The chief impetus of Medicare spending from 1987-2006 moved from inpatient hospital services to outpatient treatment of chronic conditions, according to a study published in Health Affairs.
The focus moved from inpatient treatment, especially for heart disease, to outpatient care for chronic conditions such as diabetes, arthritis, hypertension and kidney disease.
The study suggested increased spending on diabetes and several other conditions resulted from rising disease incidence and not increased screening and diagnoses.
It said high costs of chronic diseases also stem from system fragmentation providing episodic care from multiple sources that rarely coordinate care.
Read Health Affairs' report on Medicare spending.