Table 139Medicare enrollees and expenditures and percent distribution, according to type of service: United States and other areas, selected years 1970–2004
[Data are compiled from various sources by the Centers for Medicare & Medicaid Services]
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Type of service 1970 1980 1990 1995 2000 2001 2002 2003 2004 1
EnrolleesNumber in millions
Total220.428.434.337.639.740.140.541.141.7
 Hospital insurance20.128.033.737.239.339.740.140.641.2
 Supplementary medical insurance19.527.332.635.637.337.738.038.438.8
ExpendituresAmount in billions
Total$7.5$36.8$110.8$184.0$221.8$244.8$265.7$280.8$308.9
Total hospital insurance (HI)5.325.666.8117.4131.1143.4152.5154.6170.6
 HI payments to managed care organizations3- - -0.02.76.721.420.819.219.520.8
 HI payments for fee-for-service utilization5.325.564.2110.7109.7122.6133.3135.1149.8
  Inpatient hospital4.824.156.982.387.195.6104.1108.6116.2
  Skilled nursing facility0.20.42.59.111.113.415.314.816.9
  Home health agency0.10.53.716.23.84.25.04.85.8
  Home health agency transfer4- - -- - -- - -- - -1.73.11.2−2.2
  Hospice- - -- - -0.31.93.03.74.96.27.6
  Administrative expenses50.20.50.81.22.92.52.82.83.3
Total supplementary medical insurance (SMI)2.211.244.066.690.7101.4113.2126.1138.3
 SMI payments to managed care organizations30.00.22.86.618.417.617.517.318.7
 SMI payments for fee-for-service utilization62.211.041.260.072.383.895.7108.9119.6
  Physician/supplies71.88.229.6- - -- - -- - -- - -- - -- - -
  Outpatient hospital80.11.98.5- - -- - -- - -- - -- - -- - -
  Independent laboratory90.00.11.5- - -- - -- - -- - -- - -- - -
  Physician fee schedule- - -- - -- - -31.737.042.044.848.253.8
  Durable medical equipment- - -- - -- - -3.74.75.46.67.78.0
  Laboratory10- - -- - -- - -4.34.04.45.05.56.0
  Other11- - -- - -- - -9.913.716.019.622.625.0
  Hospital12- - -- - -- - -8.78.512.813.515.317.4
  Home health agency0.20.10.24.44.45.15.15.9
  Home health agency transfer4- - -- - -- - -- - -−1.7−3.1−1.22.2
  Administrative expenses50.20.61.51.61.81.82.32.43.4
Percent distribution of expenditures
Total hospital insurance (HI)100.0100.0100.0100.0100.0100.0100.0100.0100.0
 HI payments to managed care organizations3- - -0.04.05.716.314.512.612.612.2
 HI payments for fee-for-service utilization100.099.696.194.383.785.587.487.487.8
  Inpatient hospital90.694.585.170.166.566.768.270.368.1
  Skilled nursing facility3.81.63.77.88.59.410.19.69.9
  Home health agency1.92.05.513.82.92.93.33.13.4
  Home health agency transfer4- - -- - -- - -- - -1.32.20.8−1.4
  Hospice- - -- - -0.41.62.32.63.24.04.4
  Administrative expenses53.82.01.21.02.21.71.91.82.0
Type of service 1970 1980 1990 1995 2000 2001 2002 2003 2004 1
Percent distribution of expenditures
Total supplementary medical insurance (SMI)100.0100.0100.0100.0100.0100.0100.0100.0100.0
 SMI payments to managed care organizations30.01.86.49.920.317.315.513.713.5
 SMI payments for fee-for-service utilization6100.098.293.690.179.882.784.586.386.5
  Physician/supplies785.773.267.3- - -- - -- - -- - -- - -- - -
  Outpatient hospital84.817.019.3- - -- - -- - -- - -- - -- - -
  Independent laboratory90.00.93.4- - -- - -- - -- - -- - -- - -
  Physician fee schedule- - -- - -- - -47.540.841.539.638.238.9
  Durable medical equipment- - -- - -- - -5.55.25.45.86.15.8
  Laboratory10- - -- - -- - -6.44.44.34.44.34.3
  Other11- - -- - -- - -14.815.115.817.317.918.1
  Hospital12- - -- - -- - -13.09.412.612.012.212.6
  Home health agency0.01.80.20.34.84.44.54.04.2
  Home health agency transfer4- - -- - -- - -0.0−1.9−3.1−1.11.7
  Administrative expenses59.55.43.42.42.01.82.01.92.5

- - - Data not available.

0.0 Quantity greater than 0 but less than 0.05.

– Quantity zero.

1

Preliminary figures.

2

Average number enrolled in the hospital insurance (HI) and/or supplementary medical insurance (SMI) programs for the calendar year. See Appendix II, Medicare.

3

Medicare-approved managed care organizations.

4

Reflects home health transfer amounts between HI and SMI.

5

Includes research, costs of experiments and demonstration projects, and peer review activity.

6

Type of service reporting categories for fee-for-service reimbursement differ before and after 1991.

7

Includes payment for physicians, practitioners, durable medical equipment, and all suppliers other than Independent laboratory, which is shown separately through 1990. Beginning in 1991, those physician services subject to the Physician fee schedule are so broken out. Payments for laboratory services paid under the Laboratory fee schedule and performed in a physician office are included under "Laboratory" beginning in 1991. Payments for durable medical equipment are broken out and so labeled beginning in 1991. The remaining services from the "Physician" category are included in "Other."

8

Includes payments for hospital outpatient department services, for skilled nursing facility outpatient services, for Part B services received as an inpatient in a hospital or skilled nursing facility setting, and for other types of outpatient facilities. Beginning in 1991, payments for hospital outpatient department services, except for laboratory services, are listed under "Hospital." Hospital outpatient laboratory services are included in the "Laboratory" line.

9

Beginning in 1991, those independent laboratory services that were paid under the laboratory fee schedule (most of Independent lab) are included in the "Laboratory" line; the remaining services are included in "Physician fee schedule" and "Other" lines.

10

Payments for laboratory services paid under the laboratory fee schedule performed in a physician office, independent lab, or in a hospital outpatient department.

11

Includes payments for physician-administered drugs; free-standing ambulatory surgical center facility services; ambulance services; supplies; free-standing end-stage renal disease (ESRD) dialysis facility services; rural health clinics; outpatient rehabilitation facilities; psychiatric hospitals; and federally qualified health centers.

12

Includes the hospital facility costs for Medicare Part B services that are predominantly in the outpatient department, with the exception of hospital outpatient laboratory services, which are included on the "Laboratory" line. Physician reimbursement is included on the "Physician fee schedule" line.

NOTES: Percents are calculated using unrounded data. Table includes service disbursements as of February 2005 for Medicare enrollees residing in Puerto Rico, Virgin Islands, Guam, other outlying areas, foreign countries, and unknown residence. Totals do not necessarily equal the sum of rounded components. Some numbers in this table have been revised and differ from previous editions of Health, United States. Data for additional years are available. See Appendix III.

SOURCE: Centers for Medicare & Medicaid Services, Office of the Actuary, Medicare and Medicaid Cost Estimates Group, Medicare Administrative Data.

From: Trend Tables

Cover of Health, United States, 2005
Health, United States, 2005: With Chartbook on Trends in the Health of Americans.
National Center for Health Statistics (US) .
Hyattsville (MD): National Center for Health Statistics (US); 2005 Nov.

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