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. 2013 Jul 23;3(3):mmrr.003.03.b02.
doi: 10.5600/mmrr.003.03.b02. eCollection 2013.

Multiple chronic conditions among Medicare beneficiaries: state-level variations in prevalence, utilization, and cost, 2011

Kimberly A Lochner  1 , Richard A Goodman  2 , Samual Posner  3 , Anand Parekh  4
Affiliations

Multiple chronic conditions among Medicare beneficiaries: state-level variations in prevalence, utilization, and cost, 2011

Kimberly A Lochner et al. Medicare Medicaid Res Rev. .

Abstract

Objectives: Individuals with multiple (>2) chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment. To assist health policy makers and to fill research gaps on MCC, we describe state-level variation of MCC among Medicare beneficiaries, with a focus on those with six or more conditions.

Methods: Using Centers for Medicare & Medicaid Services administrative data for 2011, we characterized a beneficiary as having MCC by counting the number of conditions from a set of fifteen conditions, which were identified using diagnosis codes on the claims. The study population included fee-for-service beneficiaries residing in the 50 U.S. states and Washington, DC.

Results: Among beneficiaries with six or more chronic conditions, prevalence rates were lowest in Alaska and Wyoming (7%) and highest in Florida and New Jersey (18%); readmission rates were lowest in Utah (19%) and highest in Washington, DC (31%); the number of emergency department visits per beneficiary were lowest in New York and Florida (1.6) and highest in Washington, DC (2.7); and Medicare spending per beneficiary was lowest in Hawaii ($24,086) and highest in Maryland, Washington, DC, and Louisiana (over $37,000).

Conclusion: These findings expand upon prior research on MCC among Medicare beneficiaries at the national level and demonstrate considerable state-level variation in the prevalence, health care utilization, and Medicare spending for beneficiaries with MCC. State-level data on MCC is important for decision making aimed at improved program planning, financing, and delivery of care for individuals with MCC.

Keywords: Administrative Data Uses; Chronic Disease; Geographic; Medicare; Small area variations; Spatial Factors.

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Figures

Exhibit 6
Exhibit 6. State Maps of Prevalence, Hospital Readmissions, ED visits, and Medicare Spending for Medicare Beneficiaries with Six or More Chronic Conditions by State: 2011
See this image and copyright information in PMC

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