A growing number of Medicare patients have one or more chronic diseases, which leads to greater use of health care services. According to a new American Hospital Association TrendWatch report, about four out of five Medicare beneficiaries are affected by a chronic condition such as heart disease, cancer, hypertension, diabetes and stroke, and two-thirds of beneficiaries in 2008 had at least two or more chronic conditions.

This older, sicker population uses more health care services, which translates to higher spending. Overall spending for a patient with one chronic condition is almost three times greater than spending for someone without any chronic conditions, and spending for a patient with five or more chronic conditions is about 17 times greater, according to the report.

Among the other findings:

  • The percentage of obese patients age 65 and older has doubled since 1987 to 38 percent in 2009–2010. Obesity is a risk factor for several chronic conditions.
  • The rate of diabetes among seniors has increased from 18 percent in 2002 to nearly 27 percent in 2010.
  • The prevalence of patients with end-stage renal disease grew by 53 percent between 1999 and 2009. In 2008, Medicare spent an average of $65,256 per ESRD beneficiary compared with $9,676 per beneficiary age 65 and older without ESRD.
  • Americans are living longer. Life expectancy is 78.2 years. As a result, and in combination with the aging baby boomer population, the number of Medicare beneficiaries is projected to double in the next 40 years.
  • The overall risk of mortality dropped by 60 percent from 1935 to 2010. People who would have died of heart disease, kidney disease, cancer or diabetes a generation ago are living longer with better quality of life as these diseases are managed effectively through new surgical and medical interventions. Between 2000 and 2008, for example, the age-adjusted death rates for heart disease and cancer decreased by 28 percent and 12 percent, respectively.
  • Medical and technological advances improve outcomes, but they also often raise costs. For example, average inpatient Medicare spending per heart attack case rose from $10,336 in 1999 to $14,009 in 2006.

For more, go to www.aha.org/research/policy/2012.shtml.