Page 7 - ACO Report Revised
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ACOs and the High Cost of the Disabled and
End State Renal Disease (ESRD)
Most Medicare beneficiaries 2021 ACO Medicare Beneficiary Distribution
in ACOs are classified as the “Aged, N = 10,489,936
non-dual (83%).
“Aged dual” (6%) beneficiar-
ies qualify for both Medicare and
Medicaid.
• Medicare and Medicare Ad-
vantage Plans pay for covered
healthcare services first; Medi-
care is primary.
• Medicaid may pay for healthcare
costs Medicare does not cover at
all, or partially covers; i.e., Medi- Source: CMS
caid is the secondary insurer.
Original Medicare Beneficiary and Program Cost
Distribution, 2018
For the entire Original Medi-
care population:
• 85% are aged 65+ and do not
have ESRD. This cohort ac-
counts for 76% of Medicare
spending.
• Beneficiaries under 65 with a
disability and the ESRD cohort
account for 24% of program
costs.
The ESRD population ac-
counts for 1% of beneficiaries
but five percent of program
costs.
Original Medicare pro-
gram spending totaled Source: MedPAC analysis of the Medicare Current Benefi-
$767 billion in 2018 ciary Survey, Cost Supplement file 2018
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