Chronic Disease

While medical innovations and public health gains in the past century have been measurable in leaps and bounds, significant progress against acute disease has revealed an equally enormous challenge—chronic disease on an unprecedented scale. Close to half of Americans have chronic conditions and 1 in 4 have more than one. They cause 7 out of every 10 deaths and cost our country 75 cents of every health care dollar. With chronic disease prevalence growing at a faster rate than the population as a whole, the forecast is daunting.

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    • Lost wages for family caregivers
      The total impact of caregiving on lost wages for family caregivers age 50 and older is $283,716 for men, and $323,880 for men.  
    • Caregivers cut back on own preventive health
      One in 4 family caregivers cut back on spending for their own preventive health or dental care when caring for a loved one.  
    • Unpaid care from family caregivers
      Each week, family caregivers provide an average of 20.4 hours of unpaid care.  
    • Impact of family caregiving on individual health
      Family caregivers commonly experience poor health and are at increased risk for heart disease, poor immune function, fatigue, depression, and more.  
    • Impact of family caregiving on work
      Seven out of 10 family caregivers have to cut back on work hours, change jobs, or stop working in order to care for their loved one.  
    • Out-of-pocket costs to family caregivers
      Being a family caregiver costs $5,531 in out-of-pocket direct costs each year.  
    • More than 60 million new family caregivers each year
      Every year, 61.6 million family caregivers take on the roll of unpaid caregiver to a family member or loved one.  
    • Economic contributions of family caregivers
      Family caregivers contribute an estimated $450 billion each year in economic value.  
    • Out-of-pocket health care for seniors in 2010
      In 2010, older Americans spent over a third of their Social Security checks on out-of-pocket health care expenses.  
    • Health care spending on individuals with chronic disease
      Around 3/4 of the $2 trillion spent on health care in the U.S. is spent on individuals with a chronic disease.  
    • Chronic diseases limit activities of daily living
      One in 4 Americans living with a chronic illness are limited in their activities of daily living.  
    • Percent of older adults with a chronic condition
      In 2011, 80% of older adults in the U.S. had one chronic condition. Half had at least two.  
    • Growth of chronic conditions in older adults
      The percentage of adults age 65 and older with multiple chronic conditions grew from 37.2% in 1999-2000, to 45.3% in 2009-2010.  
    • In 2011, the leading causes of death in the U.S. were chronic diseases: heart disease, cancer, chronic lower respiratory diseases, and stroke (cerebrovascular diseases).  
    • In 2009, half of the adult population in the U.S.—133 million—was living with at least one chronic disease.  
    • In 2010, national health spending was estimated at $2.6 trillion.  
    • The health share of the GDP is projected to increase from 17.6% to 19.8% between 2009 and 2020.  
    • National health spending is projected to grow 5.8% each year from 2010 through 2020.  
    • Most older Americans have at least one chronic condition.  From 2006-2008, the most frequently occurring conditions among older Americans were: Hypertension (38%) Diagnosed arthritis (50%) All types of heart disease (32%) Any cancer (22%) Diabetes…  
    • In 2011, the median annual rate for a private nursing home was $77,745—compared to $60,225 in 2005.  
    • The national median rate for a private nursing home room in 2011 was $213/day.  
    • The national median rate of licensed home health aide services in 2011 was $19/hour.  
    • The national median rate of adult day health care in 2011 was $60/day.  
    • The national median rate for homemaker (or personal care assistant) services in 2011 was $18/hour.  
    • The national median rate for assisted living facilities in 2011 was $3,261/month.  
    • The national median rate for a semi-private nursing home room in 2011 was $193/day.  
    • Two-thirds of people over the age of 65 will need long-term care in their lifetimes.  
    • The annual rate for a private nursing home room in 2010 was $75,190, compared to $60,225 in 2005 (a growth of $14,965).  
    • The national median rate for a semi-private nursing home room in 2010 was $185/day.  
    • The national median rate for a private nursing home room was $206/day.  
    • The national median rate for an assisted living facility (one bedroom/single occupancy with non-constant “hands-on” personal and medical care) in 2010 was $3,185/month.  
    • The national median rate for adult day health care (support services in a community-based, protective setting during any part of a day, but less than 24-hour care) in 2010 was…  
    • The national median rate for non-medicare certified, licensed home health aide services (non-medical “hands-on” care such as activities such as bathing, dressing and transferring) in 2010 was $19/hour.  
    • The national median rate for non-medicare certified, licensed homemaker services (“hands-off” care such as helping with cooking and running errands) in 2010 was $18/hour.  
    • In 2007, two-thirds of individuals age 65 and older who had limitation in instrumental activities of daily living received personal assistance.    
    • In 2006, health care costs for Medicare enrollees age 65 and older were: 25% for inpatient hospital care 16% for prescription drugs 35% for physician/outpatient services 13% for long-term care facilities  
    • In 2007, the number of home health care visits was 3,409 per 1,000 Medicare enrollees.  
    • In 2005, the number of physician visits was 13,914 per 1,000 Medicare enrollees.  
    • Between 1992 and 2007 skilled nursing facility stays increased from 28 to 81 stays per 1,000 Medicare enrollees.  
    • The hospitalization rate in 2007 was 336 stays per 1,000 Medicare enrollees.  
    • The average lenth of a hospital stay in 2007 was 5.6 days.  
    • In 2004, Americans aged 65 and older with five or more chronic conditions incurred $3,862 on average, while those with no chronic conditions incurred prescription drug costs at an average…  
    • In 2004, approximately 8% of those 65 and older incurred no prescription drug costs, but close to 24% incurred $2,500 or more that year.  
    • In 2004, average annual prescription drug costs for noninstitutionalized Medicare enrollees over 65 was $2,107 per person.  
    • Annual health care costs for Medicare enrollees age 65 and over with no chronic disease was, on average, $5,186.  This number rises to $25,132 for those whith five of more…  
    • Among those aged 65-74, 13% of men and 22% of women reported an inability to perform at least one of five activites, compared to those 85 and over, of which,…  
    • In 2007, 42% of people over 65 reported a functional limitation, while 14% had trouble performing one or more instrumental activity of daily living but had no limitations on regular…  
    • Average annual prescription drug costs for noninstitutionalized Medicare enrollees age 65 and over, by sources of payment, 1992-2004  
    • Average annual health care costs for Medicare enrollees age 65 and over, by age group, 1992-2006  
    • Death rates for selected leading causes of death among people age 65 and over, 1981-2006  
    • Percentage of noninstitutionalized Medicare enrollees age 65 and over who have limitations in instrumental activities of daily living (IADLs) and who receive personal assistance, by age group, selected years 1992-2007  
    • Medicare-covered physician and home health care visits per 1,000 Medicare enrollees age 65 and over in fee-for-service, 1992-2007  
    • Major components of health care costs among Medicare enrollees age 65 and over, 1992-2006  
    • Medicare-covered hospital and skilled nursing facility stays per 1,000 Medicare enrollees age 65 and over in fee-for-service, 1992-2007  
    • Percentage of Medicare enrollees age 65 and over who have limitations in activities of daily living (ADLs) or instrumental activities of daily living (IADLs), or who are in a facility,…  
    • Proportion of Americans Age 65 and Older with Alzheimer’s Disease by Stage of Disease, 2010–2050  
    • Costs for hospital stays with the six most expensive principal procedures: United States, 1999-2006  
    • Adults 45 years of age and over reporting prescription drug use in the past month for selected drug categories, by age and sex: United States, 1988-1994 and 2003-2006  
    • Limitation of activity caused by selected chronic health conditions among older adults, by age: United States, 2006-2007  
    • Hypertension, diabetes, and serious heart conditions among adults 45-64 years of age, by percent of poverty level: United States, 2007  
    • Arthritis and other musculoskeletal conditions were the most frequently reported chronic conditions causing limitation of activity. Heart and circulatory conditions were the second leading cause of activity limitation.  
    • The percentage of noninstitutionalized adults 65 years of age and over with limitation of activity decreased from 39% to 36% between 1997 and 1999 and then remained at 34-35% between…  
    • Absent policy change, the Congressional Budget Office estimates that Medicare spending will grow at an average of 7% each year from 2010 to 2018, rising to $879 billion annually and…  
    • Contribution of Key Medical Conditions to Inflation-Adjusted Health Care Spending Growth Among Medicare Beneficiaries, 1987-1997, 1997-2006, and 1987-2006  
    • Treated Prevalence of the Top-Ten Health Conditions Among Medicare Beneficiaries, 1987, 1997, and 2006  
    • Most older Americans have at least 1 chronic condition and many have multiple conditions. Among the most frequently occurring conditions older persons in 2005-2007 were: hypertension (41%), diagnosed arthritis (49%),…  
    • About 11% (3.7 million) of older Medicare enrollees received personal care from a paid or unpaid source in 1999.  
    • Total Medicare spending reached $469.2 billion in 2008.  
    • Nursing home spending reached $138.4 billion in 2008.  
    • Spending on physician and clinical services reached $496.2 billion in 2008.  
    • Hospital spending by Medicare increased 7.7% in 2008–from 4.7% in 2007.  
    • In 2008, overall spending on hospital services reached $718.4 billion.  
    • National health spending in 2008 reached $2.3 trillion, or $7,681 per person.  This was a 4/4% increase from 2007.  
    • The health care portion of the gross domestic product (GDP) grew from 15.9% in 2007 to 16.2% in 2008.  
    • CBO’s 75-Year Projections for Total National Health Spending  
    • In 2001, 5% of Medicare beneficiaries accounted for 43% of Medicare spending. For these beneficiaries, health care spending averaged around $63,000 per year. The bottom 50% of beneficiaries…  
    • Percentage of Medicare dollars Spent on Chronic Illness, 1987, 1997, and 2002  
    • Percentage of the Population With Chronic Diseases, 1995-2030  
    • In 2007, the Medicare program had about 44 million enrollees and expenditures of $432 billion, up from $408 billion the previous year. Expenditures for the new Medicare drug program (Part…  
    • In 2006, 42% of Americans age 75 years and over living in the community reported having a limitation in their usual activity due to a chronic condition, compared with 13%…  
    • Out-of-pocket spending grew 5.3% in 2007, compared to 3.3% in 2006. This acceleration was mostly due to increased payments for prescription drugs, nursing home services, and nondurable medical supplies.  
    • Medicaid spending grew 6.4% in 2007 to $329.4 billion.  
    • In 2007, Medicare spending grew 7.2% to $431.2 billion.  
    • Nursing home spending increased 4.8% in 2007 to reach $131.3 billion.  
    • Home health spending increased 11.3% (to $59 billion) in 2007.  
    • Hospital spending growth increased 7.3% to $696.5 billion in 2007, compared to 6.9% in 2006.  
    • Home health care spending is projected to reach $64.4 billion in 2008.  
    • Hospital spending is projected to reach $746.5 billion in 2008.  
    • Spending on physician and clinical services is expected to reach $508.5 billion in 2008.  
    • Spending on prescription drugs is projected to grow 3.5% in 2008–a slowdown of 1.4% from 2007–and reach $235.4 billion. Drug spending growth is expected to rebound to 4.5% in…  
    • National health spending is projected to reach $4.4 trillion by 2018.  
    • National health spending numbers are projected to reach $2.4 trillion for 2008.  
    • Public payers are anticipated to become the largest health care funding source in 2016, and pay for more than half of national health spending in 2018.  
    • The health share of the GDP is projected to rise from 16.2% in 2007 to 17.6% in 2009. It is then projected to climb to 20.3% by 2018.  
    • Between 2008 and 2018, average annual growth in health spending is projected to be 6.2%. This is 2.1% higher than the annual GDP growth.  
    • Of the total health care spending in Medicare households, 62.9% is spent on health insurance premiums, 18.1% is spent on prescription drugs, 15.3% is spent on medical services, and 3.8%…  
    • Average health care spending made up 14.1% of all spending in Medicare households.  
    • In the United States, chronic disease accounts for 75% of the more than $2 trillion spent on health care per year.  
    • In 2005, a person with 3 or more chronic conditions who was 65 and older and insured through Medicare paid, on average, $2,588 in out-of-pocket medical expenses.  
    • The annual out-of-pocket medical costs for chronic disease rose from and average of $427 per American in 1996 to $741 in 2005.  
    • Medicines in Development for Older Americans, 2008  
    • National Health Expenditures and Their Share of Gross Domestic Product, 1960-2006  
    • Eliminating hypertension in all elderly persons would result in 75 million additional disability-adjusted life years (DALYs) and reduce Medicare spending by around $890 billion.  
    • Current projections predict a rise in Medicare spending from 2.6% of gross domestic product in 2008 to 9.2% in 2050.  
    • From 2004-2005, 25% of 65-74 year olds and 60% of adults aged 85 and older reported a limitation of activity due to chronic conditions.  
    • In 2005, national health care expenditures in the U.S. totaled $2 trillion–a 6.9% increase from 2004. The rate of increase slowed for the third consecutive year, though it was still…  
    • In 2006, Alzheimer’s disease became the 6th leading cause of death, compared to its ranking of 7th in 2005. Diabetes, ranked 6th in 2005, became the 7th leading cause in…  
    • Deaths and death rates for 2006 and age-adjusted death rates and percentage changes in age-adjusted rates from 2005 to 2006 for the 15 leading causes of death: United States, final…  
    • People with 5 or more chronic conditions see an average of close to 14 different physicians and fill 50 prescriptions per year.  
    • Based on preliminary data from 2004, the top 15 causes of death in the United States in 2004 were: 1. Disease of the heart – 654,092 deaths 2. Malignant neoplasms – 550-270…  
    • If Left Unchecked Chronic Disease Could Cost the U.S. Almost $6 Trilion in Lost Economic Output by 2050  
    • Presenteeism is Responsible for the Largest Share of Lost Economic Output Associated with Chronic Health Problems  
    • Health Care Spending Related to Chronic Diseases is Dwarfed by the Indirect Costs of These Health Problems  
    • Increases in Prevalence and Treatment Intensity of Chronic Disease are Responsible for About Two-Thirds of the Increase in Health Care Costs Over the Past Two Decades  
    • Family Caregivers are a Critical Source of Support for Americans with Chronic Illnesses  
    • Chronic Diseases are the Leading Causes of Death in the U.S.  
    • Older Adults Are More Likely to Have Chronic Conditions, but Americans of All Ages are Affected  
    • Many Americans Have More Than One Chronic Health Problem  
    • Average annual prescription drug costs and sources of payment among noninstitutionalized Medicare enrollees age 65 and over, 1992-2004  
    • Medicare-covered hospital and skilled nursing facility stays per 1,000 Medicare enrollees age 65 and over in fee-for-service, 1992-2005  
    • Percentage of Medicare enrollees age 65 and over with functional limitations, by residential setting, 2005  
    • Major components of health care costs among Medicare enrollees age 65 and over, 1992 and 2004  
    • Death rates for selected leading causes of death among people age 65 and over, 1981-2004  
    • Percentage of people age 65 and over who reported having selected chronic conditions, by sex, 2005-2006  
    • Average annual health care costs for Medicare enrollees age 65 and over, in 2004 dollars, by age group, 1992-2004  
    • Percentage of Medicare enrollees age 65 and over who have limitations in activities of daily living (ADLs) or instrumental activities of daily living (IADLs), or who are in a facility,…  
    • “In 1985, the age adjusted nursing home residence rate was 54 people per 1,000 age 65 and over. By 2004 this rate had declined to 35 people per 1,000. Among…  
    • In 2004, older Americans with no chronic conditions spent an average of $800 on prescription drugs. Those with 5 or more chronic conditions spent on average $3,862.  
    • In 2004, around 8% of older Americans incurred $2,500 or more in prescription drug costs.  
    • The average prescription drug costs for older Americans in 2004 were $2,107 per person.  
    • In 2004, Americans with no chronic conditions incurred about $4,700 on average in health care costs. Those with 5 or more chronic conditions incurred $20,300.  
    • The hospitalization rate for Medicare enrollees increased between 1992 and 1999 from 306 stays per 1,000 enrollees to 350 per 1,000. The rate then decreased to 350 per 1,000 in…  
    • More than 42% of Americans aged 65 and older reported a functional limitation in 2005.  
    • In 2004, the leading causes of death among Americans aged 65 and older were: – Heart disease (1,418 deaths per 100,000 people) – Cancer (1,052 per 100,000) – Stroke (346 per 100,000) – Chronic…  
    • Among Americans aged 65 and older, heart disease and cancer are the top two leading causes of death.  
    • Around 13% of all household expenditures in households headed by people age 65 and older were on healthcare expenses, compared to 7% in households headed by people age 55-64.  
    • The Gallup Healthways Well-Being Index found that 24% of those surveyed were not able to perform their usual activities on 1 or more days during the previous month because of…  
    • The Working Population  
    • Prevalence of Disease Conditions in the Working Population  
    • In 2002, the healthy life expectancy at birth was 69 years in the U.S. – 67 years for men and 71 years for women.  
    • Growth in hospital spending is expected to increase from 7% (2006) to 7.5% in 2007–partially because of higher Medicaid payment rates.  
    • Private health expenditures is expected to grow to 6.3% in 2007–increasing from 5.4% in 2006.  
    • By 2017, U.S. health care spending is expected to grow to more than $4.3 trillion and comprise 19.5% of the GDP.  
    • U.S. health care spending is expected to grow 6.7% in 2007, and remain near the same rate through 2017.  
    • The health share of the GDP is expected to reach 19.5% by 2017.  
    • The health share of the GDP is expected to increase to 16.3% in 2007.  
    • Total U.S. health expenditures reached $2.1 trillion in 2006, which translates to $7,026 per person or 16% of the nation’s GDP.  
    • In 2005, national health expenditures were projected to surpass $2 trillion.  
    • Almost 37% of older persons reported a severe disability in 2006 and 16% reported that they needed some type of assistance as a result.  
    • In 2005, health costs incurred on average by older consumers consisted of $2,617 (60%) for insurance, $887 (20%) for drugs, $663 (15.3%) for medical services, and $164 (4%) for medical…  
    • Older Americans spent 12.4% of their total expenditures on health, more than twice the proportion spent by all consumers (5.7%).  
    • In 2005 older Americans averaged $4,331 in out-of-pocket health care expenditures, an increase of 57% since 1995. In contrast, the total population spent considerably less, averaging $2,766 in out-of-pocket…  
    • The average length of stay for older Americans has decreased by 6 days since 1980.  
    • In 2005, over 13.2 million persons aged 65 and older were discharged from short stay hospitals. This is a rate of 3,596 for every 10,000 persons aged 65+ which…  
    • Percent of Persons with Limitations in Activities of Daily Living by Age Group: 2005  
    • It is projected that by 2020 the U.S. will spend $685 billion a year in direct medical costs for persons with chronic diseases, and by 2050–$906 billion.  
    • Prescription drug spending growth accelerated in 2006 to 8.5%, partly as a result of Medicare Part D’s impact.  
    • The health care portion of the GDP was 16.0% in 2006, slightly higher than in 2005.  
    • The U.S. health care spending increased 6.7% to $2.1 trillion, or $7,026 per person in 2006.  
    • One in Four Americans Has Multiple Chronic Conditions  
    • Older Adults are More Likely to Have Multiple Chronic Conditions  
    • Physician and Home Health Care Visits Increase with the Number of Chronic Conditions  
    • Seniors with Chronic Conditions Rarely Have a Single Condition  
    • Two-Thirds of Medicare Spending is For Beneficiaries with Five or More Chronic Conditions  
    • Women Are More Likely Than Men to Have a Chronic Condition Primarily Because They Live Longer  
    • Percentage of Health Care Spending for Individuals with Chronic Conditions Varies by Type of Health Insurance  
    • People with Chronic Conditions are the Heaviest Users of Health Care Services  
    • People with Chronic Conditions Accounted for 85 Percent of All Health Care Spending in 2004  
    • In 1998, the care given to people with chronic conditions accounted for 78% of health care spending–Now they account for 85%.  
    • 46 million more Americans are projected to have at least one chronic condition in 2030 than in 2000.  
    • The number of people with chronic conditions exceeded a previous prediction by reaching 125 million in 2000 and will grow to almost 157 million by 2020.  
    • The U.S. spent 85% of our health care dollars on people with chronic conditions in 2004.  
    • In 2005, 133 million people had at least one chronic condition. The number will increase to 157 million by 2020.  
    • Avoidable Treatment Expenditures, 2023  
    • State Chronic Disease Index  
    • Projected Rise in Cases of Chronic Diseases, 2003-2023  
    • Number of People Reporting Selected Chronic Diseases, 2003  
    • Lost Productivity by Source, 2003  
    • Lost Productivity by Chronic Disease, 2003  
    • Percent Growth in Number of People Reporting Chronic Diseases, 2003-2023: Current Path versus Alternative Path  
    • Economic Impact of Chronic Disease, 2003  
    • Current Path, Combined Value of Treatment Expenditures and Productivity Losses, 2003-2023  
    • Costs That Can Be Avoided, 2003-2023  
    • Avoidable Treatment Costs and Output Losses, 2023  
    • Avoidable Productivity Losses, 2023  
    • Projected Annual Costs of Chronic Diseases, 2023 (US$ Trillions)  
    • The costs of productivity loss because of a chronic disease were 4 times as great as the direct medical costs of a chronic condition.  
    • Changes in behavior, preventative measures and innovation could save $1.6 trillion in treatment costs.  
    • In an optimistic scenario, more effective prevention and management of disease could save $218 billion in treatment expenditures annually in 2023.  
    • The total annual economic burden of 7 major chronic diseases. including cost of expenditures, will be $4.2 trillion in 2023.  
    • The indirect impacts of 7 major chronic diseases will total $3.4 trillion in 2023– which is 4 times the cost of treatment.  
    • Lost workdays and lower employee productivity because of hypertension cost $279.5 billion– the highest amount among chronic diseases.  
    • Chronic disease cost $42 trillion in treatment costs and economic output.  
    • In 2030 there will be a 42% increase in cases of chronic diseases– 230.7 million people.  
    • The most common chronic diseases are costing the U.S. more than $1 trillion per year– which is expected to increase to $6 trillion by the middle of the century.  
    • More than half of Americans suffer from one or more chronic diseases.  
    • The combined cost of treatment expenditures and lost economic output for seven common chronic diseases (cancer, diabetes, heart disease, hypertension, stroke, mental disorders, and pulmonary conditions) totaled $1.3 trillion in…  
    • In 2003, over 162 million cases of seven common chronic diseases (cancer, diabetes, heart disease, hypertension, stroke, mental disorders, pulmonary disorders) were reported in The United States, while only 109…  
    • Improvements in preventing and managing chronic disease could reduce future economic costs in the United States by 27% ($1.1 trillion) in 2023. $905 billion would come from gains in productivity;…  
    • Resonable disease prevention and management efforts could add $5.7 trillion to the nation’s economic output by 2050– a boost of 18%.  
    • If resonable improvements in preventing and managing chronic disease are made, 40.2 million cases of chronic disease will be avoided in 2023.  
    • Lost workdays and lower employee productivity as a result of chronic disease cost the United States over $1 trillion in 2003.  
    • In 2003, more than 13.2 million people age 65 and older were discharged from short stay hospitals. This is a rate of 3,679 for every 10,000 people age 65 and…  
    • Medicare income in 2006 was $437 billion, and expenditures were $408 billion.  
    • In 2006, 43.2 million Americans were covered by Medicare– 7 million disabled.  
    • Delaying the onset of Alzheimer’s disease, innovations that delay disability among the elderly through 2009, and a 25% increase in efficiency and effectiveness of cancer treatment would save $138 billion…  
    • Appropriate use of diagnostics prevents between $28-$46 million in prescription drug, outpatient and inpatient costs.  
    • Chronically ill patients receive only about 55% of all clinically recommended care.  
    • Medicare spending is projected to almost triple from 3% of the U.S. GDP in 2006 to 8.8% by 2030.  
    • Analysis of Medicare data on quality and costs of care for acute myocardial infarction (AMI), hip fracture, and colorectal cancer (with resection) reveals substantial variations in one-year, risk-adjusted mortality rates…  
    • 40% of American adults reported that they went without care in 2004 because of costs during the year. This rate is 4 times higher than in the U.K., the benchmark…  
    • Only 3 of 5 U.S. adults with chronic disease report having a self-management plan. This type of plan encourages patients to take steps to control their conditions.  
    • The Cleveland Clinic lists these medical innovations in their top ten, because of the potential for short term clinical impact, high probability of success, the availability, and/or data to support…  
    • The percentage of recommended care received by Medicare beneficiaries was 3.2% higher than those who did not have health insurance.  
    • Quality-of-care scores were found to decline with age. The percentage of recommended care received by individuals age 18-30 was 57.5%, compared to 52.1% for those 65 and older.  
    • If the major risk factors for chronic disease were eliminated, at least 80% of heart disease, stroke and type 2 diabetes would be prevented; and 40% of cancer would be…  
    • Health Care Costs: 1965-2004  
    • Trends in Chronic Disability Among Persons Age 65 or Older, 1984-1999  
    • Older Persons with Disability, Their Family Availability and Care Arrangements, 1994 and 1999  
    • Trends in Informal and Formal Care Among Older Community Residents Receiving Care, 1984-1999  
    • Out-of-Pocket Spending on Prescription Drugs by Medicare beneficiaries, by Presence of Prescription Drug Coverage, 2003  
    • Average Out-of-Pocket Spending on Health Care by Medicare Beneficiaries, by Type of Supplemental Coverage, 2003  
    • Average Out-of-Pocket Spending on Health Care by Medicare Beneficiaries, by Income as a Percent of Federal Poverty Level, 2003  
    • Out-of-Pocket Spending on Health Care by Medicare Beneficiaries, by Type of Expenditure, 2003  
    • In 1999, nearly 40% of caregiving children were assisting parents who were age 85 or older, compared to about 34% in 1994. Nearly 13% of caregiving children were age 65…  
    • 11% of caregiving spouses were age 85 or older, up from 8.6% in 1994.  
    • More than 1/2 of family caregivers were providing help to spouses or parents with 3 or more activities of daily living (ADL) disabilities in 1999, up about 5% from 1994.  
    • Older persons with a spouse and a child, and older persons living with others were most likely to rely entirely on informal care (about 62% for both groups).  
    • 1/3 of older people without a spouse or child received no care in 1999, compared to 1/4 of older people with a spouse and a child (or children).  
    • A larger proportion of older community residents who received personal assistance were relying entirely on their informal caregivers in 1991 than in 1994 (2/3 compared to 57% in 1994) as…  
    • Among older persons in the community with disability who did receive personal assistance, the proportion receiving any informal care (informal care or informal/formal combination of care) fell somewhat, from 94.9%…  
    • Out-of-pocket spending on health care tends to rise with income. Medicare beneficiaries with incomes above 400% of poverty spent an average of $3,785, which is the highest among the income…  
    • In 2003, Medicare beneficiaries with excellent health spent $2,845 (16% of their income) on health care.  
    • In 2003, Medicare beneficiaries in fair or poor health had the highest average out-of-pocket health care costs of the health status groups, both in dollars and % of income ($4,000…  
    • In 2003, Medicare beneficiaries age 65-74 had the lowest out-of-pocket expenses as a percent of income (18%), while beneficiaries age 85 and older had the highest (30%).  
    • Average out-of-pocket health care spending tends to increase with age. Medicare beneficiaries age 65-74 spent $2,920 out-of-pocket in 2003, while beneficiaries age 85 and older spent $4,615.  
    • Spending on prescription drugs by non-institutionalized Medicare beneficiaries age 65 and older averaged $830 (24% of out-of-pocket spending) in 2003.  
    • In 2003, 45% of beneficiaries’ total out-of-pocket health care expenses were for premiums for Medicare Part B, private Medicare plans (primarily HMOs) and private supplemental insurace.  
    • Non-institutionalized Medicare beneficiaries age 65 and older spent an average of $3,455 (22% of their income) on healthcare in 2003.  
    • The decade-long projection detailed here expects that nearly $0.20 of every $1.00 spent will be devoted to health by 2016.  
    • Nursing home spending growth is expected to remain fairly steady from 2007 through 2010 averaging around 5.0% per year, before a gradual acceleration over the latter half of the projection…  
    • Private health insurance benefit spending is predicted to slow from a peak of 9.5% in 2001 to 4.7% in 2006, partially because of Medicare Part D.  
    • From 2008 to 2016, combined state and federal Medicaid spending is projected to grow an average of 8.1% per year and to represent 16.4% of national health expenditures by 2016.  
    • Spending for two Medicaid services is expected to accelerate in 2006: home health care (from 14% in 2005 to 19.8% in 2006), and other personal health care (from 8.1% in…  
    • In 2007, growth in national health spending is projected to decelerate slightly to 6.6%, while spending growth among private payers and Medicaid accelerates.  
    • Growth in national health spending is projected to be 0.4% higher than the GDP. Health spending is expected to grow an average of 2.1% faster per year than GDP, resulting…  
    • This year’s national health spending projection anticipates an average annual growth of 6.9% from 2006 to 2016.  
    • National health spending growth is projected to slow from 6.9% in 2005 to 6.8% in 2006, which marks the 4th consecutive year of a slowing trend.  
    • From 1970-2000, increased longevity added approximately $3.2 trillion per year to national wealth, the equivalent of half of the average annual gross domestic product over the period. Half of these…  
    • Medicines in Development for Older Americans  
    • According to the Pharmaceutical Research and Manufacturers of America, medical research could result in $149 billion in savings for government programs by 2025.  
    • As the baby boomers age, deaths from heart disease are projected to increase 2.5 times faster than the population as a whole, and the prevalence of heart disease is projected…  
    • Increased use of multiple prescription medications has been shown to raise the risk of adverse drug interactions for older adults. The risk of injury is associated with the use of…  
    • Each year, older adults who have 5 or more chronic illnesses visit, on average, 14 different physicians, make 37 physician office visits, and have 50 prescriptions filled.  
    • Even though the proportion of Americans using prescription drugs remained constant between 1996 and 2003, spending per person more than doubled from $424 to $950.  
    • At least 80% of older Americans live with at least 1 chronic condition. 50% live with at least 2 chronic conditions.  
    • American adults age 65 and older use 1/3 of all prescription medications.  
    • The national average annual cost for a private one-bedroom unit in an assisted living facility is $32,294.40 ($88.48/day). This is a 6.7% increase over 2005 rates. Note–these rates exclude one-time…  
    • 2004 saw the sharpest drop in deaths in around 60 years – down almost 50,000 from 2003. The research team for “Death: Preliminary Data for 2004” from the National Center…  
    • In 2003, 28.6% of Americans 75 years and older made 1 – 3 health care visits (visits to doctor’s offices, emergency departments, and home visits); 36% made 4 – 9;…  
    • In 2003, 45.8% of the American population (civilian, noninstitutionalized) made 1 – 3 health care visits (visits to doctor’s offices, emergency departments, or home visits); 24.8% made 4 – 9;…  
    • In 2003, 34% of the population age 65 – 74 years (civilian, noninstitutionalized) made 1 – 3 health care visits (visits to doctor’s offices, emergency departments, and home visits); 35.7%…  
    • In 2004, national health expenditures were approximately $1.88 trillion.  
    • The typical caregiver is a 46-year-old woman with at least some college experience, providing more than 20 hours of weekly care to her mother. However, nearly 4 in 10 caregivers…  
    • Spending $11,000 on general medical care adds an average of 1 year of life. Spending only $1,345 on pharmaceutical research and development yields the same return.  
    • Every $1 invested in newer medications saves $7 in other costs.  
    • Increased longevity added about $3.2 trillion per year to national wealth between 1970 and 2000, an uncounted value equal to approximately 1/2 of the average annual GDP during that period.  
    • The share of elderly with impairments in their ability to live independently went down between 1% and 1.5% annually between 1984 and 2004, compared to the historical annual decline in…  
    • Spending on long-term care services for the elderly is projected to increase at least 2 1/2 times by 2050–to $379 billion.  
    • By 2020, 81 million people will have 2 or more chronic conditions.  
    • Between 2000 and 2030, the number of Americans with 1 or more chronic conditions will increase by 37%–46 million people.  
    • 2/3 of Medicare expenditures are for the 9.5 million beneficiaries who have 5 or more chronic conditions.  
    • 99% of Medicare spending is on behalf of beneficiaries with at least 1 chronic condition. 96% of Medicare spending is on behalf of beneficiaries with multiple chronic conditions.  
    • Compared to individuals with no chronic conditions, the average per capita spending for someone with 1 chronic condition is more than 2.5 times greater; with 3 chronic conditions is more…  
    • Medicare beneficiaries with 4 or more chronic conditions are 99 times more likely to be admitted to the hospital for ambulatory sensitive conditions, than Medicare beneficiaries without chronic conditions.  
    • Medicare beneficiaries with 5 or more chronic conditions see an average of 14 different physicians a year.  
    • The average 75-year-old suffers from 3 chronic conditions and takes 5 prescription medications.  
    • In 2002, older people made up 13% of the U.S. population yet accounted for 36% of all hospital stays, 49% of all days of hospital care, and 50% of all…  
    • About 80% of the senior population has 1 or more chronic conditions. Because of these conditions, 25% are limited in their ability to perform activities of daily living.  
    • 5 chronic diseases–heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD), and diabetes–account for more than 2/3 of all deaths.  
    • Percent Change in Selected Leading Causes of Death from 2000 to 2004  
    • Growth in public spending on personal health care, which is projected to be 8% in 2005, is expected to continue to outpace growth in private spending.  
    • This year’s outlook for national health spending calls for growth to average 7.2% over the coming decade — 2.1 percentage points faster than projected average annual growth in GDP over…  
    • Distribution of Medicare enrollees age 65 and over receiving personal care for a chronic disability, by type of care, 1984, 1989, 1994, and 1999  
    • Analysis suggests that in the past 20 years, each additional dollar spent on health care services produced health gains valued at between $2.40 and $3.00.  
    • The United States would have spent $634 billion less on health care in 2000 without many of the improvements in health and the associated investments that were seen between 1980…  
    • Between 1980 and 2000, annual age adjusted per person health care costs increased by $2,254 (102%) but were accompanied by significant health gains including: a 16% decline in annual death…  
    • Prevalence of Selected Chronic Conditions Among Adults Age 65 and Over, 2000-2001  
    • 1.7 million Americans die from a chronic disease each year–7 out of 10 deaths in the United States.  
    • 133 million Americans have at least one chronic disease–45% of the total population.  
    • Chronic diseases are the leading cause of death and disability in the United States–accounting for 70% of all deaths.  
    • Health care spending accounts for 16% of the GDP, with total spending estimated to reach $2.2 trillion in 2006.  
    • Freestanding home health care spending continued to grow in 2005, increasing 11.1%, which was the 3rd straight year of double-digit growth. Home health care spending was the fastest growing health…  
    • “Medicaid spending growth increased slightly in 2005 to 3.9%, while Medicare nursing home expenditures grew 12.0% following growth of 16.2% in 2004.”  
    • Hospital spending accounted for 31% of all money spent on health care in 2005, which was the largest share of overall health spending.  
    • Out-of-pocket spending for health care was $249.4 billion in 2005.  
    • In 2005, Medicare spending reached $342.0 billion which was a 9.3% increase. Medicare spending increased 10.3% in 2004.  
    • Public-sector spending on health care increased 7.7% in 2005, compared with 7.8% in 2004.  
    • In 2004 and 2005, hospital spending continued to grow quickly by 7.9% each year and accounted for the largest share of the overall spending increase in both years.  
    • The health care portion of the GDP was 16%, which was slightly higher than the 15.9% in 2004.  
    • U.S. health care spending increased 6.9% in 2005 to almost $2.0 trillion, or $6,697 a person.  
    • Health care spending exceeded 15% U.S. GDP in 2004 ($1.9 trillion) and is expected to increase to as much as 20% by 2015.  
    • Age-adjusted Percentage of Medicare Enrollees Age 65 and Over Who are Chronically Disabled, by Level and Category of Disability, 1984, 1989, 1994, and 1999  
    • Distribution of Medicare Enrollees Age 65 and Over Using Assistive Devices and/or Receiving Personal Care for a Chronic Disability, 1984, 1989, 1994, and 1999  
    • Among older Americans, 6 of the 7 leading causes of death are chronic diseases.  
    • In 2004, hospital spending, which is 30% of national heath expenditures, increased by 8.6%.  
    • Over 2/5 of Americans age 65 and older who had health care expenses paid at least $1,000 out-of-pocket in 2003.  
    • New Medicines Account for 40% of Increase in Life Expectancy  
    • Benefit of Increased Health Care Spending: Disability rates declining for seniors, 1982-1999  
    • Greater Adherence to Medicines Decreases Total Health Care Spending  
    • Increased Use of Medicines Reduces Overall Health Care Costs: Mental health/substance abuse (MH/SA) spending per patient fell as drug spending increased, 1992-1999  
    • Using Newer Medicines Results in Savings of $111 per Treated Condition  
    • In 2000, Americans saved 206 million days of hospital care because of health care investments.  
    • For every $1 spent on newer instead of older medicines, total health care spending is reduced by $6.17.  
    • For each $1 spent on newer pharmaceuticals. $6.17 is saved in total health care spending. $4.44 of this savings is in hospital spending alone.  
    • Public spending represents 3/4 of home health spending and is expected to grow to more than 80% by 2015.  
    • Total hospital spending growth is expected to stay an average of 2% higher than GDP growth between 2006 and 2015.  
    • “Medicare spending has grown about nine-fold in the past two decades, from $37 billion in 1980 to $336 billion in 2005.”  
    • About 95% of health care spending for older Americans is for chronic diseases.  
    • In 2002, 61% of all deaths of those age 65 and older were caused by heart disease (32%), cancer (22%), and stroke (8%).  
    • Providing health care for an older American costs 3 to 5 times more than for an individual under age 65. As the population ages, the nation’s health care spending is…  
    • From 2008 to 2016, Medicare growth is expected to average 7.6% per year, and represent 20.9% of total national health care expenditures towards the end of the projection period.  
    • Total spending on health care is projected to reach $4.1 trillion by 2016.  
    • Total health care spending in 2006 is projected to be $2.1 trillion.  
    • The health share of the GDP is expected to hold steady in 2006 before it resumes a historical upward trend, reaching 19.6% of GDP by 2016.  
    • New medicines, or “new chemical entities” accounted for 40% (0.8 years) of the two-year gain in life expectancy seen in 52 countries from 1986-2000.  
    • 95% of all nursing homes in the United States are Medicare certified.  
    • Certified home care providers charge the most of any home health aides, averaging $36.22 per hour (a 17% increase over 2005). Non-certified but licensed providers charge an average of $22.15…  
    • The average annual rate for home health aides is $25.32. This includes licensed and Medicare-certified home care providers, non-certified but licensed home care providers, and non-certified and non-licensed home care…  
    • The lowest annual cost for a one-bedroom in an assisted living facility is in North Dakota ($20,714 excluding community fees) and Arkansas ($20,937 excluding community fees).  
    • The highest annual costs for a one-bedroom in an assisted living facility are in the Bridgeport area in Connecticut ($57,566.52 excluding community fees) and New Jersey state, excluding the Newark…  
    • The national annual average cost for a one-bedroom in an assisted living facility increased $2,029 from 2005.  
    • On average, the cost of care for a private (single occupancy) room in a Medicare certified nursing home is 17% greater in America’s urban areas than non-urban areas. The greatest…  
    • The national average annual cost for a semi-private room (double occupancy) in a Medicare certified nursing home is $62,532 ($171.32/day). This is a 2.3% increase over 2005 rates.  
    • The lowest average annual cost for a private room (single occupancy) in a Medicare certified nursing facility is in Louisiana and Missouri (excluding St. Louis and Kansas City) at a…  
    • The highest average annual cost for a private room (single occupancy) in a Medicare certified nursing home is in Alaska at a cost of $191,140. The next highest cost is…  
    • The national average annual cost for a private room (single occupant) in a Medicare certificed nursing home increased $1,490 from 2005 rates.  
    • The national average annual cost for a private room (single occupant) in a Medicare certified nursing home is $70,912 ($194.28/day). This is a 2.2% increase from 2005 rates.  
    • “The United States spends more on health per capita than any other country, and health spending continues to increase rapidy. Much of this spending is for care that controls or…  
    • In 2000, there were more than 1.3 million home health care patients.  
    • In 2000, there were 105,496 hospice patients.  
    • In 2003, 26.3% of noninstitutionalized Americans between the ages of 65 and 74, and 44% of Americans age 75 and over, had activity limitations caused by chronic conditions.  
    • 12.1% of noninstitutionalized Americans in 2003 had activity limitations caused by chronic conditions.  
    • In 2003, national health expenditures were 15.3% of the GDP, compared to 5.1% in 1960.  
    • In 2003, the U.S. spent $1.7 trillion on health, an average of $5,671 per person.  
    • By 2015, spending on nursing home and home health care is expected to double from 2004 to $320.5 billion.  
    • By 2015, national health expenditures are projected to surpass $4 trillion.  
    • In 2004, nursing home and home health care cost the nation $158.4 billion.  
    • Health spending is projected to consistently outpace the gross domestic product (GDP) over the next decade, growing from 16% of the GDP in 2004 to 20% in 2015.  
    • There are an estimated 44 million American adult caregivers (21% of the adult population) who provide unpaid care to an adult. These caregivers are present in 22.9 million households (21%…  
    • The Number of People with Chronic Condtions is Rapidly Increasing  
    • More than Three-Fifths of Health Care Spending Is on Behalf of People with Multiple Chronic Conditions  
    • Decline in Disability Rates for People Aged over 65 Years, 1982-2000  
    • People with Chronic Conditions Account for 83 Percent of all Health Care Spending  
    • People with Multiple Chronic Illnesses Are More Likely to Have Activity Limitations  
    • One Quarter of Individuals with Chronic Illness Also Have Activity Limitations  
    • Individuals with Chronic Illnesses and Activity Limitations Have More Home Health Care Visits  
    • People with Chronic Illnesses and Activity Limitations Have More Inpatient Stays  
    • People with Multiple Chronic Conditions Are Much More Likely to be Hospitalized  
    • People with Chronic Illnesses and Activity Limitations Fill More Prescriptions  
    • People with Chronic Illnesses and Activity Limitations Have More Physician Visits  
    • Using newer drugs could lower overall health expenses by as much as $111 per person, per condition, for the general population, and $155 for Medicare beneficiaries.  
    • Medicare could save $26 billion per year if currently healthy older people were able to remain fully independent over the course of a single year.  
    • During the twentieth century, cumulative gains in life expectancy, for both men and women, were worth over $1.2 million per person.  
    • Each new drug approved between 1970 and 1991 saves an average of 11,200 life-years in 1991.  
    • By 2030, 20% of the population will be people age 65 and older with chronic conditions.  
    • The United States spends more than $26 billion annually on additional health care costs for people over 65 who lose their ability to live independently over the course of a…  
    • In 2003, heart disease, stroke, cancer, diabetes, and Alzheimer’s disease cost an estimated $771 billion.