United 
States Congress


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COMMITTEE ON
WAYS AND MEANS
U.S. HOUSE OF REPRESENTATIVES


MEDICARE AND HEALTH CARE
CHARTBOOK

FEBRUARY 27, 1997
105th Congress


Prepared for the use of Members of the Committee on Ways and Means. This document has not been officially approved by the Committee and may not reflect the views of its Members



UNITED STATES
GOVERNMENT PRINTING OFFICE
WASHINGTON : 1997


For sale by the U.S. Government Printing Office
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Washington DC 20402
ISBSN 0-16-054178-6


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The pages retrieved from the online MEDICARE AND HEALTH CARE CHARTBOOK are in Adobe Acrobat PDF format. If you don't have the Adobe Acrobat Reader, you can download it from Adobe Systems to view PDF files.


Contents

Section 1. What We Spend on Health Care (91K)
Figure 1.1   National Health Expenditures
Figure 1.2   Health Spending as a Share of the Economy in Selected Nations
Figure 1.3   Who Pays Our Health Bills
Figure 1.4   Health Spending by Payment Source
Figure 1.5   Health Spending as a Share of Government Expenditures
Figure 1.6   Per Capita Health Spending in Selected Nations
Figure 1.7   Major Components of Health Expenditures
Figure 1.8   Personal Health Care Spending, by Service Category
Figure 1.9   Growth Rates for Hospital, Physician, and Nursing Home Spending
Figure 1.10  Sources of Hospital Service Payments
Figure 1.11  Total Hospital Marginal Revenues
Figure 1.12  Trends in Hospital Utilization: Inpatient Days and Outpatient Visits
Figure 1.13  Sources of Physician Services Payments
Figure 1.14  Physician Contacts Per Person
Figure 1.15  Physician Supply, Selected Years 1965-1994
Figure 1.16  Sources of Nursing Home Care Payments
Figure 1.17  Nursing Home Use by the Aged


Section 2. Insurance and the Uninsured (1.4MB)
Figure 2.1   Health Insurance Coverage by Type of Insurance
Figure 2.2   Uninsured by Age
Figure 2.3   Uninsured by Region of Residence
Figure 2.4   Source of Children's Insurance
Figure 2.5   Uninsured Children by Age
Figure 2.6   Uninsured Children by Family's Income Relative to Poverty Threshold
Figure 2.7   Uninsured Children by Parents' Insurance Status
Figure 2.8   Uninsured Children by Parents' Employment Status
Figure 2.9   Uninsured Children by Size of Parent's Employer
Figure 2.10  Length of Time Since Child was Last Insured
Figure 2.11  Percent of Children Seeing a Physician in a Two-Week Period
Figure 2.12  Enrollment in Employment-Based Health Plans, by Plan Type
Figure 2.13  Change in Employment-Based Health Insurance Premiums
Figure 2.14  Comparison of Medicare Growth with Private Health Insurance
Figure 2.15  Distribution of Plans by Number of Members
Figure 2.16  Increasing Diversification in the HMO Industry
Figure 2.17  Trends in Inpatient Utilization Rates: HMO Enrollees and the U.S. Population
Figure 2.18  Selected Procedures Per 100,000 Among HMO Members and the Overall Population
Figure 2.19  Preferred Provider Organization (PPO) Enrollment
Figure 2.20  Preferred Provider Organization (PPO) Ownership
Figure 2.21  Extent of Physician Affiliation with Capitation Contracts


Section 3. Medicare (455K)
Figure 3.1   Total Medicare Outlays
Figure 3.2   Total and Net Medicare Outlays
Figure 3.3   Total and Net Medicare Outlays in 1995 Constant Dollars
Figure 3.4   Age Distribution of Medicare Beneficiaries
Figure 3.5   Race/Ethnicity Distribution of Medicare Beneficiaries
Figure 3.6   Medicare Enrollment
Figure 3.7   Medicare Enrollment: Elderly, Disabled and ESRD
Figure 3.8   The Aging of the U.S. Population
Figure 3.9   Income Distribution of Elderly and Disabled Medicare Beneficiaries
Figure 3.10  Percent of Poor Persons in the U.S. Population
Figure 3.11  Distribution of Medicare Benefit Payments by Service Category
Figure 3.12  Trends in Distribution of Total Medicare Payments for Selected Services
Figure 3.13  Five-Year Average Annual Medicare Growth Rates
Figure 3.14  Medicare Short-Stay Hospital Utilization, Selected Fiscal Years
Figure 3.15  Trend in Indirect Medical Education (IME) and Direct Graduate Medical Education (Direct GME) Spending for Medicare
Figure 3.16  Trend in Number of Medical Residents
Figure 3.17  Selected Primary Care Residents as a Percent of Total Residents
Figure 3.18  Trend in Medicare Payments for Skilled Nursing Facility (SNF) Care
Figure 3.19  Average Annual Rates of Change for Skilled Nursing Facility Care, by Persons Served, Days Used Per Person Served, and Payment Per Day
Figure 3.20  Trend in Medicare Payments for Home Health
Figure 3.21  Average Annual Rate of Change for Home Health Benefits by People Served, Visits Per Person Served, and Payments Per Visit
Figure 3.22  Medicare Spending for Selected Service Categories, by Major Diagnostic Classifications
Figure 3.23  Average Medicare Benefit Payment Per Beneficiary
Figure 3.24  Distribution of Medicare Spending for Beneficiaries
Figure 3.25  Average Medicare Part A and Part B Benefit Payment Per Elderly Enrollee, by Age
Figure 3.26  Average Medicare Benefit Payment Per User of Services by Mortality, ESRD, and Hospital Status
Figure 3.27  Average Medicare Payments Per Enrollee by State
Figure 3.28  Trends in Medicare Part A and Part B Administrative Expenses
Figure 3.29  Administrative Costs: Medicare Compared to Private Insurance and HMOs
Figure 3.30  Trends in Medicare Claims Volume
Figure 3.31  Medicare Part A Trust Fund: Income and Outlays
Figure 3.32  Medicare Part A Trust Fund: End-of-Year Balance
Figure 3.33  Medicare Part A Trust Fund: Projected Income and Cost Rates
Figure 3.34  Medicare Part A Trust Fund: Number of Workers Per Beneficiary
Figure 3.35  Medicare Part B Premium as a Percent of Total Part B Trust Fund Income
Figure 3.36  Sources of Payment for Health Care, for All Beneficiaries, Elderly and Disabled
Figure 3.37  Spending for Health as a Percentage of After-Tax Income, Elderly and Non-Elderly Households
Figure 3.38  Sources of Health Insurance for Medicare Beneficiaries
Figure 3.39  Sources of Health Insurance, by Medicare Status


Section 4. Medicare Risk HMOs (455K)
Figure 4.1   Risk HMOs Participating in Medicare
Figure 4.2   Beneficiaries Enrolled in Medicare Risk HMOs
Figure 4.3   Distribution of Medicare Beneficiaries, by Number of Risk HMOs Available in Their Area
Figure 4.4   Medicare Beneficiaries in Urban and Rural Locations Who are Enrolled in Risk HMOs
Figure 4.5   Variation in Number of Risk HMOs Available to Medicare Beneficiaries in Urban and Rural Locations
Figure 4.6   Medicare Beneficiaries Enrolled in Risk HMOs, by State
Figure 4.7   Distribution of Medicare Risk HMO Enrollees Among Selected States
Figure 4.8   Growth in Medicare Risk HMO Enrollment
Figure 4.9   Growth in Medicare Risk HMO Enrollment
Figure 4.10  State Medicare Population with at Least One Medicare Risk HMO Available
Figure 4.11  Percent of Medicare Beneficiaries Enrolled in Risk HMOs by Number of Plans Available in Their Area
Figure 4.12  Medicare Risk Contract Plan Terminations, 1985-1995185
Figure 4.13  Enrollment Distribution by Duration of Medicare Risk HMO Contract
Figure 4.14  Medicare Risk HMO Contracts by Plan Model
Figure 4.15  Spread of County AAPCCs by Location
Figure 4.16  Spread of County AAPCCs Within Selected PMSAs
Figure 4.17  Medicare Risk HMOs Offering Additional Benefits in Their Basic Option Package
Figure 4.18  Distribution of Medicare Risk HMOs by Premium Charged
Figure 4.19  Age Distribution of Medicare HMO and Fee-for-Service Enrollees
Figure 4.20  Distribution of Medicare HMO Enrollees versus Medicare Fee-for-Service Enrollees, by Income
Figure 4.21  Medicare Risk HMOs: Costs as a Percentage of Average Medicare Spending Per Beneficiary
Figure 4.22  Relative Health Status of Medicare HMO Enrollees
Figure 4.23  Beneficiary Satisfaction with Medicare HMOs and Fee-for-Service
Figure 4.24  Beneficiary Dissatisfaction with Medicare HMOs and Fee-for-Service
Figure 4.25  Reasons for Disenrolling from Medicare Risk HMOs and Switching to Medicare Fee-for-Service
Figure 4.26  Trends in Relative Growth in HMO Enrollment: Medicare Versus Non-Medicare Markets
Figure 4.27  Non-Medicare and Medicare HMO Penetration in Selected States
Figure 4.28  Estimated Medical Education and Disproportionate Share Payments as Components of Medicare Risk HMO Payment Rates, by Urban and Rural Location


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