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Resource utilization for HCV unchanged, Medicare patient responsibility increased over time

While total resource utilization for Medicare beneficiaries with hepatitis C did not change during a 6-year period, the amount of patient responsibility increased in a recent study.

Researchers determined yearly spending related to chronic hepatitis C (CHC) among Medicare beneficiaries from 2005 to 2010, including 48,880 outpatient claims among 21,655 patients and 4,884 admission claims among 3,092 patients.

Among inpatient claims, the percentage of Medicare beneficiaries aged younger than 65 years (66.21% vs. 73.4%; P=.0061) increased as did the number of Medicare patients with disabilities (63.09% to 68.11%; P=.0486). Annual claims frequency remained consistent (1.53 to 1.64), while the mean number of diagnoses per claim rose (8.11 vs. 8.6; P<.0001).

Total charges submitted to Medicare for inpatient procedures grew from $64,418 to $76,200 (P=.0017) after adjustment for inflation, but total yearly length of stay and inpatient procedures performed during hospitalization did not. The mean total amount spent yearly per patient did not significantly increase ($22,245 vs. $23,383; P=.136). Multivariate analysis indicated that the number of inpatient procedures performed annually and related conditions per inpatient claim were independently predictive of increased resource utilization.

Outpatient average claim frequency did not increase (2.32 to 2.16 per year; P=.2963), while the mean number of diagnoses grew (2.18 vs. 2.71; P<.0001). Total payments ($488 vs. $584; P=.0132) and outpatient service charges ($2,293 vs. $3,144; P<.0001) rose for the period. Multivariate analysis showed significant associations between higher costs for Medicare and patients and between more conditions and diagnoses per claim. Advanced age was associated with less spending and a smaller percentage paid by the patient, while Hispanic and Asian ethnicity were linked to higher costs.

“This report of Medicare data supports efforts directed toward more aggressive identification and treatment of CHC patients who are younger than 65 years who are experiencing other disabilities,” the researchers wrote. “In addition, further study should be undertaken to understand why the total charges submitted to Medicare increased for inpatient stays over time without a subsequent increase in length of stay or number of procedures performed.”

Disclosure: The researchers report no relevant financial disclosures.