Medicare and End-of-Life Care in California - Slideshow

1. Figure 1
NOTE: Estimates rounded to the nearest thousand.
SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data
Warehouse, 2014 (for total Medicare beneficiary deaths in California in 2014); State of California, Department of Public Health,
Death Records (for total deaths in California in 2014).
4 of 5 Californians who died in 2014 were covered by
Medicare
246,000 Total Deaths in California
196,000 Total Medicare Beneficiary Deaths in California

2. Figure 2
19.1%
18.3%
16.4%
14.8% 14.8% 14.5% 14.3% 13.9%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
22%
2000 2002 2004 2006 2008 2010 2012 2014
NOTE: Excludes beneficiaries in Medicare Advantage.
SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data
Warehouse, 2000-2014.
The share of total Medicare spending for Californians at
the end of life has decreased
ShareoftotalMedicarespendinginCalifornia

3. Figure 3
NOTE: Excludes beneficiaries in Medicare Advantage.
SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data
Warehouse, 2014.
Medicare spending was higher for Californians at the end
of life in 2014
$42,048
per person
$9,466
per person
Decedents with Medicare
in California
Others with Medicare
in California

4. Figure 4
NOTE: Excludes beneficiaries in Medicare Advantage. 65-year-olds excluded because most are enrolled for less than one year.
SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data
Warehouse, 2014.
Medicare spending for Californians’ end-of-life care
decreased with age in 2014
$5,919 $11,719
$49,456
$24,676
$0
$10,000
$20,000
$30,000
$40,000
$50,000
66-69 70-74 75-79 80-84 85-89 90-94 95+
SpendingperCalifornian
Others with Medicare in California
Age Group in Years
Decedents with Medicare in California

5. Figure 5
20%
39%
NOTE: Excludes beneficiaries in Medicare Advantage.
SOURCE: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from CMS Chronic Conditions Data
Warehouse, 2000 and 2014.
Medicare hospice use and spending in California has
increased
2000 2014 2000 2014
$142.5
Million
$814.4
Million
Share of California
Decedents with Medicare
who Received Hospice Care
Total Medicare Hospice
Spending in California

6. Figure 6
SOURCE: California Health Care Foundation, Cambia Health Foundation, John A. Hartford Foundation, “Topline Results: Survey of
Physicians on Advance Care Planning Conversations,” fielded February 18-March 7, 2016.
Most physicians in California report not having had training
to discuss end-of-life care
34%
Report having
had training
Report NOT having
had training
63%
3% - Don’t
know
Before January 1, 2016, Medicare did not reimburse physicians for patient visits to discuss EOL care.