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Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.

Selected Research

High Cost Medicare Beneficiaries
Congressional Budget Office, 5-1-05

Researchers and policymakers are hoping to rein in public and private health care costs by focusing on the relatively small number of patients with multiple chronic conditions who account for the vast majority of health care expenditures. This study by the CBO shows that this is, in principle, possible—but it is also probably very difficult.

For example, high-cost beneficiaries (those in the top 25 percent in terms of their spending) accounted for 85 percent of annual expenditures in 2001 and for 68 percent of five-year cumulative expenditures from 1997 to 2001. In addition, those high-cost beneficiaries, compared with beneficiaries in the bottom 75 percent in terms of their spending, were slightly older, more likely to suffer from chronic conditions, such as coronary artery disease and diabetes, and more likely to die in a given year.

The real challenge, however, is reliably identifying those beneficiaries and treating them in a way that saves money. Currently, the Centers for Medicare and Medicaid Services are running several demonstration projects on various strategies for reducing expenditures on high-cost beneficiaries, while still offering quality care. We’ll know more about what works—and what doesn’t—when those studies are completed.



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