | 162 | 1.3% | 32 | 0.3% | 215 | 1.7% |
| 41 | 13,013 | 100 | 4,186 | 32.2% | 3,506 | 26.9% | 2,528 | 19.4% | 2,410 | 18.5% | 135 | 1.0% | 18 | 0.1% | 230 | 1.8% |
| 42 | 12,712 | 100 | 4,540 | 35.7% | 3,155 | 24.8% | 2,316 | 18.2% | 2,281 | 17.9% | 140 | 1.1% | 50 | 0.4% | 231 | 1.8% |
| 43 | 13,034 | 100 | 4,208 | 32.3% | 3,544 | 27.2% | 2,354 | 18.1% | 2,523 | 19.4% | 161 | 1.2% | 48 | 0.4% | 195 | 1.5% |
| 44 | 13,747 | 100 | 4,494 | 32.7% | 3,811 | 27.7% | 2,425 | 17.6% | 2,454 | 17.9% | 260 | 1.9% | 41 | 0.3% | 262 | 1.9% |
| 45 | 13,578 | 100 | 4,448 | 32.8% | 3,515 | 25.9% | 2,534 | 18.7% | 2,594 | 19.1% | 197 | 1.5% | 58 | 0.4% | 232 | 1.7% |
| 46 | 13,114 | 100 | 4,434 | 33.8% | 3,447 | 26.3% | 2,325 | 17.7% | 2,381 | 18.2% | 205 | 1.6% | 55 | 0.4% | 267 | 2.0% |
| 47 | 13,831 | 100 | 4,587 | 33.2% | 3,752 | 27.1% | 2,370 | 17.1% | 2,515 | 18.2% | 255 | 1.8% | 68 | 0.5% | 284 | 2.1% |
| 48 | 14,467 | 100 | 4,653 | 32.2% | 4,102 | 28.4% | 2,438 | 16.9% | 2,632 | 18.2% | 271 | 1.9% | 51 | 0.4% | 319 | 2.2% |
| 49 | 13,802 | 100 | 4,681 | 33.9% | 3,610 | 26.2% | 2,405 | 17.4% | 2,567 | 18.6% | 182 | 1.3% | 92 | 0.7% | 263 | 1.9% |
| 50 | 13,715 | 100 | 4,684 | 34.1% | 3,556 | 25.9% | 2,307 | 16.8% | 2,502 | 18.2% | 283 | 2.1% | 67 | 0.5% | 316 | 2.3% |
| 51 | 14,250 | 100 | 4,630 | 32.5% | 4,017 | 28.2% | 2,273 | 15.9% | 2,609 | 18.3% | 328 | 2.3% | 75 | 0.5% | 318 | 2.2% |
| 52 | 13,510 | 100 | 4,243 | 31.4% | 3,827 | 28.3% | 2,165 | 16.0% | 2,561 | 19.0% | 322 | 2.4% | 80 | 0.6% | 312 | 2.3% |
| 53 | 13,703 | 100 | 4,313 | 31.5% | 3,778 | 27.6% | 2,183 | 15.9% | 2,621 | 19.1% | 402 | 2.9% | 72 | 0.5% | 335 | 2.4% |
| 54 | 13,449 | 100 | 4,151 | 30.9% | 3,667 | 27.3% | 2,217 | 16.5% | 2,609 | 19.4% | 368 | 2.7% | 98 | 0.7% | 339 | 2.5% |
| 55 | 13,700 | 100 | 4,176 | 30.5% | 3,838 | 28.0% | 2,195 | 16.0% | 2,660 | 19.4% | 389 | 2.8% | 95 | 0.7% | 347 | 2.5% |
| 56 | 13,526 | 100 | 4,015 | 29.7% | 3,771 | 27.9% | 2,168 | 16.0% | 2,639 | 19.5% | 478 | 3.5% | 82 | 0.6% | 372 | 2.8% |
| 57 | 13,246 | 100 | 3,776 | 28.5% | 3,857 | 29.1% | 2,126 | 16.0% | 2,561 | 19.3% | 457 | 3.5% | 94 | 0.7% | 374 | 2.8% |
| 58 | 13,844 | 100 | 3,727 | 26.9% | 4,118 | 29.7% | 2,238 | 16.2% | 2,721 | 19.7% | 526 | 3.8% | 103 | 0.7% | 412 | 3.0% |
| 59 | 13,450 | 100 | 3,556 | 26.4% | 4,042 | 30.1% | 2,147 | 16.0% | 2,723 | 20.2% | 447 | 3.3% | 101 | 0.8% | 434 | 3.2% |
| 60 | 13,590 | 100 | 3,464 | 25.5% | 4,147 | 30.5% | 2,241 | 16.5% | 2,674 | 19.7% | 540 | 4.0% | 115 | 0.8% | 410 | 3.0% |
| 61 | 13,674 | 100 | 3,327 | 24.3% | 4,253 | 31.1% | 2,167 | 15.8% | 2,808 | 20.5% | 563 | 4.1% | 126 | 0.9% | 430 | 3.1% |
| 62 | 13,289 | 100 | 3,136 | 23.6% | 4,073 | 30.6% | 2,174 | 16.4% | 2,718 | 20.5% | 595 | 4.5% | 169 | 1.3% | 424 | 3.2% |
| 63 | 13,672 | 100 | 2,983 | 21.8% | 4,376 | 32.0% | 2,263 | 16.6% | 2,842 | 20.8% | 624 | 4.6% | 134 | 1.0% | 451 | 3.3% |
| 64 | 13,575 | 100 | 2,854 | 21.0% | 4,383 | 32.3% | 2,236 | 16.5% | 2,775 | 20.4% | 693 | 5.1% | 167 | 1.2% | 466 | 3.4% |
| NOTE: Analysis excludes beneficiaries in Medicare Advantage. SOURCE: Kaiser Family Foundation analysis of a five percent sample of Medicare claims from the CMS Chronic Conditions Data Warehouse, 2014. |
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