Functional impairments raise costs among chronically ill Medicare beneficiaries, report says

Medicare beneficiaries suffering from five or more chronic conditions and functional impairments are nearly twice as expensive as Medicare enrollees with only the chronic conditions, a new report finds.

Medicare spending on seniors who had five or more chronic conditions and functional impairments — meaning they need assistance with activities of daily living, such as bathing and preparing meals — was $19,763 per capita in 2006. Comparatively, Medicare spent approximately $10,133 on seniors with the same chronic illnesses but without functional impairments, according to The SCAN Foundation and Avalere Health. Those with functional impairments also were more likely to have an impatient hospital stay or emergency room visit.

Researchers say chronically ill seniors, especially struggling with ADLs, are a key group to focus on when developing coordination of care efforts. About 21% of Medicare beneficiaries have five or more chronic conditions, while 26% of those with multiple conditions also had functional impairment.

“It’s time to ramp up effective models of coordinated care that can address the total needs of this critical population in a more person-centered, cost-effective manner,” Bruce Chernof, M.D., president and CEO of The SCAN Foundation, said.