Higher Costs for Uninsured After Enrolling in Medicare

More doctor visits, hospitalizations observed in previously uninsured patients after enrolling in Medicare

FRIDAY, July 13 (HealthDay News) -- Individuals who lack health insurance before becoming eligible for Medicare and who have cardiovascular disease or diabetes have more visits to the doctor, hospitalizations and health care costs after enrolling in Medicare than previously insured individuals, according to a report in the July 12 issue of the New England Journal of Medicine.

John Z. Ayanian, M.D., of Harvard Medical School in Boston, and colleagues analyzed data from 1992 through 2004 on self-reported health care use and spending in 5,158 individuals who were uninsured or privately insured before enrolling in Medicare at 65 years of age.

The researchers found that among the 2,951 individuals previously diagnosed with hypertension, diabetes, heart disease or stroke, those who had been uninsured had significantly more visits to the doctor, hospitalizations and costs after Medicare coverage was acquired than those who had already been insured. After adjusting for supplemental and prescription drug coverage, previously uninsured adults had 13 percent more doctor visits, 20 percent more hospitalizations and 51 percent higher medical costs than previously insured adults aged 65 to 72.

"The costs of expanding health insurance coverage for uninsured adults before they reach the age of 65 years may be partially offset by subsequent reductions in health care use and spending for these adults after the age of 65, particularly if they have cardiovascular disease or diabetes before the age of 65 years," Ayanian and colleagues conclude.

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