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Medicare Spending at the End of Life: A Snapshot of Beneficiaries Who Died in 2014 and the Cost of Their Care

Juliette Cubanski, Tricia Neuman, Shannon Griffin, and Anthony Damico
Published:

Table 1: Prevalence of Selected Conditions Among Traditional Medicare Beneficiaries, 2014

Condition

All traditional Medicare beneficiaries

Decedents

Survivors
Hypertension  50%  67%  49%
Ischemic Heart disease 25% 53% 23%
Chronic Kidney Disease 15% 51% 14%
Anemia 20% 50% 19%
Congestive Heart Failure 12% 48% 11%
Alzheimer’s Disease/Dementia 9% 43% 8%
Diabetes 24% 38% 24%
Rheumatoid Arthritis/Osteoarthritis 27% 35% 26%
Chronic Obstructive Pulmonary Disease 10% 29% 9%
Depression 15% 27% 14%
Any Cancer 7% 17% 7%
Stroke/Transient Ischemic Attack 3% 11% 3%
NOTE: Excludes beneficiaries in Medicare Advantage.
SOURCE: Kaiser Family Foundation analysis of a five percent sample of 2014 Medicare claims from the CMS Chronic Conditions Data Warehouse.
Table 2: Amount and Distribution of Average Medicare Per Capita Spending Overall and by Type of Service for Traditional Medicare Beneficiaries, 2014
Type of service Part of Medicare covering service All traditional
Medicare beneficiaries		 Decedents Survivors
Amount Percent of total Amount Percent of total Amount Percent of total
Total $10,126 100.0% $34,529 100.0% $9,121 100.0%
Part D drugs D 1,590 15.7 1,352 3.9 1,600 17.5
Acute inpatient hospital A 2,691 26.6 15,586 45.1 2,160 23.7
Outpatient hospital A 1,531 15.1 2,536 7.3 1,490 16.3
Other inpatient hospital A 402 4.0 1,988 5.8 337 3.7
Evaluation & management B 446 4.4 2,026 5.9 381 4.2
Other Part B procedures B 477 4.7 636 1.8 470 5.2
Skilled nursing facility A 702 6.9 3,425 9.9 589 6.5
Physician office services B 390 3.9 277 0.8 395 4.3
Home health A or B1 443 4.4 1,231 3.6 410 4.5
Part B drugs B 333 3.3 554 1.6 324 3.5
Tests B 236 2.3 211 0.6 237 2.6
Durable medical equipment B 143 1.4 190 0.6 141 1.6
Other Part B services B 166 1.6 764 2.2 141 1.5
Imaging B 157 1.6 264 0.8 153 1.7
Hospice A 271 2.7 3,329 9.6 145 1.6
Dialysis B 21 0.2 57 0.2 20 0.2
Anesthesia B 51 0.5 81 0.2 50 0.5
Ambulatory surgery center B 77 0.8 21 0.1 79 0.9
 NOTE: Excludes beneficiaries in Medicare Advantage. Percentages may not sum to 100% due to rounding.
1Home 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 2014 Medicare claims from the CMS Chronic Conditions Data Warehouse.
Table 3: Amount and Distribution of Average Medicare Per Capita Spending Overall and by Type of Service for Decedents in Traditional Medicare Over Age 65, by Age, 2014
TOTAL PER CAPITA Inpatient hospital Outpatient hospital Part B providers/ services/ supplies Part B and
Part D prescription 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 $33,676 100% $16,701 49.6% $2,375 7.1% $4,406 13.1% $1,735 5.2% $3,641 10.8% $3,538 10.5% $1,280 3.8%
66 38,840 100 22,289 57.4 3,842 9.9 5,493 14.1 2,614 6.7 1,907 4.9 1,849 4.8 846 2.2
67 40,843 100 23,265 57.0 3,701 9.1 5,657 13.9 2,734 6.7 2,375 5.8 2,158 5.3 954 2.3
68 42,314 100 24,111 57.0 4,130 9.8 5,607 13.3 2,696 6.4 2,321 5.5 2,412 5.7 1,038 2.5
69 40,692 100 23,101 56.8 3,797 9.3 5,751 14.1 2,473 6.1 2,160 5.3 2,385 5.9 1,024 2.5
70 40,753 100 22,557 55.3 3,772 9.3 5,599 13.7 2,817 6.9 2,631 6.5 2,281 5.6 1,096 2.7
71 43,316 100 23,942 55.3 3,942 9.1 5,941 13.7 2,856 6.6 2,950 6.8 2,550 5.9 1,135 2.6
72 41,381 100 22,520 54.4 3,664 8.9 5,757 13.9 2,587 6.3 2,901 7.0 2,789 6.7 1,162 2.8
73 43,353 100 23,652 54.6 4,124 9.5 6,133 14.1 2,655 6.1 3,091 7.1 2,547 5.9 1,150 2.7
74 40,939 100 22,079 53.9 3,548 8.7 5,592 13.7 2,568 6.3 3,432 8.4 2,515 6.1 1,206 2.9
75 41,909 100 22,994 54.9 3,432 8.2 5,791 13.8 2,332 5.6 3,334 8.0 2,856 6.8 1,171 2.8
76 40,882 100 22,034 53.9 3,149 7.7 5,649 13.8 2,522 6.2 3,173 7.8 3,028 7.4 1,327 3.2
77 40,758 100 21,851 53.6 3,007 7.4 5,660 13.9 2,426 6.0 3,575 8.8 2,956 7.3 1,282 3.1
78 39,014 100 20,223 51.8 2,960 7.6 5,395 13.8 2,219 5.7 3,672 9.4 3,278 8.4 1,268 3.3
79 39,760 100 20,954 52.7 2,976 7.5 5,526 13.9 2,031 5.1 3,758 9.5 3,222 8.1 1,293 3.3
80 36,841 100 18,710 50.8 2,572 7.0 4,800 13.0 1,896 5.1 3,858 10.5 3,549 9.6 1,456 4.0
81 36,640 100 19,396 52.9 2,393 6.5 4,986 13.6 1,806 4.9 3,642 9.9 3,073 8.4 1,344 3.7
82 34,938 100 17,408 49.8 2,694 7.7 4,552 13.0 1,591 4.6 3,962 11.3 3,300 9.4 1,431 4.1
83 32,969 100 16,081 48.8 2,144 6.5 4,372 13.3 1,542 4.7 4,199 12.7 3,263 9.9 1,368 4.1
84 32,880 100 15,595 47.4 2,269 6.9 4,252 12.9 1,526 4.6 4,168 12.7 3,724 11.3 1,347 4.1
85 33,381 100 16,105 48.2 2,009 6.0 4,304 12.9 1,523 4.6 4,399 13.2 3,620 10.8 1,422 4.3
86 30,634 100 14,388 47.0 1,759 5.7 3,885 12.7 1,407 4.6 4,123 13.5 3,789 12.4 1,285 4.2
87 30,831 100 14,249 46.2 1,644 5.3 3,935 12.8 1,365 4.4 4,204 13.6 3,940 12.8 1,495 4.9
88 30,009 100 13,841 46.1 1,627 5.4 3,701 12.3 1,167 3.9 4,393 14.6 3,839 12.8 1,440 4.8
89 29,655 100 12,998 43.8 1,496 5.0 3,612 12.2 1,387 4.7 4,437 15.0 4,274 14.4 1,451 4.9
90 27,779 100 12,030 43.3 1,500 5.4 3,454 12.4 1,118 4.0 4,199 15.1 4,064 14.6 1,415 5.1
91 25,592 100 10,717 41.9 1,307 5.1 3,136 12.3 963 3.8 3,799 14.8 4,329 16.9 1,341 5.2
92 26,276 100 10,740 40.9 1,220 4.6 3,118 11.9 961 3.7 4,151 15.8 4,662 17.7 1,424 5.4
93 24,270 100 9,627 39.7 1,213 5.0 2,774 11.4 835 3.4 3,960 16.3 4,568 18.8 1,293 5.3
94 25,443 100 9,867 38.8 1,091 4.3 2,883 11.3 922 3.6 4,503 17.7 4,864 19.1 1,313 5.2
95 23,181 100 9,129 39.4 1,046 4.5 2,691 11.6 940 4.1 3,690 15.9 4,538 19.6 1,147 4.9
96 22,668 100 8,107 35.8 1,123 5.0 2,548 11.2 855 3.8 3,652 16.1 5,068 22.4 1,317 5.8
97 21,491 100 7,768 36.1 1,000 4.7 2,223 10.3 750 3.5 3,192 14.9 5,475 25.5 1,083 5.0
98 20,259 100 7,344 36.2 893 4.4 2,130 10.5 814 4.0 3,091 15.3 4,816 23.8 1,170 5.8
99 19,011 100 6,740 35.5 771 4.1 2,107 11.1 684 3.6 2,930 15.4 4,739 24.9 1,041 5.5
100 18,471 100 5,926 32.1 813 4.4 1,688 9.1 773 4.2 2,279 12.3 6,247 33.8 745 4.0
101 16,564 100 5,288 31.9 825 5.0 1,604 9.7 842 5.1 1,958 11.8 5,163 31.2 885 5.3
102 18,739 100 5,714 30.5 570 3.0 1,876 10.0 841 4.5 2,203 11.8 6,188 33.0 1,348 7.2
103 17,714 100 4,488 25.3 516 2.9 1,338 7.6 467 2.6 3,015 17.0 6,727 38.0 1,163 6.6
104 14,985 100 4,932 32.9 1,206 8.0 1,469 9.8 961 6.4 2,243 15.0 3,438 22.9 736 4.9
NOTE: Excludes beneficiaries in Medicare Advantage. 65-year-olds are excluded from the analysis of spending by year of age because they are enrolled for less than a full year. Percentages may not sum to 100% due to rounding.
SOURCE: Kaiser Family Foundation analysis of a five percent sample of 2014 Medicare claims from the CMS Chronic Conditions Data Warehouse.
Table 4: Amount and Distribution of Average Medicare Per Capita Spending Overall and by Type of Service for Survivors in Traditional Medicare Over Age 65, by Age, 2014
TOTAL PER CAPITA Inpatient hospital Outpatient hospital Part B providers/ services/ supplies Part B and
Part D prescription 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 $8,839 100% $2,441 27.6% $1,404 15.9% $2,154 24.4% $1,509 17.1% $691 7.8% $179 2.0% $461 5.2%
66 5,271 100 1,472 27.9 986 18.7 1,368 26.0 1,092 20.7 183 3.5 19 0.4 151 2.9
67 5,694 100 1,551 27.2 1,052 18.5 1,509 26.5 1,174 20.6 210 3.7 26 0.5 172 3.0
68 6,257 100 1,738 27.8 1,128 18.0 1,655 26.5 1,282 20.5 239 3.8 27 0.4 188 3.0
69 6,676 100 1,824 27.3 1,232 18.5 1,778 26.6 1,338 20.0 268 4.0 30 0.4 206 3.1
70 7,180 100 2,003 27.9 1,277 17.8 1,903 26.5 1,412 19.7 311 4.3 40 0.6 235 3.3
71 7,632 100 2,142 28.1 1,374 18.0 2,021 26.5 1,453 19.0 330 4.3 51 0.7 260 3.4
72 7,889 100 2,150 27.2 1,422 18.0 2,098 26.6 1,536 19.5 352 4.5 51 0.7 280 3.6
73 8,398 100 2,292 27.3 1,488 17.7 2,228 26.5 1,607 19.1 396 4.7 72 0.9 314 3.7
74 8,933 100 2,509 28.1 1,569 17.6 2,327 26.1 1,640 18.4 472 5.3 76 0.8 340 3.8
75 9,178 100 2,517 27.4 1,599 17.4 2,390 26.0 1,693 18.5 521 5.7 84 0.9 372 4.1
76 9,627 100 2,667 27.7 1,644 17.1 2,492 25.9 1,728 18.0 588 6.1 90 0.9 416 4.3
77 9,886 100 2,796 28.3 1,631 16.5 2,536 25.6 1,742 17.6 642 6.5 101 1.0 439 4.4
78 10,370 100 2,947 28.4 1,722 16.6 2,603 25.1 1,738 16.8 724 7.0 128 1.2 508 4.9
79 10,579 100 3,021 28.6 1,697 16.0 2,624 24.8 1,728 16.3 810 7.7 147 1.4 552 5.2
80 10,730 100 2,986 27.8 1,678 15.6 2,618 24.4 1,764 16.4 920 8.6 178 1.7 587 5.5
81 10,909 100 3,099 28.4 1,636 15.0 2,622 24.0 1,720 15.8 967 8.9 226 2.1 640 5.9
82 11,201 100 3,181 28.4 1,673 14.9 2,677 23.9 1,680 15.0 1,088 9.7 199 1.8 704 6.3
83 11,540 100 3,286 28.5 1,635 14.2 2,711 23.5 1,706 14.8 1,164 10.1 272 2.4 766 6.6
84 11,983 100 3,391 28.3 1,673 14.0 2,717 22.7 1,780 14.9 1,303 10.9 299 2.5 821 6.9
85 12,342 100 3,449 27.9 1,639 13.3 2,731 22.1 1,770 14.3 1,460 11.8 390 3.2 902 7.3
86 12,434 100 3,425 27.5 1,676 13.5 2,677 21.5 1,735 14.0 1,564 12.6 390 3.1 967 7.8
87 12,793 100 3,518 27.5 1,634 12.8 2,706 21.2 1,710 13.4 1,758 13.7 430 3.4 1,036 8.1
88 12,818 100 3,488 27.2 1,538 12.0 2,669 20.8 1,678 13.1 1,781 13.9 551 4.3 1,112 8.7
89 13,446 100 3,668 27.3 1,534 11.4 2,685 20.0 1,722 12.8 2,023 15.0 613 4.6 1,201 8.9
90 13,457 100 3,588 26.7 1,507 11.2 2,592 19.3 1,645 12.2 2,113 15.7 808 6.0 1,205 9.0
91 13,335 100 3,481 26.1 1,425 10.7 2,505 18.8 1,576 11.8 2,166 16.2 871 6.5 1,311 9.8
92 13,999 100 3,701 26.4 1,390 9.9 2,510 17.9 1,621 11.6 2,334 16.7 1,037 7.4 1,406 10.0
93 13,640 100 3,419 25.1 1,414 10.4 2,443 17.9 1,524 11.2 2,365 17.3 1,093 8.0 1,381 10.1
94 14,173 100 3,557 25.1 1,327 9.4 2,436 17.2 1,567 11.1 2,447 17.3 1,341 9.5 1,497 10.6
95 14,039 100 3,526 25.1 1,284 9.1 2,370 16.9 1,502 10.7 2,382 17.0 1,473 10.5 1,503 10.7
96 14,232 100 3,444 24.2 1,242 8.7 2,239 15.7 1,572 11.0 2,575 18.1 1,661 11.7 1,498 10.5
97 14,620 100 3,349 22.9 1,178 8.1 2,206 15.1 1,470 10.1 2,881 19.7 1,957 13.4 1,579 10.8
98 14,114 100 3,064 21.7 1,195 8.5 2,067 14.6 1,442 10.2 2,591 18.4 2,319 16.4 1,436 10.2
99 13,929 100 3,065 22.0 1,038 7.5 2,015 14.5 1,371 9.8 2,434 17.5 2,578 18.5 1,428 10.3
100 14,546 100 2,791 19.2 976 6.7 1,940 13.3 1,470 10.1 2,563 17.6 3,377 23.2 1,429 9.8
101 13,018 100 2,625 20.2 952 7.3 1,831 14.1 1,313 10.1 2,378 18.3 2,593 19.9 1,327 10.2
102 13,386 100 2,790 20.8 864 6.5 1,816 13.6 1,259 9.4 2,192 16.4 3,024 22.6 1,442 10.8
103 12,273 100 2,938 23.9 833 6.8 1,630 13.3 1,028 8.4 1,935 15.8 2,182 17.8 1,728 14.1
104 9,217 100 1,780 19.3 582 6.3 1,139 12.4 801 8.7 1,632 17.7 2,350 25.5 935 10.1
NOTE: Excludes beneficiaries in Medicare Advantage. 65-year-olds are excluded from the analysis of spending by year of age because they are enrolled for less than a full year.
SOURCE: Kaiser Family Foundation analysis of a five percent sample of 2014 Medicare claims from the CMS Chronic Conditions Data Warehouse.
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