Table 2.
Characteristics of Fee-for-Service Medicare Beneficiaries by Level of Care Need
| Characteristics | Relatively healthy (N = 3794) | Simple chronic (N = 7317) | Multiple chronic (N = 7389) | Major complex chronic (N = 3379) | Frail ( N = 1580) | Non-elderly disabled (N = 5664) | P value |
|---|---|---|---|---|---|---|---|
| Individual-level characteristics, N (%) | |||||||
| Age | |||||||
| < 65 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 5664 (100.0) | < .001 |
| 65–69 | 903 (23.7) | 1286 (17.5) | 1172 (15.8) | 478 (14.2) | 140 (8.9) | 0 (0.0) | < .001 |
| 70–74 | 1128 (29.7) | 1810 (24.7) | 1574 (21.3) | 632 (18.7) | 188 (11.9) | 0 (0.0) | < .001 |
| 75–79 | 788 (20.8) | 1490 (20.4) | 1552 (21.0) | 705 (20.9) | 284 (18.0) | 0 (0.0) | < .001 |
| ≥ 80 | 975 (25.7) | 2731 (37.3) | 3091 (41.8) | 1564 (46.3) | 968 (61.3) | 0 (0.0) | < .001 |
| Female | 1946 (51.3) | 4509 (61.6) | 4124 (55.8) | 1618 (47.9) | 1055 (66.8) | 2572 (45.4) | < .001 |
| Race/ethnicity | |||||||
| Non-Hispanic White | 3253 (85.7) | 6324 (86.4) | 6118 (82.8) | 2784 (82.4) | 1307 (82.7) | 3783 (66.8) | < .001 |
| Non-Hispanic Black | 245 (6.5) | 459 (6.3) | 650 (8.8) | 307 (9.1) | 140 (8.9) | 1192 (21.0) | < .001 |
| Non-Hispanic Asian | 62 (1.6) | 104 (1.4) | 102 (1.4) | 37 (1.1) | 30 (1.9) | 74 (1.3) | 0.221 |
| Hispanic | 196 (5.2) | 361 (4.9) | 396 (5.4) | 201 (5.9) | 82 (5.2) | 522 (9.2) | < .001 |
| Others | 90 (2.4) | 189 (2.6) | 242 (3.3) | 125 (3.7) | 38 (2.4) | 290 (5.1) | < .001 |
| Education | |||||||
| Less than high school | 453 (11.9) | 1238 (16.9) | 1685 (22.8) | 958 (28.4) | 415 (26.3) | 1454 (25.7) | < .001 |
| High school completion | 1229 (32.4) | 2562 (35.0) | 2625 (35.5) | 1210 (35.8) | 543 (34.4) | 2533 (44.7) | < .001 |
| Some college or associate’s degree | 874 (23.0) | 1506 (20.6) | 1498 (20.3) | 605 (17.9) | 307 (19.4) | 1279 (22.6) | < .001 |
| Bachelor’s degree | 643 (16.9) | 1048 (14.3) | 881 (11.9) | 334 (9.9) | 170 (10.8) | 267 (4.7) | < .001 |
| Advanced degree | 588 (15.5) | 944 (12.9) | 675 (9.1) | 259 (7.7) | 134 (8.5) | 97 (1.7) | < .001 |
| Income | |||||||
| Less than $25,000 | 1006 (26.5) | 2317 (31.7) | 2900 (39.2) | 1420 (42.0) | 751 (47.5) | 4378 (77.3) | < .001 |
| $25,000–$40,000 | 1783 (47.0) | 4118 (56.3) | 3359 (45.5) | 1590 (47.1) | 636 (40.3) | 904 (16.0) | < .001 |
| More than $40,000 | 929 (24.5) | 595 (8.1) | 862 (11.7) | 220 (6.5) | 103 (6.5) | 175 (3.1) | < .001 |
| Insurance | |||||||
| Medicaid | 184 (4.8) | 615 (8.4) | 967 (13.1) | 591 (17.5) | 296 (18.7) | 3464 (61.2) | < .001 |
| Medigap | 1357 (35.8) | 2543 (34.8) | 2642 (35.8) | 1116 (33.0) | 563 (35.6) | 301 (5.3) | < .001 |
| Prescription drug coverage | 1931 (50.9) | 3748 (51.2) | 4533 (61.3) | 2019 (59.8) | 999 (63.2) | 4594 (81.1) | < .001 |
| Limited English proficiency | 86 (2.3) | 383 (5.2) | 466 (6.3) | 327 (9.7) | 226 (14.3) | 863 (15.2) | < .001 |
| Married | 2210 (58.2) | 4042 (55.2) | 3903 (52.8) | 1764 (52.2) | 618 (39.1) | 1443 (25.5) | < .001 |
| Metro area | 2803 (73.9) | 5151 (70.4) | 4772 (64.6) | 2120 (62.7) | 1130 (71.5) | 3750 (66.2) | < .001 |
| Census region of residence | |||||||
| New England | 144 (3.8) | 264 (3.6) | 263 (3.6) | 115 (3.4) | 57 (3.6) | 172 (3.0) | 0.233 |
| Middle Atlantic | 505 (13.3) | 838 (11.5) | 888 (12.0) | 396 (11.7) | 185 (11.7) | 748 (13.2) | < .001 |
| East North Atlantic | 561 (14.8) | 1230 (16.8) | 1476 (20.0) | 757 (22.4) | 283 (17.9) | 1035 (18.3) | < .001 |
| West North Atlantic | 260 (6.9) | 573 (7.8) | 609 (8.2) | 260 (7.7) | 114 (7.2) | 403 (7.1) | 0.028 |
| South Atlantic | 854 (22.5) | 1614 (22.1) | 1592 (21.5) | 693 (20.5) | 390 (24.7) | 1388 (24.5) | < .001 |
| East South Central | 311 (8.2) | 697 (9.5) | 741 (10.0) | 373 (11.0) | 175 (11.1) | 570 (10.1) | < .001 |
| West South Central | 401 (10.6) | 784 (10.7) | 723 (9.8) | 365 (10.8) | 195 (12.3) | 549 (9.7) | 0.19 |
| Mountain | 360 (9.5) | 572 (7.8) | 509 (6.9) | 177 (5.2) | 83 (5.3) | 348 (6.1) | < .001 |
| Pacific | 398 (10.5) | 745 (10.2) | 588 (8.0) | 243 (7.2) | 98 (6.2) | 451 (8.0) | < .001 |
| Poor general health status compared with same-age people | 9 (0.2) | 132 (1.8) | 301 (4.1) | 351 (10.4) | 191 (12.1) | 1078 (19.0) | < .001 |
| Good overall health status compared to 1 year ago | 3587 (94.5) | 6069 (82.9) | 5780 (78.2) | 2237 (66.2) | 875 (55.4) | 4151 (73.3) | < .001 |
| Limited social activities | 235 (6.2) | 1651 (22.6) | 2394 (32.4) | 1619 (47.9) | 1022 (64.7) | 3263 (57.6) | < .001 |
| Number of ADL limitations | |||||||
| 0 | 3794 (100.0) | 4012 (54.8) | 3367 (45.6) | 1029 (30.5) | 207 (13.1) | 1582 (27.9) | < .001 |
| 1–2 | 0 (0.0) | 1329 (18.2) | 1555 (21.0) | 689 (20.4) | 274 (17.3) | 1379 (24.3) | < .001 |
| 3 + | 0 (0.0) | 1976 (27.0) | 2467 (33.4) | 1661 (49.2) | 1099 (69.6) | 2703 (47.7) | < .001 |
| County-level characteristics, mean (SD) | |||||||
| Population | 838,435.7 (1,476,622.6) | 771,273.9 (1,446,021.5) | 660,267.2 (1,301,522.1) | 727,782.8 (1,525,500.2) | 824,035.6 (1,427,449.0) | 710,629.0 (143,4501.1) | < .001 |
| % of 65 year and older | 0.3 (0.3) | 0.3 (0.4) | 0.3 (0.3) | 0.3 (0.3) | 0.3 (0.3) | 0.3 (0.3) | < .001 |
| % of dual-eligible Medicare beneficiaries | 20.0 (8.4) | 20.7 (8.3) | 21.2 (8.5) | 22.1 (8.8) | 21.5 (8.9) | 23.2 (8.9) | < .001 |
| Average fee-for-service Medicare spending | 10,637.4 (1649.9) | 10,888.8 (1750.4) | 10,777.8 (1741.5) | 11,043.7 (1784.4) | 11,205.4 (1782.2) | 10,940.2 (1706.6) | < .001 |
| HCC risk score | 1.0 (0.1) | 1.0 (0.1) | 1.0 (0.1) | 1.0 (0.1) | 1.0 (0.1) | 1.0 (0.1) | < .001 |
| Medicare Advantage penetration | 22.7 (14.7) | 19.6 (13.7) | 19.7 (13.7) | 19.4 (13.7) | 20.4 (13.9) | 20.5 (14.4) | < .001 |
| Unemployment rate | 7.1 (2.8) | 8.4 (2.6) | 8.1 (2.8) | 8.7 (2.7) | 8.2 (2.6) | 8.3 (2.8) | < .001 |
| Median household income | 57,175.3 (16,791.6) | 53,140.7 (14,682.8) | 52,471.5 (14,769.5) | 50,055.3 (13,287.8) | 52,362.5 (14,760.3) | 50,373.4 (13,725.0) | < .001 |
| % of residents with incomes below poverty | 14.5 (5.5) | 15.4 (5.5) | 15.6 (5.7) | 16.3 (5.5) | 15.8 (5.6) | 16.7 (5.9) | < .001 |
| Hospital beds per 1000 residents | 2352.2 (4057.5) | 2278.2 (4108.8) | 1983.3 (3821.7) | 2224.7 (4436.9) | 2509.4 (4200.8) | 2192.6 (4146.3) | < .001 |
| Medical doctors per 1000 residents | 2.5 (1.6) | 2.4 (1.5) | 2.3 (1.5) | 2.2 (1.5) | 2.5 (1.5) | 2.3 (1.6) | < .001 |
| Primary care physicians per 1000 residents | 3.2 (1.8) | 3.0 (1.6) | 2.9 (1.7) | 2.8 (1.7) | 3.1 (1.7) | 2.9 (1.7) | < .001 |
| Specialists per 1000 residents | 0.9 (0.4) | 0.8 (0.4) | 0.8 (0.4) | 0.8 (0.4) | 0.8 (0.4) | 0.8 (0.4) | < .001 |
ESRD end-stage renal disease, ADL activities of daily living, HCC hierarchical condition category