Cumulative Expenditures under the DI, SSI, Medicare, and Medicaid Programs for a Cohort of Disabled Working-Age Adults
Version of Record online: 11 AUG 2014
Published 2014. This article is a U.S. Government work and is in the public domain in the USA
Health Services Research
Volume 50, Issue 2, pages 514–536, April 2015
How to Cite
Riley, G. F. and Rupp, K. (2015), Cumulative Expenditures under the DI, SSI, Medicare, and Medicaid Programs for a Cohort of Disabled Working-Age Adults. Health Services Research, 50: 514–536. doi: 10.1111/1475-6773.12219
- Issue online: 10 MAR 2015
- Version of Record online: 11 AUG 2014
- Social Security Disability Insurance;
- Supplemental Security Income
To estimate cumulative DI, SSI, Medicare, and Medicaid expenditures from initial disability benefit award to death or age 65.
Administrative records for a cohort of new CY2000 DI and SSI awardees aged 18–64.
Actual expenditures were obtained for 2000–2006/7. Subsequent expenditures were simulated using a regression-adjusted Markov process to assign individuals to annual disability benefit coverage states. Program expenditures were simulated conditional on assigned benefit coverage status. Estimates reflect present value of expenditures at initial award in 2000 and are expressed in constant 2012 dollars. Expenditure estimates were also updated to reflect benefit levels and characteristics of new awardees in 2012.
We matched records for a 10 percent nationally representative sample.
Overall average cumulative expenditures are $292,401 through death or age 65, with 51.4 percent for cash benefits and 48.6 percent for health care. Expenditures are about twice the average for individuals first awarded benefits at age 18–30. Overall average expenditures increased by 10 percent when updated for a simulated 2012 cohort.
Data on cumulative expenditures, especially combined across programs, are useful for evaluating the long-term payoff of investments designed to modify entry to and exit from the disability rolls.