medicare and end-of-life care in california - slideshow
TRANSCRIPT
Figure 1
NOTE: Estimates rounded to the nearest thousand.SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data Warehouse, 2014 (for total Medicare beneficiary deaths in California in 2014); State of California, Department of Public Health,Death Records (for total deaths in California in 2014).
4 of 5 Californians who died in 2014 were covered by Medicare
246,000 Total Deaths in California
196,000 Total Medicare Beneficiary Deaths in California
Figure 2
19.1%18.3%
16.4%14.8% 14.8% 14.5% 14.3% 13.9%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
22%
2000 2002 2004 2006 2008 2010 2012 2014
NOTE: Excludes beneficiaries in Medicare Advantage. SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data Warehouse, 2000-2014.
The share of total Medicare spending for Californians at the end of life has decreased
Shar
e o
f to
tal M
ed
icar
e s
pen
din
g in
Cal
ifo
rnia
Figure 3
NOTE: Excludes beneficiaries in Medicare Advantage. SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data Warehouse, 2014.
Medicare spending was higher for Californians at the end of life in 2014
$42,048 per person
$9,466 per person
Decedents with Medicare in California
Others with Medicare in California
Figure 4
NOTE: Excludes beneficiaries in Medicare Advantage. 65-year-olds excluded because most are enrolled for less than one year.SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data Warehouse, 2014.
Medicare spending for Californians’ end-of-life care decreased with age in 2014
$5,919 $11,719
$49,456
$24,676
$0
$10,000
$20,000
$30,000
$40,000
$50,000
66-69 70-74 75-79 80-84 85-89 90-94 95+
Spe
nd
ing
pe
r C
alif
orn
ian
Others with Medicare in California
Age Group in Years
Decedents with Medicare in California
Figure 5
20%
39%
NOTE: Excludes beneficiaries in Medicare Advantage. SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data Warehouse, 2000 and 2014.
Medicare hospice use and spending in California has increased
2000 2014 2000 2014
$142.5Million
$814.4Million
Share of California Decedents with Medicare
who Received Hospice Care
Total Medicare Hospice Spending in California
Figure 6
SOURCE: California Health Care Foundation, Cambia Health Foundation, John A. Hartford Foundation, “Topline Results: Survey ofPhysicians on Advance Care Planning Conversations,” fielded February 18-March 7, 2016.
Most physicians in California report not having had training to discuss end-of-life care
34%
Report having had training
Report NOT having had training
63%
3% - Don’t know
Before January 1, 2016, Medicare did not reimburse physicians for patient visits to discuss EOL care.