CMS Report Examines Patterns of Multiple Chronic Conditions in States with Large Medicare Populations

A report released by the Centers for Medicare and Medicaid Services (CMS) is the first to examine state-specific patterns of multiple chronic conditions (MCC) within a large Medicare population—over 31 million beneficiaries were included in the study, using 2011 claims data from the traditional Medicare program. CMS found that two-thirds of Medicare beneficiaries in traditional, or fee-for-service Medicare, have two or more chronic conditions. About 14 percent of beneficiaries have six or more chronic conditions and this segment of the Medicare population accounts for almost half of total Medicare spending.

CMS found that prevalence rates for Medicare beneficiaries with six or more chronic conditions were highest in Florida and New Jersey. State-level per capita Medicare spending was $9,436 on average throughout the U.S. and increased to $31,543 on average for beneficiaries with more six or more chronic conditions. Spending on beneficiaries with six or more chronic conditions was lowest in Oregon, Maine and New York, with all three states spending less than $28,000 per capita. The number of emergency department (ED) visits per beneficiary with six or more chronic conditions was also lowest in New York, followed by Florida. CMS found that while New York had a high prevalence of beneficiaries with six or more chronic conditions, its Medicare spending per beneficiary and rates for both hospital readmission and

ED visits were near or below the national average for each indicator. According to CMS, variations like the ones found in New York prove the need for further study of state-specific patterns of MCC, as well state practices for health monitoring, surveillance, program planning, regulation, financing and delivery of health care.

Read the CMS report.