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Uninsured Means Higher Costs Later

Uninsured Means Higher Costs Later

New findings from researchers demonstrate that individuals who were either continuously or intermittently uninsured between the ages of 51 and 64 cost Medicare more than those who had continuous insurance coverage in the years prior to Medicare eligibility.

On average, those who were previously uninsured cost Medicare an additional 1,000 U.S. dollars annually per person when compared with those who had been consistently covered. These increased costs were due primarily to complications resulting from cardiovascular disease and diabetes and from apparently delayed surgeries for arthritis. Had these middle-aged adults been consistently covered, they would have likely cost Medicare less.

In order to get a picture of how coverage before age 65—or a lack thereof—affects Medicare spending after age 65, the researchers looked at two sources of data. First, they analyzed information from the Health and Retirement Study, a nationally representative survey that collected health insurance and other information from a large sample of adults. Starting in 1992, when members of this sample group were between the ages of 51 and 61, survey information was collected every two years until 2006, tracking each person's transition into Medicare. From these data they identified two groups: one group of 2,951 adults who had been continuously insured before becoming eligible for Medicare at age 65, and another group of 1,616 adults who were either intermittently or continuously uninsured before age 65.

Next, they analyzed Medicare claims data for these same individuals from age 65 until age 74, using rigorous statistical methods to ensure that the two groups of adults were evenly balanced for all recorded demographic and health characteristics before age 65. The researchers found that the previously uninsured cost the Medicare system substantially more than the previously insured (on average, 5,796 U.S. dollars versus 4,773 U.S. dollars per person annually).

"The bulk of the higher spending was explained by chronic conditions we know how to treat, which makes perfect clinical sense," says lead author J. Michael McWilliams. "When uninsured adults do not receive adequate care for hypertension, heart disease, and diabetes before age 65, they develop complications that require costlier care after age 65."; Source: Harvard Medical School


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