The Medicare Current Beneficiary Survey (MCBS) is a versatile analytic tool that can be used to compare different populations within the Medicare Program. This highlight utilizes data from the 1999 MCBS Cost and Use File to compare functional limitations, health status, chronic conditions, marital status, and household composition of Medicare beneficiaries who received acute care services by the type, if any, of post-acute care (PAC) received.
The data that follows divides Medicare beneficiaries into three categories: those who received PAC at a skilled nursing facility (SNF), those who received PAC from a home health agency (HHA), and those who received acute care with no PAC. The categories previously mentioned are mutually exclusive so beneficiaries who received both types of PAC during 1999 were considered to only to have received care from a SNF. Those living in a long-term care facility for all of 1999 as well as those who were enrolled in a Medicare health maintenance organization were excluded from the results.
The population that resulted consisted of 2,388 MCBS sample persons who received acute care during 1999. Nationally, the MCBS acute care population represents over 6.85 million Medicare beneficiaries or 17 percent of the Medicare population. Within this 17 percent, 28 percent received PAC from a HHA, 17 percent received PAC from a SNF, and the remaining 55 percent received inpatient hospital services with no PAC.
Figure 1. Health Status of Beneficiaries, by Type of Post-Acute Care: 1999.
- Fifty percent of both beneficiaries who received home health services, and those receiving PAC in a SNF reported their health status was fair or poor compared with 41 percent of beneficiaries receiving only inpatient hospital care.
- Overall, only 24 percent of Medicare beneficiaries receiving acute care reported their health as very good or excellent.
Figure 2. Beneficiaries Reporting No Chronic Conditions, by Type of Post-Acute Care: 1999.
- Beneficiaries who received PAC from a SNF were least likely to report having any chronic conditions.
- Beneficiaries who received no PAC and those who received home health services reported similar rates of chronic conditions (91 and 96 percent with one or more, respectively).
Figure 3. Number of ADLs and IADLs, by Type of Post-Acute Care: 1999.
- Beneficiaries who required no PAC were twice as likely to report having no difficulty performing activities of daily living (ADLs) or instrumental activities of daily living (IADLs) than those receiving SNF or HHA services.
- Overall, 31 percent of beneficiaries who received acute care services reported having no difficulty performing any ADLs or IADLs.
Figure 4. Marital Status, by Type of Post-Acute Care: 1999.
- Beneficiaries who received no PAC were more likely to be married than those receiving SNF or HHA care.
- Beneficiaries who received SNF services were the most likely to be widowed.
Figure 5. Household Composition, by Type of Post-Acute Care: 1999.
- Beneficiaries required no PAC were much more likely to live with their spouse while beneficiaries who received PAC from a SNF were more likely to live alone.
- Of all beneficiaries who received acute care services 36 percent lived alone.
Footnotes
The author is with the Centers for Medicare & Medicaid Services (CMS). The views expressed in this article are those of the author and do not necessarily reflect the views of CMS.
Reprint Requests: Andrew Shatto, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, C3-16-27, Baltimore, MD 2144-1850. E-mail: ashatto@cms.hlis.gov