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End-of-life expenditures by Ohio Medicaid beneficiaries dying of cancer.

Koroukian SM, Beaird H, Madigan E, Diaz M - Health Care Financ Rev (2006)

Bottom Line: We evaluate the extent to which the Ohio Medicaid Program serves as a safety net to terminally ill cancer patients, and the costs associated with providing care to this patient population.Over a 10-year period, Ohio Medicaid served nearly 45,000 beneficiaries dying of cancer, and spent more than $1 billion in medical care expenditures in their last year of life.Eighty percent of the expenditures were incurred by 67 percent of the decedents who had been enrolled in Medicaid for at least 1 year before death, implying an opportunity for the Medicaid Program to ensure timely transition to palliative care and hospice.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106-4945, USA. skoroukian@case.edu

ABSTRACT
We evaluate the extent to which the Ohio Medicaid Program serves as a safety net to terminally ill cancer patients, and the costs associated with providing care to this patient population. Over a 10-year period, Ohio Medicaid served nearly 45,000 beneficiaries dying of cancer, and spent more than $1 billion in medical care expenditures in their last year of life. Eighty percent of the expenditures were incurred by 67 percent of the decedents who had been enrolled in Medicaid for at least 1 year before death, implying an opportunity for the Medicaid Program to ensure timely transition to palliative care and hospice.

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Medicaid Expenditures in the Last Year of Life, by Decedent's Category of Service, and Anatomic Cancer Site: 1992-2002
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f3-hcfr-28-2-065: Medicaid Expenditures in the Last Year of Life, by Decedent's Category of Service, and Anatomic Cancer Site: 1992-2002

Mentions: The distribution of expenditures by category of service showed that expenditures associated with inpatient hospital services were highest in the youngest age groups (approximately 80 percent of the total), and nearly non-existent in the oldest age group (Figures 1 and 2). Instead, nursing home expenditures comprised 80 percent of the total expenditures in the age group 85 or over, both in dually eligible and non-dually eligible beneficiaries. Such variations were observed by anatomic cancer site (Figure 3), and by length of enrollment in Medicaid in the year prior to death (Figure 4). We note the 50 to 70 percent share of inpatient expenditures relative to total expenditures among beneficiaries enrolling in Medicaid within 3 months prior to death, implying continued intensity of care, even in patients with very short life expectancy. This finding may also reflect that patients possibly enrolled in Medicaid following admission to the hospital—a move that may have been facilitated by the hospital to ensure reimbursement.


End-of-life expenditures by Ohio Medicaid beneficiaries dying of cancer.

Koroukian SM, Beaird H, Madigan E, Diaz M - Health Care Financ Rev (2006)

Medicaid Expenditures in the Last Year of Life, by Decedent's Category of Service, and Anatomic Cancer Site: 1992-2002
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194979&req=5

f3-hcfr-28-2-065: Medicaid Expenditures in the Last Year of Life, by Decedent's Category of Service, and Anatomic Cancer Site: 1992-2002
Mentions: The distribution of expenditures by category of service showed that expenditures associated with inpatient hospital services were highest in the youngest age groups (approximately 80 percent of the total), and nearly non-existent in the oldest age group (Figures 1 and 2). Instead, nursing home expenditures comprised 80 percent of the total expenditures in the age group 85 or over, both in dually eligible and non-dually eligible beneficiaries. Such variations were observed by anatomic cancer site (Figure 3), and by length of enrollment in Medicaid in the year prior to death (Figure 4). We note the 50 to 70 percent share of inpatient expenditures relative to total expenditures among beneficiaries enrolling in Medicaid within 3 months prior to death, implying continued intensity of care, even in patients with very short life expectancy. This finding may also reflect that patients possibly enrolled in Medicaid following admission to the hospital—a move that may have been facilitated by the hospital to ensure reimbursement.

Bottom Line: We evaluate the extent to which the Ohio Medicaid Program serves as a safety net to terminally ill cancer patients, and the costs associated with providing care to this patient population.Over a 10-year period, Ohio Medicaid served nearly 45,000 beneficiaries dying of cancer, and spent more than $1 billion in medical care expenditures in their last year of life.Eighty percent of the expenditures were incurred by 67 percent of the decedents who had been enrolled in Medicaid for at least 1 year before death, implying an opportunity for the Medicaid Program to ensure timely transition to palliative care and hospice.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, OH 44106-4945, USA. skoroukian@case.edu

ABSTRACT
We evaluate the extent to which the Ohio Medicaid Program serves as a safety net to terminally ill cancer patients, and the costs associated with providing care to this patient population. Over a 10-year period, Ohio Medicaid served nearly 45,000 beneficiaries dying of cancer, and spent more than $1 billion in medical care expenditures in their last year of life. Eighty percent of the expenditures were incurred by 67 percent of the decedents who had been enrolled in Medicaid for at least 1 year before death, implying an opportunity for the Medicaid Program to ensure timely transition to palliative care and hospice.

Show MeSH
Related in: MedlinePlus