1. Aging Demographics Flashcards
What percentage of the population are elderly?
13%
How much of the elderly make up hospital stays?
36%
How much of the elderly make up all days of hospital care?
49%
What percentage of physician hours do elderly care make up?
50%
How many chronic conditions does the average 75 year old have?
3 chronic conditions
How much of all prescription drugs are used by the elderly?
4.5%
What percentage of hospital stays and medicare costs do chronic disease result in?
70% of hospital stays
60% of Medicare costs
What percentage of all hospital admissions are caused by inappropriate drug prescribing?
17%
What does Part A of Medicare pay for?
Part A uses regional insurance companies (intermediaries) to pay hospitals, nursing homes, home-care agencies, and hospital programs for the Medicare-covered services they provide
Who is entitled to Part A coverage?
Older Americans who have had Medicare taxes deducted from their paychecks for at least 10 years are entitled to the coverage
What Part B of Medicare pay for?
Part B uses other regional insurance companies (carriers) to pay physicians, nurse practitioners, social workers, psychologists, rehab therapist, home care agencies, ambulances, outpatient facilities, and suppliers of durable medical equipment for the Medicare covered goods and services they provide
When do pts become eligible for Part B coverage?
At age 65, people become eligible for Part B coverage if they are entitled to Part A coverage or if they are citizens or permanent residents of the US
Eligible pts must enroll in Part B and pay premiums by agreeing to have them deducted from social security
Who pays for the physicians’ fees
80% of submitted Part B claim and no more than a 20% co-insurance payment
Who pays for the acute hospital stay?
Part A - pays 80% of hospital stay, other 20% is covered by Highmark
Who pays for inpatient therapy?
Part A
