Published on 05 July 2011
Health Care Spending: Top 5 Most Costly Medical Conditions in the Elderly

A third of U.S. health care expenditures are spent on care for the elderly.  In terms of overall medical and drug spending, the top five conditions among the elderly are:

  1. Heart conditions
  2. Cancer
  3. Osteoarthritis and non-traumatic joint disorders
  4. Hypertension
  5. Trauma-related disorders

Every year, of the 40 million seniors in the U.S. who live at home (non-institutionalized), about 86% (34 million) are treated for at least one of these five medical conditions.  For 2008:

  • Heart Conditions:  32% of seniors (12.7 million) received care for heart disease, at an average cost of $3,820 per person.
  • Cancer: 20% of elderly (8 million) received oncology services, at an average per capita cost of $4,028.
  • Osteoarthritis and non-traumatic joint disorders: 33.5% of seniors (13.4 million) received treatment for osteoarthritis, at an average per capita cost of $1,856.
  • Hypertension: 59.5% of elderly (23.8 million) were treated for hypertension, at an average per-person expenditure of $1,002.
  • Trauma-related disorders: 13.8% of seniors (5.5 million) received medical care for trauma, at an average per capita cost of $3,742.

As you might expect, the federal Medicare program pays the largest share of expenditures for all five of the most costly conditions of the elderly (persons age 65 or older).  Of all health care costs related to these conditions, Medicare pays:

  • 78.2% of the cost of treating trauma and related disorders.
  • 67.5% of heart disease treatment costs.
  • 63.5% of cancer treatment costs.
  • 60.0% of costs of osteoarthritis and non-traumatic joint disorders.
  • 55.2% of costs of treating hypertension.

The portion of costs paid out-of-pocket (OOP) by seniors vary:

  • Hypertension 16.7%
  • Osteoarthritis 10.7%
  • Cancer 6.0%
  • Heart disease 5.8%
  • Trauma-related disorders 4.3%

To learn more, read Top Five Most Costly Conditions among the Elderly, Age 65 and Older, 2008: Estimates for the U.S. Civilian Non-Institutionalized Adult Population by Anita Soni, PhD and Marc Roemer, MS at the Agency for Healthcare Research and Quality.

 

About Author

An expert on Medicaid, Medicare, and health reform, Kip Piper, MA, FACHE, is a consultant, speaker, and author. Kip Piper advises health plans, hospitals and health systems, states, and pharma, biotech, medical device, HIT, and investment firms. With 30 years’ experience, Kip is a senior consultant with Sellers Dorsey, top specialists in Medicaid and health reform. He is also a senior advisor with Fleishman-Hillard and TogoRun. For more, visit KipPiper.com. Follow on Twitter @KipPiper, Google +, Facebook and connect on LinkedIn.

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