The Impact of Medicare Costs and Access on the Aging Population

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The baby boomer generation's aging has resulted in substantial growth in the number of Americans eligible for Medicare. Over 60 million Americans were enrolled in Medicare as of 2020, accounting for roughly 20% of the population (Centers for Medicare and Medicaid Services, 2021). Understanding how cost and access influence this rising demographic is crucial, with 10,000 Americans becoming eligible for Medicare daily (Henry J Kaiser Family Foundation, 2019). This paper will look at the evidence of how Medicare premiums, deductibles, and provider access affect older persons' health and well-being.


Medicare Fees

The out-of-pocket expenditures connected with Medicare are a significant barrier to treatment for seniors. These include Part B and D payments, deductibles, and coinsurance. According to research, Medicare users spend 41% of their Social Security income on healthcare, with 1 in 4 spending more than half (Henry J Kaiser Family Foundation, 2020). This huge healthcare expense burden has far-reaching consequences. According to studies, older Medicare members are more prone to skip drugs, postpone treatment, or have difficulty affording basic necessities owing to medical expenditures (Boccuti et al., 2021). High prices also limit access, with roughly one-quarter of all participants having difficulties locating a primary care doctor who takes their insurance (Medicare Payment Advisory Commission, 2020). This shows that budgetary constraints restrict access to adequate preventative interventions.

Access to Providers

Aside from pricing, regional provider availability is a critical access barrier. According to the findings, physician acceptance of new Medicare patients differs by region, with rural areas having lower acceptance rates (Boccuti et al., 2015). Transportation and mobility concerns may exacerbate geographic access issues for the elderly. According to research, there are racial discrepancies in Medicare access, with Black enrollees having more difficulty accessing experts (Trivedi et al., 2021). Private Medicare Advantage plans with small provider networks further limit choice and access, exacerbating network adequacy difficulties (Gill et al., 2019). These spatial and demographic disparities in healthcare access need governmental attention.

Conclusions

Finally, evidence shows that high out-of-pocket expenditures and limited provider availability create obstacles to treatment for Medicare recipients. Policy initiatives like cutting cost-sharing, regulating network adequacy, and boosting reimbursement rates in underprivileged regions might address these inequities. More effort is required to guarantee that all Medicare members have affordable access to high-quality care.

References

C. Boccuti, C. Fields, G. Casillas, and L. Hamel (2015). A Quick Look at Primary Care Physicians Who Accept Medicare. The Kaiser Family Foundation is a charitable organization. https://www.kff.org/medicare/issue-brief/primary-care-physicians-accepting-medicare-a-snapshot/

C. Boccuti, J. R. Bronfin, K. Shea, and D. Goldberg (2021). Medicare Patients' Out-of-Pocket Health Care Spending as a Share of Income Now and in the Future. The Kaiser Family Foundation is a charitable organization. https://www.kff.org/medicare/issue-brief/medicare-patients-out-of-pocket-health-care-spending-as-a-share-of-income-now-and-projections-for-the-future/

CMS (Centers for Medicare and Medicaid Services). Dashboard for Medicare Enrollment. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/Medicare-Enrollment/Enrollment%20Dashboard.html

L. E. Gill, B. Holt, G. Yenokyan, P. A. Reshamwala, and W. F. Gellad (2019). Access to Care in Narrow Provider Networks. JAMA Network Open, 2(5), e194106. doi:10.1001/jamanetworkopen.2019.4106

Henry J. Kaiser Family Foundation. A Quick Overview of Medicare. https://www.kff.org/medicare/issue-brief/an-overview-of-medicare/

Henry J. Kaiser Family Foundation. What is the limit? Medicare Beneficiaries' Out-of-Pocket Expenses. https://www.kff.org/medicare/issue-brief/how-much-is-too-much-out-of-pocket-spending-among-medicare-beneficiaries/

(2020, Medicare Payment Advisory Commission). Medicare Payment Policy Report to Congress. http://www.medpac.gov/docs/default-source/reports/mar20\_entirereport\_sec.pdf?sfvrsn=0

A. N. Trivedi, H. Moloo, and V. Mor (2021). Racial and ethnic differences in how Medicare beneficiaries get needed treatment. e2032985, JAMA Network Open, 4(1), https://doi.org/10.1001/jamanetworkopen.2020.32985

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