©2006 California HealthCare Foundation 1
California has the largest number of Medicare
beneficiaries of any state — over 4 million enroll-
ees — and as the population ages, the percentage
of Californians with Medicare will continue to rise.
California’s entire elderly population, those 65
and over, will grow nearly 130 percent by 2030.
The increase is especially striking among those
85 years and over. Across California’s counties,
the growth of this population has ranged from
33 percent to over 150 percent since 1990.
The diversity of coming Medicare populations
will also increase in the next decades and,
accordingly, the number that speak non-English
languages will likely continue to grow.
Overall, Medicare spending continues to
rise, with approximately 10 percent of all
current Medicare expenditures occurring in
California. California’s spending per beneficiary
is also higher than the national average — about
$700 more per beneficiary per year — the eighth
highest in the nation.
This profile provides a factual framework
to help consumer advocates, health care pro-
viders, and policymakers better understand
California’s Medicare population and inform
their efforts to design programs and policies that
meet Medicare beneficiaries’ needs. Data are
drawn from the most recent national and state-
level sources available. Some of these charts
rely on data from a sub-sample of the 2002
Medicare Current Beneficiary Survey (MCBS)
in California. The MCBS is a stratified random
sample of beneficiaries representing the entire
population of aged and disabled beneficiaries
and is not necessarily representative of each
state. The MCBS sample for California includes
1,049 residents. Where possible, results were
confirmed by comparison with Census records,
the California Health Interview Survey, CMS,
and Social Security statistics.
Introduction
There are more than
4 million Medicare
beneficiaries in California
and those numbers will
continue to grow as the
baby boomers age.
Medicare Introduction
©2006 California HealthCare Foundation 2
Population Growth Rates Elderly vs. Non-elderly California and the U.S., 2000 to 2030
Projections of population
growth in California show
that the elderly population
will grow much faster than
the non-elderly population
over the next 25 years due
to the aging of the baby
boomers.
Elderly (65+)
Non-elderly(< 65)
19%
26%
104%
131%
U.S.California
Note: The under-65 population in the nation is expected to grow by 45.7 million by 2030, including growth of 7.9 million in California. The national elderly population is expected to grow by 36.5 million over the same period, with 4.7 million of this growth occurring in California.
Source: “Table 4: Interim Projections: Change in Total Population and Population 65 and Older, by State: 2000 to 2030.” U.S. Census Bureau, Population Division, Interim State Population Projections, 2005.
Medicare Overview
©2006 California HealthCare Foundation 3
Enrollment in Medicare California and Selected States
Medicare Overview
There are 40.2 million
Americans enrolled in
Medicare in the United
States. California has the
largest number of Medicare
beneficiaries in the nation
at 4.1 million, but ranks
much lower — 46th in the
nation — as a share of the
total population.
0
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
30,000,000
35,000,000
PennsylvaniaFloridaNew YorkTexasCalifornia
Enrollment as Share of Total PopulationNon-Medicare Population12%
11%
14%
17%
17%
Total Population
Note: Enrollment for California is 4,078,426; Texas 2,390,053; New York 2,763,299; Florida 2,920,971; and Pennsylvania, 2,110,470.
Source: Centers for Medicare and Medicaid Services, Medicare Enrollment Data for July 2003 and Census Bureau State Population Estimates 2000–2005 (NST-EST2005-01).
©2006 California HealthCare Foundation 4
Eligibility for Medicare California, 2002
The majority of Medicare
beneficiaries in the state
are over 65. Eleven percent
are eligible due to disability
status, and a smaller
percentage have end-stage
renal disease (ESRD).
Note: One-third of enrollees with ESRD are disabled and another one-third are 65 or older. The remaining one-third is not otherwise eligible for Medicare. These enrollees are all included in the ESRD section above.
Source: 2002 Medicare Current Beneficiary Survey.
Elderly87%
ESRD
2%
Disabled11%
Medicare Overview
©2006 California HealthCare Foundation 5
Elderly Population Growth by County, 1990 to 2004
Source: Calculated from both the 1990 and 2000 Census data. The 1990 data is available in archived population estimates (www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt). The 2004 data is a projection from the 2000 Census in the file “County estimates by demographic characteristics — age, sex, race, and Hispanic Origin: Selected Age Groups and Sex“ (www.census.gov/popest/datasets.html). See appendix for more information on growth rates by county.
Every county in California
has experienced significant
growth in the elderly
population in the last
15 years. Even more
dramatic is the growth
among those 85 and older,
with a median growth rate
of 87 percent.
Median and Below (21%)
Above Median
Age 65 to 84 Median and Below (87%)
Above Median
Age 85 and older
Medicare Overview
©2006 California HealthCare Foundation 6
Beneficiaries with Disabilities California, 1999 to 2004
The number of Medicare
beneficiaries with
disabilities has grown
steadily over the past
five years.
Source: Table 83B, Hospital Insurance and/or Supplementary Medical Insurance: Number of disabled enrollees, by census division and state or other area, July 1, 1980–2004, selected years (in thousands), 2003 Annual Statistical Supplement, 2005 (www.ssa.gov/policy/docs/statcomps/supplement/2003/index.html, www.ssa.gov/policy/docs/statcomps/supplement/2005/index.html).
200420032002200120001999
452,000 465,000481,000
500,000522,000
550,000
Medicare Overview
©2006 California HealthCare Foundation 7
Beneficiary Income Distribution California, 2002
Most Medicare
beneficiaries rely on
relatively modest means.
Note: ESRD beneficiaries are excluded unless also eligible by aged or disabled status.
Source: 2002 Medicare Current Beneficiary Survey.
Medicare Overview
$125,000 and over
$100,000 to 124,999
$75,000 to 99,999
$65,000 to 74,999
$55,000 to 64,999
$45,000 to 54,999
$35,000 to 44,999
$25,000 to 34,999
$15,000 to 24,999
$5,000 to 14,999
Under $5,000 3%
29%
23%
14%
11%
7%
4%
3%
3%
2%
1%
ElderlyDisabled
©2006 California HealthCare Foundation 8
Median Income of Beneficiaries by Age, California, 2002
Disabled beneficiaries have
the lowest median income.
Out-of-pocket costs for
health care can consume
a significant percentage
of that income.
Note: Excludes institutionalized beneficiaries and ESRD beneficiaries unless also eligible by aged or disabled status.
Source: 2002 Medicare Current Beneficiary Survey
85 and Older75 to 8465 to 74Under 65(Disabled)
$28,000
$20,400
$16,000
$18,000
Medicare Overview
©2006 California HealthCare Foundation 9
Overall Medicare Spending United States, 1967– 2004
Source: Data from the Congressional Budget Office. Historical Budget Data. Appendix F of “The Budget and Economic Outlook: Fiscal Years 2006 to 2015.” Released January 25, 2005. Data from Tables 9 and 10: Outlays for Mandatory Spending.
Over the last four decades,
Medicare spending has risen
sharply across the nation,
both in total dollars and as
a percentage of GDP.
as Percent of GDP
0.0%
0.5%
1.0%
1.5%
2.0%
2.5%
3.0%
3.5%
20042000 1996 1992 1988 1984 1980 1976 1972 1968
in Billions
$0
$50
$100
$150
$200
$250
$300
$350
20042000 1996 1992 1988 1984 1980 1976 1972 1968
Medicare Utilization and Spending
©2006 California HealthCare Foundation 10
Spending Per Medicare Beneficiary California and Selected States, 2001
Annual spending per
beneficiary in California is
the eighth highest in the
nation, more than $700
higher than the national
average. A great deal of
variation exists in Medicare
spending across the nation.
Contributing factors include
demographic differences,
medical practice, and price
variability.
Note: Denominator excludes beneficiaries enrolled in Medicare managed care.
Source: Centers for Medicare and Medicaid Services, CMS Health Care Financing Review Medicare and Medicaid Statistical Supplement, 2003, Table 15. Program Payments for Medicare Beneficiaries Residing in Urban and Rural Areas, by Area of Residence: Calendar Year 2001.
HawaiiColoradoU.S. AverageCaliforniaNew Jersey
$4,960
$4,020
$6,680
$5,940
$7,560
Medicare Utilization and Spending
©2006 California HealthCare Foundation 11
Both the unit cost and
utilization of hospitals
are rising for Medicare
beneficiaries in California.
Because inpatient care
is typically the most
expensive category of
treatment, this trend
has had a significant role
in overall Medicare
spending increases.
Hospital Utilization and Medicare Expenditures, California, 2000 to 2003
Source: Annual Statistical Supplement 2004: Medicare. Social Security Administration Table 8.B8a.
Average Medicare Expenditure per Day of Care
$0
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
2003200220012000
Number of Discharges
700,000
725,000
750,000
775,000
800,000
825,000
850,000
875,000
900,000
Medicare Utilization and Spending
©2006 California HealthCare Foundation 12
The disabled population and
the very old have the highest
overall medical expenditures
and account for the most
Medicare spending.
Average Medical Spending Among Beneficiaries, by Source and Age, California, 2002
Note: Data excludes beneficiaries enrolled in Medicare managed care and all beneficiaries in nursing homes.
Source: 2002 Medicare Current Beneficiary Survey
75 and Older65 to 74Disabled (Under 65)
Out of PocketOther
Private InsuranceMedicaid Medicare
$14,877$828
$1,571
$2,741
$2,568
$7,169
$8,666$596
$1,745
$1,306
$546
$4,473
$13,258$436
$1,544
$1,868
$764
$8,646
Medicare Utilization and Spending
©2006 California HealthCare Foundation 13
Annual out-of-pocket spend-
ing for prescription drugs
averages just under $400,
with higher spending among
the disabled and older
elderly. These averages may
change as a result of the
implementation of the new
Medicare drug benefit.
Average Annual Out-of-Pocket Spending for Prescriptions by Age, California, 2002
Note: Data excludes nursing home residents and ESRD beneficiaries unless also eligible by aged or disabled status.
Source: 2002 Medicare Current Beneficiary Survey.
75 and Over65 to 74Under 65(Disabled)
$454
$305
$431
Medicare Utilization and Spending
©2006 California HealthCare Foundation 14
Few of California’s Medicare
enrollees age 65 and older
rely exclusively only on
traditional Medicare for
health insurance. More
than half rely on Medi-Cal,
Medigap, or employer-
sponsored insurance to help
cover health care costs.
Elderly* Enrollee Health Coverage California, 2002
*Age 65 and older.
Note: This graph represents primary coverage sources; in some cases, enrollees may have an additional source of coverage.
Source: 2002 Medicare Current Beneficiary Survey.
Medicare and Employer-Sponsored26%
Medicare HMO Only27%
Medicare and Medi-Cal
22%
Medicare and Medigap
17%
Medicare Only
8%
Medicare Coverage
©2006 California HealthCare Foundation 15
Under 65 Enrollee Health Coverage California, 2002
Medicare enrollees under 65
with disabilities have less
private coverage than do
the elderly. Nearly half of
these disabled beneficia-
ries rely on Medi-Cal and
Medicare.
Note: This graph represents primary coverage sources; in some cases, enrollees may have an additional source of coverage. For adults age 18 to 64, eligibility for Medicare is tied to qualification for Social Security Disability Insurance.
Source: 2002 Medicare Current Beneficiary Survey.
Medicare and Employer-Sponsored17%
Medicare HMO Only14%
Medicare and Medi-Cal47%
Medicare and Medigap<1%
Medicare Only22%
Medicare Coverage
©2006 California HealthCare Foundation 16
California has much
higher rates of Medicare
managed care enrollment
than the nation. As of
June 2004, California
had the fourth highest
enrollment in Medicare
HMOs in the nation
(not shown).
Medicare HMO Enrollment California vs. the U.S., 1989 to 2004
Source: Data for Nation and for California 1989 through 1996 taken from Kaiser Family Foundation California Healthcare Chartbook (www.kff.org/statepolicy/7086/sec5.cfm); 1997 to 2005 California data gathered from CMS Medicare Managed Care Contract (MMCC) Plans Monthly Summary Reports from the relevant years. Taken from the March quarter report in each year except for 1997 (June). Available online at www.cms.hhs.gov/healthplans/statistics/mpsct/.
California
U.S.
0%
5%
10%
15%
20%
25%
30%
35%
40%
2004200220001998 19961994 1992 1990
Beneficiaries in an HMO
Medicare Coverage
Source: Centers for Medicare and Medicaid Services: Market Penetration — Quarterly State/County Data File, June 2004. Cited in: “Health Care Financing Review: Medicare and Medi-Cal Statistical Supplement, 2003.” Centers for Medicare and Medi-Cal.
©2006 California HealthCare Foundation 17
Elderly and Medicare Advantage Plans Density and Number by County
The majority of Medicare
Advantage plans are in
densely populated areas.
Since the implementation of
the Medicare Modernization
Act, which introduced new
Medicare plan types, at
least two plans are available
in every county.
Sources: Density of elderly in the state from the 2000 Census. Number of Medicare Advantage Plans by County from CMS, 2005.
0–56–1920+
Senior Population Per Square Mile
2– 45–1415–2425–38
Medicare Advantage Plans
Medicare Coverage
©2006 California HealthCare Foundation 18
Rates of self-reported
prescription drug coverage
tend to be higher in
Southern California and
lower in the more rural
areas of Northern California.
Elderly Prescription Drug Coverage by County, 2003
Note: In response to the question asked of all insured, 65 and older, “Are you covered for your prescription drugs? That is, does some plan pay any part of the cost?”
Source: 2003 California Health Interview Survey.
60 to 69%70 to 79%80 to 89%90 to 100%
Medicare Coverage
©2006 California HealthCare Foundation 19
Prescription Coverage Source by Beneficiary’s Income, California, 2001
Historically, lower-income
beneficiaries have relied
largely on Medi-Cal for
prescription coverage; other
beneficiaries have received
coverage from employer-
sponsored coverage,
Medigap plans, HMOs, and
other private sources. The
implementation of the new
Medicare drug benefit on
January 1, 2006, will cause
this to change.
Note: The 2001 Federal Poverty Level (FPL) for an individual was $8,590 with $3,020 added for each additional person in the household. Federal Register, Vol. 66, No. 33, February 16, 2001: 10695–10697. Does not include disabled beneficiaries or those with end-stage renal disease only.
Source: Kaiser/Commonwealth/Tufts-New England Medical Center 2001 Survey of Seniors in Eight States. Cited in “California Seniors and Prescription Drugs.” Kaiser Family Foundation and Tufts-New England Medical Center. November 2002.
Over 200% FPL101 to 200% FPLUp to 100% FPL
21%
54%
24%
17%
82%
1%
16%
28%
56%
NonePrivateMedi-Cal
Medicare Coverage
©2006 California HealthCare Foundation 20
Race/Ethnicity of Elderly Beneficiaries California vs. the U.S., 2000
California’s elderly Medicare
population is more diverse
than that of the nation.
Latino, Asian, and African
American beneficiaries make
up almost a third of the
state’s Medicare population.
Note: “Other” includes Pacific Islanders, American Indians, and multiracial.
Source: Census 2000 Summary File 1 (SF 1) 100-Percent Data.
13%
7%
California U.S.
10%
5%2%
2%
1%
10%
70% 80%
LatinoCaucasian(non-Latino)
Asian African American(non-Latino)
Other
Medicare Demographics
©2006 California HealthCare Foundation 21
Diversity of Elderly Medicare Population, California, 2000 and 2020
The diversity of the elderly
Medicare population in
California in 2020 will be
even greater than in the
current population. The
Latino population is
expected to have the
most significant increase
over the next 14 years.
Note: “Other” includes Pacific Islanders, American Indians, and multiracial.
Sources: 2000 data from Census 2000 Summary File 1 (SF1) 100-Percent Data and 2020 data from RAND analysis of Department of Finance projections.
13%
22%
2000 2020
10%
5%
2%
15%
6%
3%
70%
54%
LatinoCaucasian(non-Latino)
Asian African American(non-Latino)
Other
Medicare Demographics
©2006 California HealthCare Foundation 22
Language Spoken in the Home by Age, California, 2003
Future Medicare
beneficiaries are more likely
to speak a non-English
language in the home.
This suggests a need for
Medicare resources in
multiple languages.
*Predominantly Chinese, Vietnamese, Korean. Note: Estimates for both languages may be low because the category “other” in the survey may include combinations of languages. Data include the non-Medicare population. Insurance status not included in data.
Source: 2003 California Health Interview Survey.
85 and Older75 to 8465 to 7445 to 64Under 44
Asian* Spanish
9%8% 8%
5%6%
8%
16%
12%
21%
35%
Medicare Demographics
©2006 California HealthCare Foundation 23
Age and Gender of Beneficiaries California, 2002
Except among those
beneficiaries with
disabilities, Medicare
enrollees in California
are overwhelmingly
female due to general
population trends and
longer life expectancy.
Source: 2002 Medicare Current Beneficiary Survey.
85 and Older75 to 8465 to 74Under 65(Disabled)
Male Female
42%
58%
44%
56%
41%
29%
71%
59%
Medicare Demographics
©2006 California HealthCare Foundation 24
Number of Chronic Conditions among Beneficiaries, California, 2002
Almost two-thirds of elderly
and disabled beneficiaries
have two or more chronic
health conditions.
Note: The definition of chronic condition used here is reported hypertension, cancer, diabetes, heart disease, lung disease, stroke, arthritis or Alzheimer’s disease. An individual qualifies for disabled status based on health status in addition to the ability to work in one’s profession and many other factors. Beneficiaries do not include those with end-stage renal disease only.
Source: 2002 Medicare Current Beneficiary Survey.
Elderly Disabled
One25%
Two27%
None12%
Three or more36%
One14%
Two27%
None25%
Three or more34%
Medicare Health Status
©2006 California HealthCare Foundation 25
Many Medicare
beneficiaries have
an array of chronic
illnesses; the prevalence
of conditions varies by
beneficiary category.
Chronic Conditions of Beneficiaries by Eligibility Category, California, 2003
Note: Excludes ESRD-only beneficiaries. ESRD beneficiaries who also qualify as disabled or aged are included in that category.
Source: 2002 Medicare Current Beneficiary Survey.
StrokeObesityLungDisease
High BloodPressure
HeartDisease
DiabetesCancerAlzheimer’sDisease
Elderly Disabled
5% 0%
18%15%
17%
27%
36%
32%
55%
60%
14%
19% 18%
27%
9%11%
Medicare Health Status
©2006 California HealthCare Foundation 26
The prevalence of chronic
conditions varies by race
and ethnicity. Heart disease
and high blood pressure are
the most prominent across
all groups.
Chronic Conditions of All Beneficiaries by Race/Ethnicity, California, 2002
Notes: “Other” includes Pacific Islanders, American Indian/Alaskan Native and persons of multiple races/ethnicities.
Sources: 2002 Medicare Current Beneficiary Survey.
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
55%
60%
65%
70%
75%
StrokeObesityLungDisease
High BloodPressure
HeartDisease
DiabetesCancerAlzheimer’sDisease
LatinoCaucasian (non-Latino) Asian African American (non-Latino) Other
Medicare Health Status
©2006 California HealthCare Foundation 27
Disabled beneficiaries and
the very old are the most
likely to be living in a
nursing facility.
Beneficiaries in Nursing Homes California, 2002
Source: 2002 Medicare Current Beneficiary Survey.
85 and Older65 and OlderDisabled(Under 65)
All Beneficiaries
11%
14%
5%
4%
Medicare Health Status
©2006 California HealthCare Foundation 28
Quality of Care by Medicare SpendingCalifornia vs. Other States, 2001
The quality of care for
California’s Medicare
beneficiaries is among the
worst in the nation, despite
the fact that Medicare
spending in California is
$700 more per beneficiary
than the national average.
Of all 50 states, California
is among the worst for
high spending and low
quality of care.$3,000 $4,000 $5,000 $6,000 $7,000 $8,000 $9,0001
6
11
16
21
26
31
36
41
46
51
Overall Quality Ranking
CA
Medicare Spending per Beneficiary
Best Higher QualityLower Spending
WorstLower Quality
Higher Spending
Notes: Quality ranking is created through use of twenty-two Medicare Quality Improvement Organization quality indicators abstracted from state-wide random samples of medical records for inpatient fee-for-service care and from Medicare beneficiary surveys or Medicare claims for outpatient care (Jencks 2003). The spending per beneficiary data presented here diverges from the data shown in earlier information in this presentation because the data used by Baicker and Chandra is limited to FFS beneficiaries and is also three years older.
Source: 1999 Medicare claims data and S.F. Jencks et al, “Change in the Quality of Care Delivered to Medicare Beneficiaries, 1998 – 1999 and 2000 – 2001.” Journal of the American Medical Association. 2003. Vol. 239, No. 3: 305–312.” Cited in Baicker, Katherine and Amitabh Chandra. “Medicare Spending, The Physician Workforce, And Beneficiaries’ Quality of Care.” Health Affairs — Data Watch. Web Exclusive. April 7, 2004.
Medicare Quality
©2006 California HealthCare Foundation 29
Beneficiaries in California
receive recommended care
for chronic conditions about
half the time. Quality of
care varies across chronic
illnesses, from 41 percent
for diabetes to 63 percent
for high blood pressure.
Beneficiaries Who Received Recommended Care Orange County, California, 2001
Hypertension(High Blood Pressure)
Depression
Heart Disease
Pulmonary Disease
Diabetes
All Chronic Conditions 52%
41%
45%
52%
56%
63%
Note: This data is limited to Orange County, California. Data in geographic areas tend to be very similar however, and so this is likely reflective of California, and particularly of the Southern California region. Recommended care is defined through 439 quality indicators developed by RAND staff and validated by four multi-specialty expert panels, using the RAND/UCLA modified Delphi method.
Source: Community Tracking Survey and Telephone Surveys. Eve A. Kerr, Elizabeth A. McGlynn, John Adams, Joan Keesey and Steven M. Asch. “Profiling The Quality Of Care In Twelve Communities: Results From The CQI Study” Used with Permission from the authors. Health Affairs, Vol. 23, No. 3: 247–256.
Medicare Quality
©2006 California HealthCare Foundation 30
Preventive Care for Beneficiaries by Income, California, 2003
The poorest Medicare
beneficiaries receive
fewer recommended
preventive care services.
This income disparity
is least apparent in the
number of beneficiaries
who received a flu shot
in the previous year.
Note: The 2003 Federal Poverty Level (FPL) for an individual was $8,980 with $3,140 added for each additional person in the household. Federal Register, Vol. 68, No. 26, February 7, 2003: 6456 – 6458. PSA is a screening test for prostrate cancer.
Source: 2003 California Health Interview Survey.
Ever had a PSA test?
Had mammogram in past two years?
Flu shot in last 12 months?
Ever had a Pneumonia shot?
Had a colonoscopy in the last five years?
0–99% FPL100–199% FPL200%+ FPL
47%
51%
65%
47%
60%
66%
68%
72%
74%
75%
74%
82%
70%
77%
90%
Medicare Quality
©2006 California HealthCare Foundation 31
Medicare Appendix
Source: Calculated from both the 1990 and 2000 Census data. The 1990 data is available in archived population estimates (www.census.gov/popest/archives/1990s/co-99-13/cacamars.txt). The 2004 data is a projection from the 2000 Census in the file “County estimates by demographic characteristics — age, sex, race, and Hispanic Origin: Selected Age Groups and Sex.”
Elderly Population Growth by County, 1990 to 2004 Total 65 85 County Population and Older and Older
Alameda 12% 11% 58%Alpine 7% 70% 140%Amador 26% 28% 96%Butte 17% 2% 91%Calaveras 44% 45% 151%Colusa 25% 14% 88%Contra Costa 26% 31% 105%Del Norte 21% 18% 134%El Dorado 37% 37% 148%Fresno 30% 22% 71%Glenn 11% 0% 48%Humboldt 8% 10% 78%Imperial 39% 43% 110%Inyo 0% 0% 35%Kern 35% 26% 96%Kings 40% 33% 99%Lake 27% – 6% 86%Lassen 26% 9% 74%Los Angeles 12% 16% 56%Madera 58% 38% 91%Marin 7% 25% 90%Mariposa 26% 25% 124%Mendocino 10% 11% 84%Merced 33% 29% 91%Modoc – 1% 7% 33%Mono 28% 71% 94%Monterey 17% 18% 69%Napa 19% 4% 48%Nevada 24% 17% 107%
Total 65 85 County Population and Older and Older
Orange 24% 41% 79%Placer 78% 106% 182%Plumas 8% 17% 105%Riverside 60% 42% 137%Sacramento 27% 32% 102%San Benito 53% 29% 74%San Bernardino 35% 27% 74%San Diego 17% 20% 85%San Francisco 3% 4% 39%San Joaquin 35% 19% 76%San Luis Obispo 17% 19% 95%San Mateo 8% 13% 77%Santa Barbara 9% 13% 59%Santa Clara 13% 34% 74%Santa Cruz 9% – 3% 37%Shasta 21% 29% 121%Sierra 5% – 1% 94%Siskiyou 3% 15% 86%Solano 22% 51% 146%Sonoma 21% 13% 87%Stanislaus 35% 24% 78%Sutter 35% 41% 116%Tehama 21% 11% 66%Trinity 5% 25% 97%Tulare 29% 11% 65%Tuolumne 18% 31% 135%Ventura 19% 35% 103%Yolo 31% 29% 75%Yuba 11% 6% 67%
Almost all of California’s
counties experienced
significant growth in their
elderly population; growth
was most pronounced in
the 85 and older population.
©2006 California HealthCare Foundation 32
ResourcesMedicare Appendix
Annual Statistical Supplement, Office of Data Policy, Social Security Administration www.ssa.gov/policy/docs/statcomps/supplement/2004/index.html
California Health Care Chartbook, Kaiser Family Foundation, June 2004 www.kff.org/statepolicy/7086/index.cfm
California Health Interview Survey www.chis.ucla.edu
Centers for Medicare and Medicaid Services, Medicare Enrollment Data www.cms.hhs.gov/MedicareEnrpts
Congressional Budget Office, Historical Budget Data www.cbo.gov/budget/historical.pdf
Health Care Financing Review www.cms.hhs.gov/HealthCareFinancingReview
Medicare Current Beneficiary Survey www.cms.hhs.gov/MCBS
Medicare Web site provides information on how the program functions in California www.calmedicare.org
AuthorsCynthia R. Schuster, M.P.P.
Dana P. Goldman, Ph.D.
Mary Vaiana, Ph.D.
RAND Corporation
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