Medicare Chronic Condition Charts
30 CCW Chronic Conditions Period Prevalence, 2022
Description:
The conditions with the highest period prevalence rates are hypertension (66.8%), hyperlipidemia (65.5%), and rheumatoid arthritis or osteoarthritis (36.2%).
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Only females are included in the numerator and denominator for endometrial and female breast cancer; only males are included for prostate cancer and benign prostatic hyperplasia. Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Cardiovascular Conditions Trends, 2017–2022
Description:
The rates for the cardiovascular conditions have been stable over time. Atrial fibrillation and flutter(A fib) has increased slightly from 13.1% in 2017 to 14.1% in 2022.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Cancer Trends, 2017–2022
Description:
The rate for prostate cancer has increased slightly from 8.9% in 2017 to 9.5% in 2022; the rate for female breast cancer has risen slightly from 7.4% in 2017 to 8.2% in 2022. The rates for urologic, endometrial, lung, and colorectal cancer were stable over time.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Only females are included in the numerator and denominator for endometrial and female breast cancer; only males are included for prostate cancer. Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Endocrine and Renal Conditions Trends, 2017–2022
Description:
The proportion of the Medicare population being treated for diabetes changed from 28.0% in 2017 to 26.4% in 2022. The period prevalence rate of chronic kidney disease (CKD) has risen from 16.3% in 2017 to 18.7% in 2022. Acquired hypothyroidism increased from 20.9% in 2017 to 21.5% in 2022.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Cognitive and Mental Health Conditions Trends, 2017–2022
Description:
The prevalence of treatment for Alzheimer’s disease decreased from 3.1% in 2017 to 2.5% in 2022; the prevalence also decreased for non-Alzheimer’s dementia from 8.0% in 2017 to 7.4% in 2022. The rate of treatment for depression has been stable over time.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Musculoskeletal and Joint Conditions Trends, 2017–2022
Description:
The rate of hip or pelvic fractures has been stable over time. The rate of treatment for osteoporosis increased from 9.9% in 2017 to 11.7% in 2022. The rate of treatment for rheumatoid or osteoarthritis decreased from 36.4% in 2019 to 34.6% in 2021, then increased to 36.2% in 2022.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Neurologic Conditions Trends, 2017–2022
Description:
The rate of treatment for Parkinson's Disease has been stable over time. The rate of treatment for stroke or Transient Ischemic Attack (TIA) decreased slightly from 6.6% in 2017 to 6.3% in 2022.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Respiratory Conditions Trends, 2017–2022
Description:
Prevalence of treatment for chronic obstructive pulmonary disease (COPD) has decreased from 15.9% in 2017 to 13.1% in 2022. The period prevalence for asthma decreased from 7.9% in 2017 to 7.2% in 2022. The prevalence of treatment for all-cause pneumonia has been stable over time.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Ophthalmic Conditions Trends, 2017–2022
Description:
The proportion of Medicare beneficiaries with a cataract procedure decreased in 2020 and has reverted to typical pattern in 2022. The rate of cataract procedures declined from 26.3% in 2019 to 22.3% in 2020, and then returned to 26.0% in 2021 (and was 26.4% in 2022). The proportion of beneficiaries identified as having treatment for glaucoma increased from 13.8% in 2017 to 15.0% in 2022.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Other Conditions Trends, 2017–2022
Description:
The period prevalence of beneficiaries who had fee-for-service claims for benign prostatic hyperplasia increased from 25.4% in 2017 to 29.1% in 2022, and hyperlipidemia increased from 61.3% in 2017 to 65.5% in 2022. There was a slight decrease in prevalence for hypertension; in 2017, 67.8% of beneficiaries had hypertension, compared to 66.8% in 2022. Prevalence for anemia was stable over time.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Only males are included in the numerator and denominator for benign prostatic hyperplasia. Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Selected Chronic Conditions by Age Group, 2022
Description:
The age distribution of Medicare beneficiaries with selected chronic conditions is shown. Some conditions are comprised largely of older Medicare beneficiaries. For example, 85.7% of beneficiaries with claims for Alzheimer’s disease were 75 years of age or older; similarly, 64.8% of people with heart failure, 61.9% of those with chronic kidney disease (CKD), 60.9% of those with treatment for stroke/TIA, and 60.0% of those with colorectal cancer, were 75 or older. Other conditions, such as depression, were comprised largely of younger beneficiaries (56.3% of beneficiaries treated for depression and 52.2% of beneficiaries treated for diabetes were 74 years of age or less).
Technical Notes:
Age is calculated based on the age of the Medicare beneficiary as of December 31. If the beneficiary expired, the age is calculated based on age at time of death. Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Selected Chronic Conditions by Racial Group, 2022
Description:
There is racial variation in the prevalence of treatment for Medicare fee-for-service (FFS) beneficiaries with these conditions. Although the white racial group comprised 80.6% of the Medicare FFS population in 2022, they comprised 85.2% of the subpopulation with treatment for chronic obstructive pulmonary disease (COPD), 83.9% of the population with depression, and 82.8% of the population with colorectal cancer. In 2022, although the black racial group comprised 7.2% of the total Medicare FFS population, they comprised 10.4% of the subpopulation with diabetes, 10.0% of those with claims for chronic kidney disease (CKD), 9.4% of those with stroke, and 8.9% of the population with heart failure. Hispanics comprised 5.6% of the FFS population and 7.7% of those with diabetes and 6.6% of the population with Alzheimer’s disease.
Technical Notes:
American Indian, Native American, Other, and Unknown races are grouped together due to small cell sizes. Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Selected Chronic Conditions by Sex, 2022
Description:
The gender distribution of Medicare beneficiaries varies by condition. In Medicare for 2022, 54.2% of the population was female. For depression and Alzheimer’s disease, 66.9% and 66.1% of the subpopulation, respectively, was female. For diabetes, chronic kidney disease (CKD), heart failure, and colorectal cancer, we observed a higher proportion of males with claims for the conditions than we would have expected based on the overall population distribution of males (which was 45.8% of the total Medicare population) — 49.5% with diabetes, 49.1% with heart failure, 48.0% with CKD, and 47.4% with colorectal cancer claims were male.
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Selected Chronic Conditions by Medicare Status Code, 2022
Description:
The reason for Medicare entitlement varies by condition. In Medicare for 2022, 11.9% of the population were entitled to Medicare due to disability rather than age. A higher proportion of people than expected with treatment for depression were entitled due to disability (18.8%). For some conditions, a much higher proportion of the subpopulation were aged — for example, Alzheimer’s disease and colorectal cancer, with 98.2% and 94.5% of the subpopulations, respectively, entitled due to age.
Technical Notes:
Classification used the Medicare status code, and combined end-stage renal disease (ESRD) and Disabled categories into the "Disabled" grouping. Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for the condition within the condition-specific look back period. Chronic conditions have a one- to two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria for these chronic conditions. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage). Beneficiaries may be counted in more than one condition category.
Chart Date: August 2024
Diabetes Period Prevalence by State, 2022
Description:
The population of Medicare fee-for-service (FFS) enrollees with diabetes varied by state. Colorado had the lowest rate (17.6%), and West Virginia had the highest (30.7%).
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for diabetes within the two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage).
Chart Date: August 2024
Ischemic Heart Disease Period Prevalence by State, 2022
Description:
The population of Medicare fee-for-service (FFS) enrollees with ischemic heart disease varied by state. Idaho had the lowest rate (14.2%), and Florida had the highest (27.7%).
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for ischemic heart disease within the two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage).
Chart Date: August 2024
Depression, Bipolar, or Other Depressive Mood Disorders Period Prevalence by State, 2022
Description:
The population of Medicare fee-for-service (FFS) enrollees with depression, bipolar, or other depressive mood disorders varied by state. Hawaii had the lowest rate (9.7%), and Massachusetts had the highest (24.1%).
Technical Notes:
Period prevalence is calculated for these rates. Beneficiaries with full or nearly full fee-for-service (FFS) coverage during the year who had FFS claims for depression within the two-year look-back time period. Please refer to the CCW website to obtain the algorithm criteria. Denominator is all who were enrolled in Medicare on or after January 1, 2022, and had full or nearly full FFS coverage (i.e., 11 or 12 months of Medicare Part A and B [or coverage until time of death] and one month or less of health maintenance organization [HMO] coverage).
Chart Date: August 2024