In 1970, some 7.5 billion U.S. dollars were spent on the Medicare program in the United States. Fifty plus years later, this figure stood at 1,122.1 billion U.S. dollars. This statistic depicts total Medicare spending from 1970 to 2024. Increasing Medicare coverage Medicare is the federal health insurance program in the U.S. for the elderly and those with disabilities. In the U.S., the share of the population with any type of health insurance has increased to over 90 percent in the past decade. As of 2019, approximately 18 percent of the U.S. population was covered by Medicare in particular. Increasing Medicare costs Medicare costs are forecasted to continue increasing over time, with outlays rising to a predicted 1.78 trillion U.S. dollars by 2031 as the population continues to age. Certain diseases of old age, such as Alzheimer’s disease, are increasing in prevalence in the U.S., which will reflect on healthcare costs for the elderly. In 2021, Alzheimer's disease was estimated to cost Medicare and Medicaid around 239 billion U.S. dollars in care costs; by 2050, this number is projected to climb to 798 billion dollars.

The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications. Drug spending metrics for Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

According to research published in 2023, the total cost of care among Medicare-enrolled hospice users for all disease groups was 3.1 percent lower than the adjusted spending of beneficiaries who did not use hospice. This equates to roughly 3.5 billion U.S. dollars less in Medicare spending for hospice users in their last 12 months of life, compared to non-hospice users. However, cost of care difference varied by disease group. Medicare spent more on hospice users with cancer and neurodegenerative diseases, while spending less on hospice users with CKD/ESRD* and respiratory disorders, compared to non-hospice users. Nevertheless, as hospice episodes of care (length of stay) increase, the total cost of care decreases for hospice users, compared to non-users. Regardless of disease group, when the hospice length of stay (LOS) exceeds 15 days, Medicare spending becomes less than that of non-hospice users.

Between 2019 and 2023, spending for Eliquis under Medicare increased by 31 percent annually on average per dosage unit. This statistic illustrates the average annual Medicare spending growth among select top-selling drugs in the United States, for the time range 2019-2023.

The Medicare Part B Discarded Drug Units dataset provides spending information on claims for Medicare Part B drugs that were identified as having discarded amounts of a drug. As of January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) requires all physicians, hospitals, and other providers submitting claims for Medicare Part B drugs to report any discarded amount of a single use vial or other single use package drug on its claim for payment. With the passage of the Infrastructure Investment and Jobs Act in November 2021, manufacturers must pay a refund to Medicare for discarded amounts above a specified threshold effective for drugs furnished beginning with January 1, 2023.

The CMS Program Statistics - Medicare Skilled Nursing Facility tables provide use and payment data for skilled nursing facilities. For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page. These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data. Below is the list of tables: MDCR SNF 1. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement, Yearly Trend MDCR SNF 2. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Demographic Characteristics and Medicare-Medicaid Enrollment Status MDCR SNF 3. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Area of Residence MDCR SNF 4. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Entitlement and Covered Days of Care MDCR SNF 5. Medicare Skilled Nursing Facilities: Utilization, Program Payments, and Cost Sharing for Original Medicare Beneficiaries, by Type of Facility and Bedsize MDCR SNF 6. Medicare Skilled Nursing Facilities: Distribution of Medicare Covered Skilled Nursing Facility Days, by State of Provider and Major Resource Utilization Groups (RUG)-III (versions 2013-2018 only)

In 2023, Medicare paid hospice providers **** billion U.S. dollars. Medicare hospice spending has been steadily increasing in the past years and was estimated to reach **** billion U.S. dollars by 2033. Hospices provide end of life medical care, pain management, as well as emotional and spiritual support.

The dataset has information on the Medicare payment adjustments of geographic indices for Inpatient Prospective Payment System (IPPS) wage index for the fiscal years 2017-2023. The Medicare System adjusts fee for service payment rates for hospitals and practitioners according to the geographic location in which providers practice, recognizing that certain costs beyond the providers’ control vary between metropolitan and nonmetropolitan areas and also differ by region.

Medicare is an important public health insurance scheme for U.S. adults aged 65 years and over. As of 2023, an estimated 18.9 percent of the U.S. population was covered by Medicare, an increase from the previous year. As of 2021, California, Florida, and Texas had the largest number of adults aged 65 years and older. The Medicare program Medicare has two primary parts: Medicare Part A covers hospital care and Medicare Part B covers medical and preventative services. Both parts of Medicare are available to those aged 65 years and older under certain conditions. Medicare premiums are variable and depend on the enrollee’s income. Despite a majority of the Medicare enrollees being above the federal poverty line, there are still several programs in place to help cover the costs of healthcare for the elderly. Opinions on elderly care in the U.S. It is estimated that about 23 percent of Medicare enrollees are in fair/poor health. But there are lots of questions about who should pay for or help with elderly care long-term. In a recent survey of U.S. adults, about half of the respondents said that health insurance companies should pay for elderly care. However, a majority of adults also supported a long-term government sponsored health plan like Medicaid. The issue is still hotly debated and politicized in the United States.

Medicare Advantage Market Outlook

The global Medicare Advantage market size was valued at approximately USD 320 billion in 2023 and is projected to reach around USD 800 billion by 2032, growing at a robust CAGR of 10.8% during the forecast period. The market is primarily driven by increasing aging population, advancements in healthcare technology, and rising awareness about Medicare Advantage plans' comprehensive coverage options.

The aging global population is a significant growth factor for the Medicare Advantage market. As life expectancy increases, the proportion of elderly individuals seeking comprehensive healthcare solutions is also on the rise. This demographic shift is particularly pronounced in developed regions like North America and Europe, where the baby boomer generation is reaching retirement age. This creates a significant demand for Medicare Advantage plans, which offer a blend of health maintenance and cost-effectiveness. Additionally, the rising prevalence of chronic diseases among the elderly, such as diabetes, cardiovascular diseases, and arthritis, further fuels the need for extensive healthcare coverage provided by Medicare Advantage plans.

Technological advancements in healthcare are another vital growth factor. Telehealth, electronic health records, and advanced diagnostic tools enhance the quality of care provided to Medicare Advantage beneficiaries. These technologies streamline healthcare services, making them more accessible and efficient. For instance, telehealth allows healthcare providers to offer consultations and follow-ups remotely, which is particularly beneficial for elderly individuals who may have mobility issues. The integration of artificial intelligence and machine learning in healthcare also aids in quicker diagnosis and personalized treatment plans, thereby improving patient outcomes and satisfaction levels. As these technologies continue to evolve, they are expected to further boost the Medicare Advantage market.

Rising awareness and favorable government policies also contribute significantly to the market's growth. Governments across various regions are implementing policies to promote the adoption of Medicare Advantage plans due to their cost-effectiveness and comprehensive coverage. In the United States, for example, the Medicare Advantage program is heavily promoted by the Centers for Medicare & Medicaid Services (CMS) due to its potential to reduce overall healthcare costs while providing better care coordination. Moreover, awareness campaigns and educational programs aimed at informing citizens about the benefits of Medicare Advantage plans are leading to higher enrollment rates. This trend is expected to continue as more people become aware of the advantages these plans offer over traditional Medicare.

Plan Type Analysis

The Medicare Advantage market can be segmented based on plan type into Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), Special Needs Plans (SNPs), and others. Health Maintenance Organization (HMO) plans are popular due to their cost-effectiveness and structured care pathways. HMOs usually require beneficiaries to use a network of doctors and hospitals and often require referrals for specialists. This structured approach helps in managing healthcare costs efficiently while ensuring coordinated care. The predictability of out-of-pocket costs is another significant advantage that makes HMOs an attractive option for many beneficiaries.

Health Maintenance Organizations (HMOs) play a pivotal role in the Medicare Advantage landscape. These plans are designed to offer structured and coordinated care through a network of healthcare providers. By emphasizing preventive care and efficient management of healthcare services, HMOs help in reducing unnecessary medical expenses while ensuring high-quality care for beneficiaries. The requirement for referrals and network-based care pathways often leads to better coordination among healthcare providers, which is crucial for managing chronic conditions prevalent among the elderly. As a result, HMOs are particularly appealing to those who prioritize cost-effectiveness and structured healthcare management.

Preferred Provider Organization (PPO) plans offer more flexibility compared to HMOs. PPOs allow beneficiaries to see any doctor or specialist without

To assess the effects of Liposomal Bupivacaine (LB) and provider LB use rate for 6 months after discharge on service utilization, clinical outcomes, and Medicare expenditures among Fee for Service (FFS) beneficiaries who have undergone hospital outpatient department (HOPD) procedures. 100% Medicare Research Identifiable Files data from 2019 to 2023 was utilized. Medicare FFS beneficiaries with the top 100 HOPD surgical procedures where LB was utilized were included in the study and divided into two cohorts: received LB (treatment) and did not receive LB (comparison) during the surgical procedure. An Inverse Probability Treatment Weighting Propensity Score model was estimated to balance treatment and control groups. We estimated Emergency Department (ED) admission, Short Term Acute Care Hospitals (STACH) admission, mortality, Opioid Use Disorder (OUD) and Opioid prescription fill events, and spending metrics. LB use contributed to significant reductions in ED admission (9%; 23.28 vs. 25.69%), STACH admission (8%; 11.61 vs. 12.65%), mortality (39%; 0.67 vs. 1.1%) and opioid prescription fills (6%; 1.8 vs. 1.92) within 180-days post-discharge. Total Medicare expenditures (180-day episode) were $245 lower for the LB user ($9,645 vs. $9,891). For each 10-percentage point increase in provider LB use-rate, the likelihood of ED admission, STACH admission, mortality, and OUD decreased by 0.1, 0.15, 0.01 and 0.02 percentage points, respectively. Total Medicare expenditures (180-day episode) were reduced by $258 for every one percentage point increase in LB use-rate. Use of LB and provider LB use rate are associated with improved patient clinical, service utilization, and expenditure outcomes. Liposomal bupivacaine (LB) represents a significant advancement in postoperative pain management, with studies demonstrating its ability to reduce opioid consumption and improve recovery outcomes. Previous studies have found that increased provider LB use rate is associated with reduced ED admissions, STACH admissions, and Opioid prescription fill events among Medicare beneficiaries undergoing HOPD procedures. However, research is lacking to estimate the effect of LB use on mortality, OUD, and total Medicare spending.Using an IPTW propensity score model and associated outcome regressions we find that both LB use and provider LB use rate had a statistically significant impact on reducing total Medicare expenditures per patient per 180-day episode ($245 and $258 respectively, p 

The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI). Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

United States Health Insurance: Total Hospital & Medical Expenses: Medicare Supplement data was reported at 11.200 USD bn in 2023. This records an increase from the previous number of 10.462 USD bn for 2022. United States Health Insurance: Total Hospital & Medical Expenses: Medicare Supplement data is updated yearly, averaging 7.368 USD bn from Dec 2007 (Median) to 2023, with 17 observations. The data reached an all-time high of 11.200 USD bn in 2023 and a record low of 6.163 USD bn in 2007. United States Health Insurance: Total Hospital & Medical Expenses: Medicare Supplement data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG022: Health Insurance: Operations by Lines of Business.

According to research published in 2023, the total cost of care* among Medicare-enrolled hospice users was lower than the adjusted spending of beneficiaries who did not use hospice, as soon as length of stay (LOS) reached more than 15 days. Short hospice stays of 15 days or lower did not generate any Medicare savings, except for those patients with neurodegenerative disorders. However, roughly half of hospice stays were 18 days or less.

For the fiscal year of 2025, mandatory government spending is predicted to sum up to about 4.37 trillion U.S. dollars. It consists primarily of benefit programs such as: social security, Medicare, Medicaid, as well as other programs. Discretionary spending consists of spending controlled by lawmakers through annual appropriation acts. In FY 2025 it is proposed at 1.93 trillion U.S. dollars, and is divided into defense and nondefense spending. Spending for net interest is also listed, which consists of the government's interest payments on debt held by the public, offset by interest income the government receives.

United States Health Insurance: General Administrative Expenses: Medicare Supplement data was reported at 2.112 USD bn in 2023. This records an increase from the previous number of 2.053 USD bn for 2022. United States Health Insurance: General Administrative Expenses: Medicare Supplement data is updated yearly, averaging 1.189 USD bn from Dec 2007 (Median) to 2023, with 17 observations. The data reached an all-time high of 2.112 USD bn in 2023 and a record low of 748.000 USD mn in 2007. United States Health Insurance: General Administrative Expenses: Medicare Supplement data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG022: Health Insurance: Operations by Lines of Business.

The Medicare Supplement Health Insurance market is experiencing steady growth, driven by increasing awareness of these plans among Medicare beneficiaries. The market size is estimated to reach $12.8 billion by 2033, expanding at a CAGR of 5.08% during the forecast period (2023-2033). This growth can be attributed to the rising number of Medicare beneficiaries, who have a higher demand for supplemental coverage to cover gaps in their basic Medicare benefits. The aging population, increasing healthcare costs, and growing awareness of the benefits of Medicare Supplement plans are contributing to the market expansion. The market is segmented based on coverage type (Plan A, Plan B, Plan C, Plan D, Plan F), consumer age group (under 65, 65 to 74, 75 to 84, 85 and above), premium payment method (monthly, quarterly, annually), and policy term (short-term, long-term). Plan F is expected to remain the dominant segment in the market, owing to its comprehensive coverage and high popularity among beneficiaries. The 65 to 74 age group is the largest segment, accounting for a significant share of the market. Monthly premium payments are preferred by the majority of consumers, as they provide flexibility and convenience. Additionally, long-term policies are gaining traction as they offer stability and predictability in coverage. Key players in the market include Anthem, UnitedHealth Group, Mutual of Omaha, Globe Life Inc., and Blue Cross Blue Shield. Recent developments include: Recent developments in the Medicare Supplement Health Insurance Market have indicated a notable increase in market competition, particularly involving major players such as Anthem, UnitedHealth Group, Mutual of Omaha, and Cigna. UnitedHealth Group has recently announced strategic initiatives to expand its Medicare Supplement offerings, aiming to enhance its market share. Meanwhile, Anthem has introduced new plans designed to provide comprehensive coverage options, catering to the increasing demands of aging consumers. The impact of these additions has been reflected in the overall market growth, drawing attention from both investors and potential customers. Furthermore, Mutual of Omaha has made headlines with its technology-driven approach, focusing on streamlining claims processing and improving customer experience. In terms of mergers and acquisitions, well-known players like Aetna and Centene Corporation have explored potential partnerships to broaden their service reach, enhancing their operational capabilities in the competitive landscape. The growth in market valuation for these companies suggests a positive trajectory for the sector, addressing the ongoing need for valuable healthcare solutions throughout the aging population.. Key drivers for this market are: Aging population growth, Increased chronic disease prevalence; Enhanced digital health solutions; Expansion of telehealth services; Rising consumer awareness and education. Potential restraints include: Aging population growth, Rising healthcare costs; Increasing health awareness; Regulatory changes; Competitive insurance landscape.

The Medicare Part D Prescribers by Provider and Drug dataset provides information on prescription drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other health care providers. This dataset contains the total number of prescription fills that were dispensed and the total drug cost paid organized by prescribing National Provider Identifier (NPI), drug brand name (if applicable) and drug generic name. Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The Medicare Part D Prescribers by Provider dataset contains information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The dataset identifies providers by their National Provider Identifier (NPI) and summarizes for each prescriber the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

United States Health Insurance: Claims Adjustment Expenses: Medicare data was reported at 13.327 USD bn in 2023. This records an increase from the previous number of 10.770 USD bn for 2022. United States Health Insurance: Claims Adjustment Expenses: Medicare data is updated yearly, averaging 4.766 USD bn from Dec 2007 (Median) to 2023, with 17 observations. The data reached an all-time high of 13.327 USD bn in 2023 and a record low of 1.285 USD bn in 2007. United States Health Insurance: Claims Adjustment Expenses: Medicare data remains active status in CEIC and is reported by National Association of Insurance Commissioners. The data is categorized under Global Database’s United States – Table US.RG022: Health Insurance: Operations by Lines of Business.