Reality Check$: Cost of Care for Dementia Patients

Years ago my mother told me she had two wishes: 1) She wanted to see our high school football team beat the local powerhouse (Mt. Carmel) and, 2) After working for so many years, she wanted to collect just one unemployment check. Paying her health insurance every month reminded me of this. I hoped she would get something back from the Part B premium she’d paid for so long.

IMG_1371

Be careful of those casual wishes. The bills have started coming in for my mom’s recent hospitalization. Her episode included a hasty trip in the ambulance, two days of observation, IV fluids, and many tests to determine why her blood pressure plummeted and why she was dehydrated. The sticker price for this treatment — which included no surgery, nor even a true admission since she was only “under observation” — was itemized at $40,000. I was astonished.

Thank goodness practically all of her costs were covered by her Part B provider, but the facts left me with a lot of questions about health care costs for elderly patients, especially those with dementia. According to the Health Care Cost and Utilization Project, “Inpatient hospital services account for a small share of health care utilization (7 percent) but constitute the largest share of total health care spending in the United States (29 percent in 2009).”

The study divided hospital stays by the cost per diagnosis. Dementia is not listed as an independent diagnosis. But people with dementia often have secondary diagnoses of other conditions that aggravate their health problems. According to HCUP, the five diagnoses with the highest hospital costs had approximately double the average cost per stay in 2010. The most expensive diagnoses were: septicemia, complication of device, acute myocardial infarction, respiratory failure, and intracranial injury.

The cost for these stays has been rising steadily. The HCUP study found that “inflation-adjusted costs for hospital stays grew 3.8 percent annually between 1997 and 2010.” Most of that growth (2.9%) was attributed to an increase in the intensity of services provided to patients.

So after studying my mother’s hospital expenses and the national statistics, here’s what I’ve learned about health care:

  • Make sure you have a good Part B provider. If you don’t feel you have sufficient coverage, do some research and make a change during the open enrollment period
  • If a hospital stay is necessary, ask questions about the tests and procedures ordered to make sure they will be covered
  • Even if you arrived at the hospital in an ambulance, don’t take an ambulance home; it was the one thing that doesn’t seem to be an allowable cost even though the hospital arranged it

Obviously, the best way to keep hospital costs down is to get good primary care and try to avoid emergency visits. But we are simple humans and that’s not always possible. So instead, let’s try to our best to be prepared.

Leave a Reply