Medicare spending to treat heart attack patients rose by 16.5 percent between 1998 and 2008, with the majority of costs incurred weeks after patients left the hospital, according to a study from the University of Michigan (U-M) Frankel Cardiovascular Center.
Researchers at the U-M and the Dartmouth Institute for Health Policy & Clinical Practice found that spending increased by 25.6 percent within 30 days of hospitalization, and 74.4 percent for care one month to one year after hospitalization. Per patient, Medicare spending increased by $1,560 within the first 30 days after hospitalization and rose by $4,535 within 31 to 365 days.
Costs for care post-30 days were as follows:
- Home health, hospice and medical equipment: 23 percent
- Skilled nursing home: 17 percent
- Inpatient (hospital) care: 13 percent
- Outpatient care: 11 percent
- Doctor appointments: 10 percent
Medicare packages payments to hospitals and physicians for the first 30-days of care. Based on the study’s findings, researchers are suggesting that policy makers extend the current bundled payment, or develop episode-based payments for heart attack care.
The substantial increase in spending has occurred even as hospitalizations for heart attacks have fallen and more people have less invasive procedures to treat their symptoms, including more angioplasty instead of open heart surgery. These advances in strategies have shortened hospital stays by one day.
The study, published in the Journal of the American Medical Association Internal Medicine, is the first to account for how Medicare spent its money over the past decade to help older Americans recover from heart attacks. Researchers adjusted for differences in prices, comorbidities, and inflation. These adjustments are important considering the 212,329 Medicare patients hospitalized for heart attack in 2008 were older and sicker than those hospitalized in the previous decade.
Source: University of Michigan Health System, September 22, 2013
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