Table 141Medicare enrollees and expenditures and percent distribution, by Medicare program and type of service: United States and other areas, selected years 1970–2006
[Data are compiled from various sources by the Centers for Medicare & Medicaid Services]
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Medicare program and type of service 1970 1980 1990 1995 2000 2001 2002 2003 2004 2005 2006 1
EnrolleesNumber in millions
Total Medicare220.428.434.337.639.740.140.541.241.942.643.2
 Hospital insurance20.128.033.737.239.339.740.140.741.442.242.9
 Supplementary medical insurance319.527.332.635.637.337.738.038.6- - -- - -- - -
  Part B19.527.332.635.637.337.738.038.639.139.740.3
  Part D4- - -- - -- - -- - -- - -- - -- - -- - -1.21.827.9
ExpendituresAmount in billions
Total Medicare$ 7.5$ 36.8$ 111.0$184.2$221.7$244.8$265.8280.8308.9336.4408.3
 Total hospital insurance (HI)5.325.667.0117.6131.0143.4152.7154.6170.6182.9191.9
  HI payments to managed care organizations5- - -0.02.76.721.420.819.219.520.824.932.9
  HI payments for fee-for-service utilization5.125.063.4109.5105.1117.0129.3134.5146.5154.7155.7
   Inpatient hospital4.824.156.982.387.196.0104.2108.7116.4121.7121.0
   Skilled nursing facility0.20.42.59.111.113.115.214.717.118.519.9
   Home health agency0.10.53.716.24.04.15.04.85.45.96.0
   Hospice- - -- - -0.31.92.93.74.96.27.68.68.9
  Home health agency transfer6- - -- - -- - -- - -1.73.11.2−2.20.00.00.0
  Administrative expenses70.20.50.91.42.82.53.02.83.33.33.3
 Total supplementary medical insurance (SMI)32.211.244.066.690.7101.4113.2126.1138.3153.4216.4
 Total Part B2.211.244.066.690.7101.4113.2126.1137.9152.4169.0
  Part B payments to managed care organizations50.00.22.86.618.417.617.517.318.722.131.5
  Part B payments for fee-for-service
   Part B payments for fee-for-service utilization81.910.439.658.472.285.194.5104.3116.2126.9134.1
    Physician/supplies91.88.229.6- - -- - -- - -- - -- - -- - -- - -- - -
    Outpatient hospital100.11.98.5- - -- - -- - -- - -- - -- - -- - -- - -
    Independent laboratory110.00.11.5- - -- - -- - -- - -- - -- - -- - -- - -
    Physician fee schedule- - -- - -- - -31.737.042.044.848.354.157.758.4
    Durable medical equipment- - -- - -- - -3.74.75.46.57.57.87.98.4
    Laboratory12- - -- - -- - -4.34.04.45.05.56.06.57.1
    Other13- - -- - -- - -9.913.616.019.622.625.027.529.3
    Hospital14- - -- - -- - -8.78.412.813.615.317.420.223.8
    Home health agency0.00.20.10.24.54.55.05.15.97.17.2
  Home health agency transfer6- - -- - -- - -- - -−1.7−3.1−1.22.20.00.00.0
  Administrative expenses70.20.61.51.61.81.82.32.42.83.23.1
  Part D Transitional Assistance and Start-up Costs15- - -- - -- - -- - -- - -- - -- - -- - -0.20.70.0
Total Part D4- - -- - -- - -- - -- - -- - -- - -- - -0.41.047.4
Percent distribution of expenditures
 Total hospital insurance (HI)100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
  HI payments to managed care organizations5- - -0.04.05.716.314.512.612.612.213.617.1
  HI payments for fee-for-service utilization97.097.994.693.180.281.684.787.085.984.681.1
   Inpatient hospital91.494.385.070.066.567.068.370.368.266.663.1
   Skilled nursing facility4.71.53.77.88.59.110.09.510.010.110.4
   Home health agency1.02.15.513.83.12.93.33.13.23.23.1
   Hospice- - -- - -0.51.62.22.63.24.04.44.74.6
  Home health agency transfer6- - -- - -- - -- - -1.32.20.8−1.40.00.00.0
  Administrative expenses73.02.11.41.22.11.72.01.82.01.81.7
Medicare program and type of service 1970 1980 1990 1995 2000 2001 2002 2003 2004 2005 2006 1
Percent distribution of expenditures
Total supplementary medical insurance (SMI)3100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0100.0
 Total Part B100.0100.0100.0100.0100.0100.0100.0100.099.799.378.1
  Part B payments to managed care organizations41.21.86.49.920.217.315.513.713.614.518.6
  Part B payments for fee-for-service utilization888.192.890.187.679.684.083.582.784.082.779.3
   Physician/supplies980.972.867.3- - -- - -- - -- - -- - -- - -- - -- - -
   Outpatient hospital105.216.919.3- - -- - -- - -- - -- - -- - -- - -- - -
   Independent laboratory110.51.03.4- - -- - -- - -- - -- - -- - -- - -- - -
    Physician fee schedule- - -- - -- - -47.540.841.539.638.339.237.934.6
   Durable medical equipment- - -- - -- - -5.55.25.45.86.05.65.35.0
   Laboratory10- - -- - -- - -6.44.44.34.44.34.44.34.2
   Other11- - -- - -- - -14.815.015.817.317.918.118.017.3
   Hospital12- - -- - -- - -13.09.312.612.012.112.613.514.1
   Home health agency1.52.10.20.34.94.54.54.04.34.34.3
   Home health agency transfer6- - -- - -- - -0.0−1.9−3.1−1.01.70.00.00.0
   Administrative expenses710.75.43.52.42.01.82.01.92.01.81.8
   Part D Transitional Assistance and Start-up Costs15- - -- - -- - -- - -- - -- - -- - -- - -0.20.40.0
 Total Part D4- - -- - -- - -- - -- - -- - -- - -- - -0.30.721.9

- - - Data not available.

0.0 Quantity greater than 0 but less than 0.05.

1

Preliminary figures.

2

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

3

Starting with 2004 data, the SMI trust fund consists of two separate accounts: Part B (which pays for a portion of the costs of physicians' services, outpatient hospital services, and other related medical and health services for voluntarily enrolled aged and disabled individuals) and Part D (Medicare Prescription Drug Account which pays private plans to provide prescription drug coverage).

4

The Medicare Modernization Act, enacted on December 8, 2003, established within SMI two Part D accounts related to prescription drug benefits: the Medicare Prescription Drug Account and the Transitional Assistance Account. The Medicare Prescription Drug Account is used in conjunction with the broad, voluntary prescription drug benefits that began in 2006. The Transitional Assistance Account was used to provide transitional assistance benefits, beginning in 2004 and extending through 2005, for certain low-income beneficiaries prior to the start of the new prescription drug benefit.

5

Medicare-approved managed care organizations.

6

Starting with 1999 data, reflects annual home health HI to SMI transfer amounts.

7

Includes research, costs of experiments and demonstration projects, fraud and abuse promotion, and peer review activity (changed to Quality Improvement Organization in 2002).

8

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

9

Includes payment for physicians, practitioners, durable medical equipment, and all suppliers other than independent laboratory through 1990. Starting with 1991 data, physician services subject to the physician fee schedule are shown. 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 shown separately beginning in 1991. The remaining services from the Physician category are included in Other.

10

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

11

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

12

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

13

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

14

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.

15

Part D Administrative and Transitional Start-Up Costs were funded through the SMI Part B account.

NOTES: Percents are calculated using unrounded data. Totals do not necessarily equal the sum of rounded components. Estimates include service disbursements as of February 2006 for Medicare enrollees residing in the United States, Puerto Rico, Virgin Islands, Guam, other outlying areas, foreign countries, and unknown residence. Some numbers in this table have been revised and differ from previous editions of Health, United States.

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, 2007
Health, United States, 2007: With Chartbook on Trends in the Health of Americans.
National Center for Health Statistics (US) .
Hyattsville (MD): National Center for Health Statistics (US); 2007 Nov.

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