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MEDICARE

TABLE OF CONTENTS
Medicare
Table of Contents

Overview
07 U.S. health care expenditure distribution by payer 2014-2018
08 Percentage of U.S. Americans covered by Medicare 1990-2017
09 Characteristics of the Medicare population 2017
10 Total Medicare income 1970-2017
11 Estimated Medicare revenue sources 2017
12 Total Medicare assets at year-end 1970-2017

Spending/costs
14 Spending distribution of Medicare and Medicaid in the U.S. 2016
15 Total Medicare spending 1970-2017
16 Medicare benefit payments by type of service 2007 vs 2017
17 Supplementary Medical Insurance Medicare benefit payments 2015-2017
18 Hospital Insurance Medicare benefit payments 2015-2017
19 Leading U.S. not-for-profit hospitals by Medicare patient charges 2016
20 Leading medical traditional therapy areas by Medicare PMPY spending 2016

Enrollment/beneficiaries
Table of Contents

22 Medicare level of beneficiaries by type of beneficiary 1966-2017


23 Distribution of Medicare beneficiaries 2016, by ethnicity
24 Distribution of Medicare beneficiaries 2015 and 2016, by federal poverty level
25 Top U.S. states by Medicare beneficiaries as a percentage of total population 2016
26 Top U.S. states by number of Medicare beneficiaries 2016

Infrastructure
28 Medicare - number of hospital facilities in the U.S. 1967-2016
29 Medicare - total number of hospital beds in the U.S. 1967-2016
30 Medicare - number of skilled nursing facilities in the U.S. 1967-2016
31 Medicare - number of home health agencies in the U.S. 1967-2016
32 Medicare - number of psychiatric hospital facilities in the U.S. 1967-2016

Drugs
34 Prescription drugs spending in the U.S. by payer 2012-2016
35 Payer share of Medicare Part D retail prescriptions by therapy class 2018
36 Out of pocket costs of Medicare Part D retail prescription by drug therapy 2018
37 Share of branded drug costs in Medicare Part D gap in the U.S. 2016-2020
38 Share of generic drug costs in Medicare Part D gap in the U.S. 2016-2020
Table of Contents

39 Common Medicaid respiratory agent prescriptions by product 2016-2017

Outlook
41 Health spending distribution in the United States by payer 2014-2026
42 U.S. Medicare outlays and forecast 2000-2028
43 U.S. Medicare outlays and forecast 2000-2028 as a percentage of the GDP
44 Annual growth in Medicare per capita spending and other measures 1990-2027
45 Medicare and Medicaid costs from individuals with Alzheimer's in the U.S. 2018-2050
OVERVIEW
Medicare
Distribution of U.S. health care expenditure from 2014 to 2018, by payer
U.S. health care expenditure distribution by payer 2014-2018
Chart Title

2018 2017 2016 2015 2014

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%


34%
34%
Private insurance 33%
33.4%
33.1%
20%
20%
Medicare 20%
19.9%
20.1%
17%
17%
Medicaid 17%
16.7%
16.6%
12%
12%
Other government programs 12%
11.8%
12.1%
10%
10%
Out-of-pocket 10%
10.9%
11.1%
7%
7%
Other private 8%
7.3%
7%
Percentage of health care expenditure

Note: United States; financial years 2014 to 2018


Further information regarding this statistic can be found on page 47.
Source(s): US Department of the Treasury; CMS; ID 237043
7 Overview
Percentage of people covered by Medicare in the United States from 1990 to 2017
Percentage of U.S. Americans covered by Medicare 1990-2017

20.0%
data

18.0%

16.0%

14.0%
Percentage of population

12.0%

10.0%

8.0%

6.0%

4.0%

2.0%

0.0%
'90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17

Note: United States


Further information regarding this statistic can be found on page 48.
Source(s): US Census Bureau; ID 200962
8 Overview
Characteristics of the Medicare population in 2017
Characteristics of the Medicare population 2017
data

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

Per capita annual income below $26,200 50%

Per capita savings below $74,450 50%

1+ ADL limitations* 36%

Cognitive/mental impairment 34%

5+ chronic conditions 30%

Fair/poor health 27%

Under-65 disabled 17%

Age 85+ 13%

Long-term care facility resident 4%

Percentage of total Medicare population

Note: United States


Further information regarding this statistic can be found on page 49.
Source(s): Kaiser Family Foundation; ID 246650
9 Overview
Total Medicare income from 1970 to 2017 (in billion U.S. dollars)*
Total Medicare income 1970-2017

800
data

721
687.7
700
629.9
597.7
600
556.7
528 532.6
Total income in billion U.S. dollars

491.5 500.7
500 474.6
457.1
422.3

400
349.4

300
248.9

200 173
125.7

100 75.5
35.7
7.5 16.9
0
1970 1975 1980 1985 1990 1995 2000 2005 2006 2007 2008 2009 2010 2011 2012 2013** 2014** 2015 2016 2017

Note: United States


Further information regarding this statistic can be found on page 50.
Source(s): CMS; ID 248077
10 Overview
Estimated sources of Medicare revenue in 2017*
Estimated Medicare revenue sources 2017
Interest and other Taxation of social Payments from states Beneficiary premiums Payroll taxes General revenue
security benefits

Part A 3% 8% - 1% 87% 1%
Part B 2% - - 27% - 71%

Part D - - 11% 15% - 73%

Total 2% 3% 2% 14% 37% 41%

Note: United States


Further information regarding this statistic can be found on page 51.
Source(s): CMS; Kaiser Family Foundation; ID 245615
11 Overview
Total Medicare assets at year-end from 1970 to 2017 (in billion U.S. dollars)
Total Medicare assets at year-end 1970-2017

400
data

378.1
371.4
358.7
350.9
350 336.4
318.6
301.2
294.6
300
276.2 273.6 272.1
265.3
Total assets in billion U.S. dollars

258.6
250

214

200

143.4
150

110.2
100

50 31.9
19
11.3
2.7
0
1970 1975 1980 1985 1990 1995 2000 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Note: United States


Further information regarding this statistic can be found on page 52.
Source(s): CMS; ID 248081
12 Overview
SPENDING/COSTS
Medicare
Spending distribution of Medicare and Medicaid in the United States in 2016*
Spending distribution of Medicare and Medicaid in the U.S. 2016
Chart Title

Medicaid Medicare

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%

34%
Hospital care
40%
13%
Physician and clinical services
22%
6%
Prescription drugs
14%
9%
Nursing care facilities
6%
6%
Home health care
6%
6%
Net cost of insurance
5%
1%
Other professional services
3%
4%
Government administration
2%
1%
Other medical products
1%
17%
Other health care
1%
Spending distribution

Note: United States


Further information regarding this statistic can be found on page 53.
Source(s): CMS; CHCF; ID 247706
14 Spending/costs
Total Medicare spending from 1970 to 2017 (in billion U.S. dollars)*
Total Medicare spending 1970-2017

800
data

707.4
694.5
700
638.1
600.3
600 581.7
560.3 550.1
Total spending in billion U.S. dollars

521.2
498.3
500
455.1
434.8

400 380.5
336.9

300

219.3
200 180.1

109.7
100 71.4
35
7.1 14.8
0
1970 1975 1980 1985 1990 1995 2000 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Note: United States


Further information regarding this statistic can be found on page 54.
Source(s): CMS; ID 248073
15 Spending/costs
Medicare benefit payments by type of service in 2007 and 2017
Medicare benefit payments by type of service 2007 vs 2017
Chart Title

2007 2017

50.0%
47%
44%
45.0%
42%
41%
40.0%

35.0%
Percentage of total

30.0%

25.0%

20.0%

14%
15.0%
11%
10.0%

5.0%

0.0%
Part A* Part B* Part C

Note: United States


Further information regarding this statistic can be found on page 55.
Source(s): US Congressional Budget Office; Kaiser Family Foundation; ID 246644
16 Spending/costs
Distribution of Supplementary Medical Insurance (SMI) Medicare benefit payments from 2015
to 2017*
Supplementary Medical Insurance Medicare benefit payments 2015-2017
Chart Title

2017 2016 2015

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0%

29%
Medicare Advantage 27%
26%
23%
Prescription drugs 24%
24%
17%
Physician 18%
20%
13%
Hospital 12%
12%
3%
Home health 3%
3%
2%
DME 2%
2%
1%
Lab 1%
2%
11%
Other 11%
11%
Percentage of total payment

Note: United States


Further information regarding this statistic can be found on page 56.
Source(s): CMS; ID 237048
17 Spending/costs
Distribution of Hospital Insurance (HI) Medicare benefit payments from 2015 to 2017*
Hospital Insurance Medicare benefit payments 2015-2017
Chart Title

2017 2016 2015

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%

49%
Inpatient hospital 51%
52%

32%
Managed care 30%
29%

10%
Skilled nursing facility 10%
11%

6%
Hospice 6%
6%

2%
Home Health Agency 2%
2%

Percentage of total payment

Note: United States


Further information regarding this statistic can be found on page 57.
Source(s): CMS; ID 247990
18 Spending/costs
Top U.S. not-for-profit hospitals by Medicare patient charges as of 2016 (in billion U.S.
dollars)*
Leading U.S. not-for-profit hospitals by Medicare patient charges 2016
data

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 5.5

Cedars-Sinai Medical Center (West Hollywood,CA) 4.98

Florida Hospital Orlando (Orlando, FL) 3.36

Stanford Health (Stanford, CA) 3.21

New York Presbyterian Hospital/Weill Cornell Medical Center (New York, NY) 2.77

Hospital of the University of Pennsylvania (Philadelphia, PA) 2.67


Hospital (Location)
UPMC Presbyterian (Pittsburgh, PA) 2.47

Yale-New Haven Hospital (New Haven, CT) 2.42

Massachusetts General Hospital (Boston, MA) 2.27

Cleveland Clinic Hospital (Cleveland, OH) 2.26

UCSF Medical Center at Parnassus (San Francisco, CA) 2.09


Charges in billion U.S. dollars

Note: United States; as of April 2016


Further information regarding this statistic can be found on page 58.
Source(s): Billian's HealthDATA; CMS; ID 581299
19 Spending/costs
Top 10 traditional therapy classes in the U.S. by Medicare per-member-per-year (PMPY) spending in
2016 (in U.S. dollars)*
Leading medical traditional therapy areas by Medicare PMPY spending 2016
data

0 50 100 150 200 250 300 350 400 450 500

Diabetes 439.39

Pain/inflammation 218.76

High blood cholesterol 209.26

High blood pressure/heart disease 200.21

Mental/neurological disorders 161.08

Asthma 140.78

Anticoagulants 128.56

Heartburn/ulcer disease 105.72

Urinary disorders 88.38

Chronic obstructive pulmonary disease 82.82

PMPY spending in U.S. dollars

Note: United States


Further information regarding this statistic can be found on page 59.
Source(s): Express Scripts Inc; ID 659317
20 Spending/costs
ENROLLMENT/BENEFICIARIES
Medicare
Enrollment in the Medicare program from 1966 to 2017, by type of beneficiary (in millions)
Medicare level of beneficiaries by type of beneficiary 1966-2017
Chart Title

Age Disabled

60

49.5
50 47.8
46.8
45
43.5
41.9
40.4
40
Beneficiaries in millions

35.8
33.2

30 28.1

22.7
19.1
20

8.5 8.8 8.8 9 9.1 9 8.9


10
6.8
4.4
2.2 2.9
0
0
1966 1975 1985 1995 2005 2011 2012 2013 2014 2015 2016 2017

Note: United States


Further information regarding this statistic can be found on page 60.
Source(s): CMS; ID 237045
22 Enrollment/beneficiaries
Distribution of Medicare beneficiaries in 2016, by ethnicity
Distribution of Medicare beneficiaries 2016, by ethnicity

80.0%
data

76%

70.0%
Percentage of total Medicare beneficiaries

60.0%

50.0%

40.0%

30.0%

20.0%

10%
10.0% 8%
6%

0.0%
White Black Hispanic Other
Ethnicity

Note: United States


Further information regarding this statistic can be found on page 61.
Source(s): Kaiser Family Foundation; ID 248039
23 Enrollment/beneficiaries
Distribution of Medicare beneficiaries in 2015 and 2016, by federal poverty level
Distribution of Medicare beneficiaries 2015 and 2016, by federal poverty level
Chart Title

2015 2016

40.0%

35.0% 34%
33%
31% 31%
Percentage of total Medicare beneficiaries

30.0%

25.0% 24%
23%

20.0%

15.0%
11% 11%
10.0%

5.0%

0.0%
Under 100% 100-199% 200-399% 400% or over
Federal poverty level

Note: United States


Further information regarding this statistic can be found on page 62.
Source(s): Kaiser Family Foundation; ID 248036
24 Enrollment/beneficiaries
Top 10 U.S. states based on Medicare beneficiaries as a percentage of total population in
2016
Top U.S. states by Medicare beneficiaries as a percentage of total population 2016
data

0.0% 5.0% 10.0% 15.0% 20.0% 25.0%

Maine 23.6%

West Virginia 23.1%

Vermont 21.7%

New Hampshire 20.4%

Alabama 20.3%

Arkansas 20.3%

Pennsylvania 20.2%

Florida 20.2%

Montana 20.1%

Kentucky 19.8%

Percentage of total population

Note: United States


Further information regarding this statistic can be found on page 63.
Source(s): CMS; US Census Bureau; ID 247968
25 Enrollment/beneficiaries
Top 10 U.S. states based on number of Medicare beneficiaries in 2016
Top U.S. states by number of Medicare beneficiaries 2016
data

0 1000000 2000000 3000000 4000000 5000000 6000000 7000000

California 5,814,275

Florida 4,163,699

Texas 3,757,335

New York 3,410,034

Pennsylvania 2,581,572

Ohio 2,202,060

Illinois 2,108,645

Michigan 1,938,307

North Carolina 1,823,035

Georgia 1,573,277

Number of Medicare beneficiaries

Note: United States


Further information regarding this statistic can be found on page 64.
Source(s): CMS; ID 248030
26 Enrollment/beneficiaries
INFRASTRUCTURE
Medicare
Number of Medicare hospital facilities in the U.S. from 1967 to 2016*
Medicare - number of hospital facilities in the U.S. 1967-2016
data

0 1000 2000 3000 4000 5000 6000 7000

2016 6,146

2015 6,140

2014 6,142

2013 6,164

2012 6,170

2011 6,172

2010 6,169

2009 6,172

2008 6,171

2007 6,163

2006 6,177

2005 6,180

2000 6,031

1995 6,376

1990 6,522
Number of facilities

Note: United States


Further information regarding this statistic can be found on page 65.
Source(s): CMS; ID 195240
28 Infrastructure
Total number of Medicare hospital beds in the U.S. from 1967 to 2016*
Medicare - total number of hospital beds in the U.S. 1967-2016
data

0 200000 400000 600000 800000 1000000 1200000

2016 933,209

2015 931,951

2014 931,057

2013 934,874

2012 931,458

2011 925,951

2010 927,535

2009 926,388

2008 930,452

2007 933,998

2006 938,762

2005 947,305

2000 982,616

1995 1,056,454

1990 1,104,703
Number of beds

Note: United States


Further information regarding this statistic can be found on page 66.
Source(s): CMS; ID 195319
29 Infrastructure
Number of Medicare skilled nursing facilities in the U.S. from 1967 to 2016*
Medicare - number of skilled nursing facilities in the U.S. 1967-2016
data

0 2000 4000 6000 8000 10000 12000 14000 16000 18000

2016 15,274

2015 15,236

2014 15,179

2013 15,156

2012 15,143

2011 15,132

2010 15,084

2009 15,071

2008 15,032

2007 15,054

2006 15,028

2005 15,006

2000 14,841

1995 13,452

1990 9,008
Number of facilities

Note: United States


Further information regarding this statistic can be found on page 67.
Source(s): CMS; ID 195317
30 Infrastructure
Number of Medicare home health agencies in the U.S. from 1967 to 2016*
Medicare - number of home health agencies in the U.S. 1967-2016
data

0 2000 4000 6000 8000 10000 12000 14000

2016 11,956

2015 12,149

2014 12,268

2013 12,459

2012 12,253

2011 11,930

2010 10,914

2009 10,184

2008 9,407

2007 9,024

2006 8,618

2005 8,090

2000 7,099

1990 6,461

1980 3,012
Number of facilities

Note: United States


Further information regarding this statistic can be found on page 68.
Source(s): CMS; ID 195318
31 Infrastructure
Number of Medicare psychiatric hospital facilities in the U.S. from 1967 to 2016*
Medicare - number of psychiatric hospital facilities in the U.S. 1967-2016
data

0 100 200 300 400 500 600

2016 570

2015 560

2014 551

2013 541

2012 527

2011 509

2010 511

2009 506

2008 491

2007 490

2006 482

2005 473

2004 470

2003 478

2002 487
Number of facilities

Note: United States


Further information regarding this statistic can be found on page 69.
Source(s): CMS; ID 195316
32 Infrastructure
DRUGS
Medicare
Prescription drugs spending in the United States from 2012 to 2016, by payer (in billion U.S.
dollars)
Prescription drugs spending in the U.S. by payer 2012-2016
Chart Title

2012 2013 2014 2015 2016

160

140

120
Spending in billion U.S. dollars

100

80

60

40

20

0
Private health insurance Out-of-pocket Other payers Medicare Medicaid Other public health insurance

Note: United States


Further information regarding this statistic can be found on page 70.
Source(s): CMS; CHCF; ID 247700
34 Drugs
Medicare Part D payer share of retail prescriptions in 2018, by therapy area*
Payer share of Medicare Part D retail prescriptions by therapy class 2018
data

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0%

Acute coronary syndromes (ACS) 39%

Asthma 22.7%

Breast Cancer 27.7%

Cholesterol 38.6%

Depression 23.6%

Diabetes 33.9%

Hypertension 36.8%

Multiple Sclerosis 37.4%

Myocardial infarction (MI) 37.3%

Osteoarthritis 23.2%

Prostate cancer 20.2%

Rheumatoid arthritis 21.9%

Medicare Part D payer share of prescription drugs

Note: United States


Further information regarding this statistic can be found on page 71.
Source(s): CMS; Sanofi; IQVIA; ID 320747
35 Drugs
Out-of-pocket costs per Medicare Part D retail prescription by therapy area in 2018 (in U.S.
dollars)*
Out of pocket costs of Medicare Part D retail prescription by drug therapy 2018
data

0 5 10 15 20 25 30

Diabetes 26.9

Asthma 23.27

Prostate cancer 21.87

Breast cancer 13.82

Cholesterol 10.73

Rheumatoid arthritis 9.28

Multiple Sclerosis 8.68

Osteoarthritis 8.64

Depression 8.32

ACS 8.09

Hypertension 6.96

AMI 6.12
Out of pocket costs per prescription in U.S. dollars

Note: United States


Further information regarding this statistic can be found on page 72.
Source(s): CMS; Sanofi; IQVIA; ID 320750
36 Drugs
Cost sharing for branded drugs in the Medicare Part D coverage gap from 2016 to 2020
Share of branded drug costs in Medicare Part D gap in the U.S. 2016-2020
Chart Title

Paid by enrollee Paid by CMS Manufacturer discount

120.0%

100.0%
50% 50% 50% 50% 50%

80.0%
Distribution of drug costs

60.0%

5% 10% 15% 20% 25%


45%
40.0%
40%
35%
30%
25%
20.0%

0.0%
2016 2017 2018 2019 2020

Note: United States; 2016


Further information regarding this statistic can be found on page 73.
Source(s): CMS; Sanofi; ID 320731
37 Drugs
Cost sharing for generic drug costs in the Medicare Part D coverage gap from 2016 to 2020
Share of generic drug costs in Medicare Part D gap in the U.S. 2016-2020
Chart Title

Paid by enrollee Paid by CMS

120.0%

100.0%
42% 49% 56% 63% 75%

80.0%
Distribution of drug costs

60.0%
58%
51%

40.0% 44%
37%

25%
20.0%

0.0%
2016 2017 2018 2019 2020

Note: United States; 2015


Further information regarding this statistic can be found on page 74.
Source(s): CMS; Sanofi; ID 320743
38 Drugs
Number of common Medicaid respiratory agent prescriptions annually in 2016 and 2017, by
product*
Common Medicaid respiratory agent prescriptions by product 2016-2017
Chart Title

2016 2017

9000000
8,362,287

8000000

7,040,910
7000000

5,911,311
Medicaid prescriptions per year

6000000
5,135,837
5000000

4,072,399 4,214,275
4000000

3000000

2000000

1000000

0
Ventolin HFA (brand) Montelukast Sodium (generic) Albuterol Sulfate (generic)

Note: United States


Further information regarding this statistic can be found on page 75.
Source(s): Sanofi; IQVIA; ID 323185
39 Drugs
OUTLOOK
Medicare
Health spending distribution in the United States 2014-2016 and projections for 2026, by
payer*
Health spending distribution in the United States by payer 2014-2026
Chart Title

2026 2016 2015 2014

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0%

31.2%
33.7%
Private health insurance
33.4%
33%

24%
20.1%
Medicare
20.3%
20.5%

17.5%
16.9%
Medicaid
17%
16.4%

9.7%
10.6%
Out-of-pocket
10.6%
10.9%

3.8%
3.8%
Other public health insurance
3.8%
3.7%
Percentage of health spending

Note: United States; 2014 to 2016


Further information regarding this statistic can be found on page 76.
Source(s): CMS; CHCF; ID 247517
41 Outlook
Medicare outlays and forecast in the United States from 2000 to 2028 (in billion U.S. dollars)
U.S. Medicare outlays and forecast 2000-2028

1600
data

1400

1200
Medicare outlays in billion U.S. dollars

1000

800

600

400

200

0
'00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18* '19* '20* '21* '22* '23* '24* '25* '26* '27* '28*

Note: United States; 2000 to 2017


Further information regarding this statistic can be found on page 77.
Source(s): US Congressional Budget Office; ID 217612
42 Outlook
Medicare outlays and forecast in the United States from 2000 to 2028 (as a percentage of the
GDP)
U.S. Medicare outlays and forecast 2000-2028 as a percentage of the GDP

6.0%
data

5.0%

4.0%
Percentage of the GDP

3.0%

2.0%

1.0%

0.0%
'00 '01 '02 '03 '04 '05 '06 '07 '08 '09 '10 '11 '12 '13 '14 '15 '16 '17 '18* '19* '20* '21* '22* '23* '24* '25* '26* '27* '28*

Note: United States; 2000 to 2017


Further information regarding this statistic can be found on page 78.
Source(s): US Congressional Budget Office; ID 217656
43 Outlook
Average annual growth rate in Medicare per capita spending and other measures in the U.S. between
1990s and 2027
Annual growth in Medicare per capita spending and other measures 1990-2027
Chart Title

1990s 2000s 2010-2017 2017-2027*

10.0%

9%
9.0%

8.0%
7.3% 7.2% 7.3% 7.2%
Growth rate in per capita spending

7.0%

5.8% 5.9%
6.0%

5.0% 4.6% 4.5%


4.3%
3.8%
4.0%

3.0%

2.0% 1.5%

1.0%

0.0%
Medicare per capita spending Total Medicare spending PHI per capita spending**

Note: United States; as of June 2018


Further information regarding this statistic can be found on page 79.
Source(s): Kaiser Family Foundation; ID 245609
44 Outlook
Costs of care for individuals in the U.S. with Alzheimer's disease to Medicare and Medicaid from 2018 to
2050 (in billion U.S. dollars)
Medicare and Medicaid costs from individuals with Alzheimer's in the U.S. 2018-2050

800
data

750

700

609
600
Care costs in billion U.S. dollars

506
500

402
400

310
300
239
202
186
200

100

0
2018 2020 2025 2030 2035 2040 2045 2050

Note: United States; as of March 2018


Further information regarding this statistic can be found on page 80.
Source(s): Alzheimer's Association; ID 643072
45 Outlook
REFERENCES
Medicare
Distribution of U.S. health care expenditure from 2014 to 2018, by payer
U.S. health care expenditure distribution by payer 2014-2018

Source and methodology information Notes:


Source(s) US Department of the Treasury; CMS The statistic was assembled from several editions of the CMS Financial report .

Conducted by US Department of the Treasury

Survey period financial years 2014 to 2018

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date November 2018

Original source CMS Financial Report - Fiscal Year 2018, page 2

Website URL visit the website

Back to statistic

47 References
Percentage of people covered by Medicare in the United States from 1990 to 2017
Percentage of U.S. Americans covered by Medicare 1990-2017

Source and methodology information Notes:


Source(s) US Census Bureau This statistic was assembled from several editions of the same report.

Conducted by US Census Bureau

Survey period 1990 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by US Census Bureau

Publication date September 2018

Original source Health Insurance Coverage in the United States: 2017, page 4

Website URL visit the website

Back to statistic

48 References
Characteristics of the Medicare population in 2017
Characteristics of the Medicare population 2017

Source and methodology information Notes:


Source(s) Kaiser Family Foundation * Functional impairment; ADL = activity of daily living.

Conducted by Kaiser Family Foundation; Urban Institute; CMS

Survey period 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date November 2017

Original source An Overview of Medicare - Issue Brief, page 1

Website URL visit the website

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49 References
Total Medicare income from 1970 to 2017 (in billion U.S. dollars)*
Total Medicare income 1970-2017

Source and methodology information Notes:


Source(s) CMS * Data are for fiscal years. ** Reflects the adjustment made by Treasury in November of 2014 to account for $2.6 billion in Part B
drug fee income in September of 2013, rather than in October of 2013 when it was actually received.
Conducted by CMS

Survey period 1970 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 221

Website URL visit the website

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50 References
Estimated sources of Medicare revenue in 2017*
Estimated Medicare revenue sources 2017

Source and methodology information Notes:


Source(s) CMS; Kaiser Family Foundation * Numbers may not sum to totals due to rounding. Data are for the calendar year.

Conducted by CMS (2017 Annual Report of the Boards of Trustees of the Federal Hospital
Insurance and Federal Supplementary Medical Insurance Trust Funds)

Survey period 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date June 2018

Original source The Facts on Medicare Spending and Financing (June 2018), page 6

Website URL visit the website

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51 References
Total Medicare assets at year-end from 1970 to 2017 (in billion U.S. dollars)
Total Medicare assets at year-end 1970-2017

Source and methodology information Notes:


Source(s) CMS n.a.

Conducted by CMS

Survey period 1970 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 221

Website URL visit the website

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52 References
Spending distribution of Medicare and Medicaid in the United States in 2016*
Spending distribution of Medicare and Medicaid in the U.S. 2016

Source and methodology information Notes:


Source(s) CMS; CHCF Health spending refers to national health expenditures. Not shown: dental services (<1% of Medicare and 2% of Medicaid).
Figures may not equal 100 percent due to rounding.
Conducted by CMS

Survey period 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CHCF

Publication date May 2018

Original source California Health Care Almanac - Health Care Costs 101 (May 2018), page 29

Website URL visit the website

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53 References
Total Medicare spending from 1970 to 2017 (in billion U.S. dollars)*
Total Medicare spending 1970-2017

Source and methodology information Notes:


Source(s) CMS * Data are for fiscal years.

Conducted by CMS

Survey period 1970 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 221

Website URL visit the website

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54 References
Medicare benefit payments by type of service in 2007 and 2017
Medicare benefit payments by type of service 2007 vs 2017

Source and methodology information Notes:


Source(s) US Congressional Budget Office; Kaiser Family Foundation Sums possibly do not add to 100% due to rounding. * Includes traditional Medicare and Medicare Advantage.

Conducted by US Congressional Budget Office

Survey period 2007 and 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date June 2018

Original source The Facts on Medicare Spending and Financing (June 2018), page 2

Website URL visit the website

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55 References
Distribution of Supplementary Medical Insurance (SMI) Medicare benefit payments from 2015
to 2017*
Supplementary Medical Insurance Medicare benefit payments 2015-2017

Source and methodology information Notes:


Source(s) CMS * Supplementary Medical Insurance (SMI) is also known as Medicare Part B. Since 2004, Medicare Part D is also included.
Percentages were calculated based on given reimbursement data. Percentage points not adding to exactly 100 percent are
Conducted by CMS probably due to rounding.
Survey period 2015 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 137 and 145

Website URL visit the website

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56 References
Distribution of Hospital Insurance (HI) Medicare benefit payments from 2015 to 2017*
Hospital Insurance Medicare benefit payments 2015-2017

Source and methodology information Notes:


Source(s) CMS * Hospital Insurance (HI) is also known as Medicare Part A. Percentages were calculated based on given reimbursement data.
Percentage points not adding to exactly 100 percent are probably due to rounding.
Conducted by CMS

Survey period 2011 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 123

Website URL visit the website

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Top U.S. not-for-profit hospitals by Medicare patient charges as of 2016 (in billion U.S.
dollars)*
Leading U.S. not-for-profit hospitals by Medicare patient charges 2016

Source and methodology information Notes:


Source(s) Billian's HealthDATA; CMS * Revenues reflect the most recently publicized Centers for Medicare and Medicaid Services (CMS) claims data, as sourced in
the Billian's HealthDATA Portal. Some totals reflect facilities that co-report to CMS when filing.
Conducted by CMS

Survey period as of April 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Billian's HealthDATA

Publication date April 2016

Original source billianshealthdata.com

Website URL visit the website

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58 References
Top 10 traditional therapy classes in the U.S. by Medicare per-member-per-year (PMPY) spending in
2016 (in U.S. dollars)*
Leading medical traditional therapy areas by Medicare PMPY spending 2016

Source and methodology information Notes:


Source(s) Express Scripts Inc * PMPY metrics are calculated by dividing totals bythe total number of member-months, which is determined by adding the
numberof months of eligibility for all members in the sample. This statistic includes members with coveragefor Medicare
Conducted by Express Scripts Inc beneficiaries. Medicare beneficiaries included in this analysisreceived their prescription benefits from the following plan types:
MedicareAdvantage Prescription Drug plans (MAPDs), Prescription Drug Plans (PDPs)or Employer Group Waiver Plans
Survey period 2016
(EGWPs).
Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Express Scripts Inc

Publication date February 2017

Original source Express Scripts 2016 Drug Trend Report, page 57

Website URL visit the website

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59 References
Enrollment in the Medicare program from 1966 to 2017, by type of beneficiary (in millions)
Medicare level of beneficiaries by type of beneficiary 1966-2017

Source and methodology information Notes:


Source(s) CMS This statistic was assembled from several editions of the CMS Financial Report and the Medicare Trustees report.

Conducted by CMS

Survey period 1966 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date July 2018

Original source Medicare Trustees Report 2018, page 11

Website URL visit the website

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60 References
Distribution of Medicare beneficiaries in 2016, by ethnicity
Distribution of Medicare beneficiaries 2016, by ethnicity

Source and methodology information Notes:


Source(s) Kaiser Family Foundation Percentages may not sum to 100% due to rounding effects.Includes beneficiaries dually enrolled in Medicare and Medicaid.

Conducted by Kaiser Family Foundation; US Census Bureau

Survey period 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date January 2018

Original source kff.org

Website URL visit the website

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61 References
Distribution of Medicare beneficiaries in 2015 and 2016, by federal poverty level
Distribution of Medicare beneficiaries 2015 and 2016, by federal poverty level

Source and methodology information Notes:


Source(s) Kaiser Family Foundation Percentages may not sum to 100% due to rounding effects.Includes beneficiaries dually enrolled in Medicare and Medicaid.

Conducted by Kaiser Family Foundation; US Census Bureau

Survey period 2015 and 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date March 2018

Original source kff.org

Website URL visit the website

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62 References
Top 10 U.S. states based on Medicare beneficiaries as a percentage of total population in
2016
Top U.S. states by Medicare beneficiaries as a percentage of total population 2016

Source and methodology information Notes:


Source(s) CMS; US Census Bureau Data include aged and/or disabled individuals enrolled in Medicare Part A and/or B through Original Medicare or Medicare
Advantage and Other Health Plans during the calendar year specified. Medicare enrollment is based on CMS administrative
Conducted by CMS; US Census Bureau enrollment data and are calculated using a person-year methodology.
Survey period 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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63 References
Top 10 U.S. states based on number of Medicare beneficiaries in 2016
Top U.S. states by number of Medicare beneficiaries 2016

Source and methodology information Notes:


Source(s) CMS Data include aged and/or disabled individuals enrolled in Medicare Part A and/or B through Original Medicare or Medicare
Advantage and Other Health Plans during the calendar year specified. Medicare enrollment is based on CMS administrative
Conducted by CMS enrollment data and are calculated using a person-year methodology.
Survey period 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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64 References
Number of Medicare hospital facilities in the U.S. from 1967 to 2016*
Medicare - number of hospital facilities in the U.S. 1967-2016

Source and methodology information Notes:


Source(s) CMS * Includes Medicare Part A (hospital insurance) and/or Part B (supplementary medical insurance). Includes short stay hospitals
and other inpatient hospitals.
Conducted by CMS

Survey period 1967 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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65 References
Total number of Medicare hospital beds in the U.S. from 1967 to 2016*
Medicare - total number of hospital beds in the U.S. 1967-2016

Source and methodology information Notes:


Source(s) CMS * Includes Medicare Part A (hospital insurance) and/or Part B (supplementary medical insurance).

Conducted by CMS

Survey period 1967 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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66 References
Number of Medicare skilled nursing facilities in the U.S. from 1967 to 2016*
Medicare - number of skilled nursing facilities in the U.S. 1967-2016

Source and methodology information Notes:


Source(s) CMS * Includes Medicare Part A (hospital insurance) and/or Part B (supplementary medical insurance).

Conducted by CMS

Survey period 1967 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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67 References
Number of Medicare home health agencies in the U.S. from 1967 to 2016*
Medicare - number of home health agencies in the U.S. 1967-2016

Source and methodology information Notes:


Source(s) CMS * Includes Medicare Part A (hospital insurance) and/or Part B (supplementary medical insurance).

Conducted by CMS

Survey period 1967 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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68 References
Number of Medicare psychiatric hospital facilities in the U.S. from 1967 to 2016*
Medicare - number of psychiatric hospital facilities in the U.S. 1967-2016

Source and methodology information Notes:


Source(s) CMS * Includes Medicare Part A (hospital insurance) and/or Part B (supplementary medical insurance).

Conducted by CMS

Survey period 1967 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CMS

Publication date June 2018

Original source cms.gov

Website URL visit the website

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69 References
Prescription drugs spending in the United States from 2012 to 2016, by payer (in billion U.S.
dollars)
Prescription drugs spending in the U.S. by payer 2012-2016

Source and methodology information Notes:


Source(s) CMS; CHCF n.a.

Conducted by CMS

Survey period 2012 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CHCF

Publication date May 2018

Original source California Health Care Almanac - Health Care Costs 101 (May 2018), page 27

Website URL visit the website

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70 References
Medicare Part D payer share of retail prescriptions in 2018, by therapy area*
Payer share of Medicare Part D retail prescriptions by therapy class 2018

Source and methodology information Notes:


Source(s) CMS; Sanofi; IQVIA * Data as of mid-year 2018 and represents numbers and percentages of prescriptions dispensed by drug class to all patients.

Conducted by CMS; IQVIA

Survey period 2018

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Sanofi

Publication date September 2018

Original source Managed Care Digest Series - Payer Digest 2018, page 42

Website URL visit the website

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71 References
Out-of-pocket costs per Medicare Part D retail prescription by therapy area in 2018 (in U.S.
dollars)*
Out of pocket costs of Medicare Part D retail prescription by drug therapy 2018

Source and methodology information Notes:


Source(s) CMS; Sanofi; IQVIA * Data are as of mid-year 2018 and represent numbers and percentages of prescriptions dispensed by drug class to all patients.
"Out-of-pocket costs" reflect the amount that is calculated as the total amount to be paid by the patient to the pharmacy. This
Conducted by CMS; IQVIA represents thepatient`s total cost share, including, but not limited to, copayments, amounts applied to the deductible, over
maximum amounts, and penalties.
Survey period 2018

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Sanofi

Publication date September 2018

Original source Managed Care Digest Series - Payer Digest 2018, page 43

Website URL visit the website

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72 References
Cost sharing for branded drugs in the Medicare Part D coverage gap from 2016 to 2020
Share of branded drug costs in Medicare Part D gap in the U.S. 2016-2020

Source and methodology information Notes:


Source(s) CMS; Sanofi All figures are forecasts.

Conducted by CMS

Survey period 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Sanofi

Publication date December 2016

Original source Managed Care Digest Series - Public Payer Digest 2016, page 18

Website URL visit the website

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73 References
Cost sharing for generic drug costs in the Medicare Part D coverage gap from 2016 to 2020
Share of generic drug costs in Medicare Part D gap in the U.S. 2016-2020

Source and methodology information Notes:


Source(s) CMS; Sanofi All figures are forecasts.

Conducted by CMS

Survey period 2015

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Sanofi

Publication date December 2015

Original source Managed Care Digest Series - Public Payer Digest 2015, page 18

Website URL visit the website

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74 References
Number of common Medicaid respiratory agent prescriptions annually in 2016 and 2017, by
product*
Common Medicaid respiratory agent prescriptions by product 2016-2017

Source and methodology information Notes:


Source(s) Sanofi; IQVIA * Retail prescriptions. Data as of mid-year 2017, and represents numbers/percentages of prescription dispensed, by drug class,
to all patients.
Conducted by IQVIA

Survey period 2016 and 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Sanofi

Publication date October 2017

Original source Managed Care Digest Series - Payer Digest 2017, page 57

Website URL visit the website

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75 References
Health spending distribution in the United States 2014-2016 and projections for 2026, by
payer*
Health spending distribution in the United States by payer 2014-2026

Source and methodology information Notes:


Source(s) CMS; CHCF * Health spending refers to national health expenditures. Not shown: other payers, public health activities, andinvestment, which
totaled 15.5%, 15.0%, 14.9%, and 13.9% in 2014, 2015, 2016, and 2026 projections, respectively.
Conducted by CMS

Survey period 2014 to 2016

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by CHCF

Publication date May 2018

Original source California Health Care Almanac - Health Care Costs 101 (May 2018), page 24

Website URL visit the website

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76 References
Medicare outlays and forecast in the United States from 2000 to 2028 (in billion U.S. dollars)
U.S. Medicare outlays and forecast 2000-2028

Source and methodology information Notes:


Source(s) US Congressional Budget Office *Projections.

Conducted by US Congressional Budget Office

Survey period 2000 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by US Congressional Budget Office

Publication date April 2018

Original source The Budget and Economic Outlook Fiscal Years 2018 to 2028

Website URL visit the website

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77 References
Medicare outlays and forecast in the United States from 2000 to 2028 (as a percentage of the
GDP)
U.S. Medicare outlays and forecast 2000-2028 as a percentage of the GDP

Source and methodology information Notes:


Source(s) US Congressional Budget Office * The data for 2018 to 2028 are projections.Data from before 2017 was taken from prior editions of the report. Figures from 2016
are calculated by Statista using GDP figures provided elsewhere in the report.
Conducted by US Congressional Budget Office

Survey period 2000 to 2017

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by US Congressional Budget Office

Publication date April 2018

Original source The Budget and Economic Outlook Fiscal Years 2018 to 2028, page 44

Website URL visit the website

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78 References
Average annual growth rate in Medicare per capita spending and other measures in the U.S. between
1990s and 2027
Annual growth in Medicare per capita spending and other measures 1990-2027

Source and methodology information Notes:


Source(s) Kaiser Family Foundation * Projected. ** PHI = private health insurance.

Conducted by CMS; US Census Bureau; US Congressional Budget Office

Survey period as of June 2018

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Kaiser Family Foundation

Publication date June 2018

Original source The Facts on Medicare Spending and Financing (June 2018), page 3

Website URL visit the website

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79 References
Costs of care for individuals in the U.S. with Alzheimer's disease to Medicare and Medicaid from 2018 to
2050 (in billion U.S. dollars)
Medicare and Medicaid costs from individuals with Alzheimer's in the U.S. 2018-2050

Source and methodology information Notes:


Source(s) Alzheimer's Association n.a.

Conducted by Alzheimer's Association

Survey period as of March 2018

Region(s) United States

Number of respondents n.a.

Age group n.a.

Special characteristics n.a.

Published by Alzheimer's Association

Publication date March 2018

Original source Costs of Alzheimer`s to Medicare and Medicaid, page 2

Website URL visit the website

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80 References

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