Inpatient Utilization Rates and Healthcare Expenditure May Be Declining for Medicare Recipients

A recently published article in JAMA reports decreasing all-cause mortality, hospitalization rates, and healthcare expenditures for Medicare beneficiaries. The group of Yale researchers analyzed a cohort of 68, 374, 904 unique beneficiaries between 1999 and 2013. All-cause mortality fell from 5.30% to 4.45% . Among fee-for-service enrollees, the total number of hospitalizations per 100 000 person-years, including those in the last 6 months of life, decreased from 35, 274 to 26, 930. Mean inpatient expenditures per Medicare fee-for-service beneficiary (adjusted for inflation) decreased from  $3,290 to $2,801. Possible explanations for these trends include improvements in lifestyle, lifetime healthcare exposure, medical technology and transitional care. Taken together, it is encouraging to see decreased healthcare utilization/expenditure with improved mortality in spite of the rapidly aging population.