Wealth Patterns Among Elderly Americans: Implications For Health Care Affordability

Knickman, James R.; Hunt, Kelly A.; Snell, Emily K.; Alecxih, Lisa; Kennell, David

doi:10.1377/hlthaff.22.3.168

Cited by 14 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although TKIs have had a more substantial impact on survival, the long‐term financial burden must be considered given current recommendations for patients with CML who are in complete cytogenic response to remain on TKI therapy indefinitely . Given previous projections that approximately 50% of the Medicare population has <$13,800 in available liquid assets, the annual patient cost responsibility identified in the current study results in a devastating financial burden among these older patients over a 5‐year period. The majority reached the catastrophic coverage phase by year 5 (in 2013, the Part D threshold was $4750).…”

Section: Discussionmentioning

confidence: 99%

Medicare and patient spending among beneficiaries diagnosed with chronic myelogenous leukemia

Kenzik

Bhatia

Williams

et al. 2019

Cancer

View full text Add to dashboard Cite

Background The authors examined Medicare spending and patient spending in older patients with chronic myelogenous leukemia (CML) over the first 5 years from the time of CML diagnosis in the tyrosine kinase inhibitor (TKI) era. Methods Medicare beneficiaries with CML who were diagnosed between 2007 and 2012 at age >65 years were identified from the Surveillance, Epidemiology, and End Results (SEER)–Medicare database (805 beneficiaries). A noncancer Medicare beneficiary sample was frequency‐matched based on age, sex, and race/ethnicity (805 individuals). Patients were followed until 5 years from diagnosis, disenrollment, death, or December 31, 2014, whichever came first. Total Medicare spending, service‐specific spending, and amount owed by patients was estimated monthly and then summed over 60 months and averaged to generate annual spending. Results The median age at the time of diagnosis of CML was 76 years (range, 66‐102 years). Overall, 51.4% of patients received TKIs (27.8% received imatinib alone), 28% received non‐TKI therapy, and 21% received no treatment. The 5‐year survival rate for patients with ≥85% time receiving TKIs was 79% compared with 76% for noncancer controls versus 62% for those with <85% time receiving TKIs. Annual Medicare spending was found to be significantly higher for patients treated with TKIs ($143,053) compared with those treated without TKIs ($41,268 vs $10,498 for noncancer controls). Annual patient cost responsibility was $11,712 per patient receiving any TKIs versus $7330 for those receiving non‐TKI outpatient chemotherapy versus $3561 for noncancer controls. Conclusions Older patients with CML with adequate time receiving TKI therapy have 5‐year survival rates that are comparable to those of their counterparts without cancer. However, TKI use is accompanied with significant Medicare and patient spending; patients receiving multiple TKIs (ie, dasatinib or nilotinib along with imatinib) constitute the group with the highest spending.

show abstract

Section: Discussionmentioning

confidence: 99%

Medicare and patient spending among beneficiaries diagnosed with chronic myelogenous leukemia

Kenzik

Bhatia

Williams

et al. 2019

Cancer

View full text Add to dashboard Cite

show abstract

“…In conclusion, while views will differ about appropriate public policy, all should recognize that retirees face a triad of potential needs: for income beyond Social Security, for acute health care not covered by Medicare, and for LTC (Smeeding 1986;Holden and Smeeding 1990;Knickman et al 2003). Policy debate that focuses only on income security and acute care-and the corresponding Social Security and Medicare programs-misses the third risk that retirees face: that of needing LTC.…”

Section: Discussionmentioning

confidence: 99%

“…Many of the simulations and analyses done previously using this model have been presented in unpublished reports prepared for use in the policy process. However, the model also has been the basis for published studies by Rivlin and Wiener (1988), Wiener, Illston, and Hanley (1994), Knickman and Snell (2002), and Knickman et al (2003).…”

Section: Methodsmentioning

confidence: 99%

Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

Kemper

Komisar²,

Alecxih³

2005

INQUIRY

124

View full text Add to dashboard Cite

The leading edge of the baby boom generation is nearing retirement and facing uncertainty about its need for long-term care (LTC). Using a microsimulation model, this analysis projected that people currently turning age 65 will need LTC for three years on average. An important share of needed care will be covered by public programs and some private insurance, but much of the care will be an uninsured private responsibility of individuals and their families-a responsibility that will be distributed unequally. While over a third of those now turning 65 are projected to never receive family care, three out of 10 will rely on family care for more than two years. Similarly, half of people turning 65 will have no private out-of-pocket expenditures for LTC, while more than one in 20 are projected to spend $100,000 or more of their own money (in present discounted value). Policy debate that focuses only on income security and acute care-and the corresponding Social Security and Medicare programs-misses the third, largely private, risk that retirees face: that of needing LTC.

show abstract

“…The baby-boomer generation has grown up with high expectations for health care and has experienced higher utilization rates than those of previous generations. In addition, as the baby-boomers age, many, but certainly not all, will have disposable income they may choose to spend on health care (Knickman et al, 2003).…”

Section: Current Physician Supply Statusmentioning

confidence: 99%

The new media and the acceleration of medical education

Hess

Shrum

2011

On the Horizon

View full text Add to dashboard Cite

Purpose -Medical education in the USA has historically been designed around social and economic conditions within the medical community, contributing to a fluctuating emphasis on the number of medical schools, as well as the methods by which medicine has been taught, and ultimately leading to a shortage in the physician supply. This paper aims to describe the current status of medical education training, including the tracing of its origins, and to articulate the ability of new media to accelerate and restructure the physician preparation process.Design/methodology/approach -The application of new media requires a rethinking of long-held assumptions regarding the medical education process. Medical school faculty must be willing to develop new curriculum models, integrating new media technologies to facilitate varied learning modalities. Likewise, clinicians and basic scientists in medical schools must determine the most appropriate information needed by a practicing physician and make that information available via new media platforms.Findings -The utilization of new media presents the opportunity to both accelerate and restructure the medical education and training process. The development of teaching and learning modalities via new media can positively impact the physician supply problem by transforming medical education to a competency and evidence-based curriculum in an accelerated format.Originality/value -The impending health consequences of a physician shortage have crystallized the need to begin immediately to expand the physician supply. In order to meet the health needs of a growing and aging population, it is imperative that the methods of medical education be altered to accelerate and improve the physician preparation process. This restructuring of the medical education curriculum is dependent on the utilization of new media to leverage the digital literacy of today's medical students.

show abstract

Wealth Patterns Among Elderly Americans: Implications For Health Care Affordability

Cited by 14 publications

References 8 publications

Medicare and patient spending among beneficiaries diagnosed with chronic myelogenous leukemia

Medicare and patient spending among beneficiaries diagnosed with chronic myelogenous leukemia

Long-Term Care over an Uncertain Future: What Can Current Retirees Expect?

The new media and the acceleration of medical education

Contact Info

Product

Resources

About