TY  - JOUR
AU  - Cutler,David M.
AU  - Meara,Ellen
TI  - The Concentration of Medical Spending:  An Update
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 7279
PY  - 1999
Y2  - August 1999
UR  - http://www.nber.org/papers/w7279
L1  - http://www.nber.org/papers/w7279.pdf
N1  - Author contact info:
David M. Cutler
Department of Economics
Harvard University
1875 Cambridge Street
Cambridge, MA  02138
Tel: 617/496-5216
Fax: 617/496-8951
E-Mail: dcutler@harvard.edu

Ellen Meara
Dartmouth Institute for Health Policy
and Clinical Practice
35 Centerra Parkway
Lebanon, NH 03755
Tel: 603/653-0899
E-Mail: ellen.r.meara@dartmouth.edu
M1  - published as David M. Cutler, Ellen Meara. "The Concentration of Medical Spending:  An Update," in David A. Wise, editor, "Themes in the Economics of Aging" University of Chicago Press (2001)

M2  - featured in NBER digest on 2000-02-01
AB  - In the last two decades, Medicare spending has doubled in real terms despite the fact that the health of Medicare beneficiaries improved over this period.  The goals of this paper are to document how trends in spending by age have changed among elderly Medicare beneficiaries in the last decade and to reconcile the decline in disability rates with rapid increases in spending among the elderly.  First, we conclude that the trend of disproportionate spending growth among the oldest old has continued between 1985 and 1995.  Spending among the younger elderly, those 65-69 rose by two percent annually in real per person terms.  In contrast, spending for those over age 85 rose by four percent.  Second we show that the reasons for the large increase in spending on the oldest elderly relative to the younger elderly is the rapid increase in the use of post-acute services such as home health care and skilled nursing care.  Spending on post-acute care for the very old has risen 20 percent per year in the last decade.
ER  -