Table A.3.
Out-of-pocket cost estimates, physician spending, for MA PFFS plans offered in 2007.
| Age group and health status | Mean, TM | Mean, MA PFFS | 1st percentile | 25th percentile | 50th percentile | 75th percentile | 99th percentile |
|---|---|---|---|---|---|---|---|
| Ages 65–69 | |||||||
| Excellent | 17 | 8 | 0 | 7 | 10 | 10 | 12 |
| Very good | 17 | 9 | 0 | 8 | 11 | 11 | 12 |
| Good | 20 | 13 | 0 | 11 | 16 | 16 | 18 |
| Fair | 28 | 18 | 0 | 15 | 21 | 22 | 23 |
| Poor | 35 | 23 | 0 | 18 | 26 | 28 | 31 |
| Ages 70–74 | |||||||
| Excellent | 16 | 9 | 0 | 7 | 11 | 11 | 12 |
| Very good | 20 | 12 | 0 | 10 | 15 | 15 | 16 |
| Good | 24 | 15 | 0 | 13 | 18 | 19 | 21 |
| Fair | 33 | 20 | 0 | 16 | 24 | 25 | 26 |
| Poor | 31 | 21 | 0 | 17 | 24 | 26 | 27 |
| Ages 75–79 | |||||||
| Excellent | 20 | 12 | 0 | 10 | 14 | 15 | 16 |
| Very good | 22 | 14 | 0 | 12 | 17 | 17 | 19 |
| Good | 27 | 18 | 0 | 15 | 22 | 23 | 24 |
| Fair | 32 | 21 | 0 | 17 | 24 | 26 | 27 |
| Poor | 47 | 25 | 0 | 20 | 28 | 31 | 41 |
| Ages 80–84 | |||||||
| Excellent | 21 | 13 | 0 | 11 | 15 | 15 | 17 |
| Very good | 23 | 14 | 0 | 12 | 17 | 18 | 19 |
| Good | 28 | 18 | 0 | 14 | 21 | 22 | 23 |
| Fair | 31 | 20 | 0 | 17 | 24 | 25 | 26 |
| Poor | 37 | 22 | 0 | 18 | 25 | 27 | 29 |
| Ages [85-plus | |||||||
| Excellent | 21 | 12 | 0 | 10 | 14 | 15 | 16 |
| Very good | 24 | 14 | 0 | 12 | 17 | 18 | 19 |
| Good | 26 | 17 | 0 | 14 | 20 | 21 | 22 |
| Fair | 26 | 19 | 0 | 16 | 22 | 23 | 24 |
| Poor | 27 | 18 | 0 | 14 | 20 | 22 | 22 |
Note: This table presents enrollment-weighted descriptive statistics on physician out-of-pocket cost for the 338 MA PFFS plans that were offered in 2007, separated by age group and health status group. The first column of the table presents the OOPC estimate for TM enrollees. For every age-health status cell, the OOPC associated with the 99th percentile MA PFFS plan is lower than the TM OOPC.