Chronic Health Conditions in Pennsylvania - News Release

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PA Medicare Payments in 2007 for Diabetes, Asthma, COPD and Heart Failure Hospitalizations estimated at $615 Million

Harrisburg, PA - June 10, 2010 - Four common and costly chronic conditions – diabetes, asthma, chronic obstructive pulmonary disease (COPD), and heart failure – are the focus of a new report released today by the Pennsylvania Health Care Cost Containment Council (PHC4). The report found that Pennsylvania’s hospitalization rates for all four conditions were higher than the national rates for these conditions in both 2004 and 2007. Also, the Commonwealth’s hospitalization rates for three of the four conditions – diabetes, asthma and COPD – increased from 2004 to 2008. [See Editor’s Note.]

Based on the average Medicare payment for each of these conditions, total Medicare payments for Pennsylvania hospitalizations for the four conditions in 2007 were estimated at $615 million. PHC4 estimated that if all payers paid at the Medicare rate, total payments for all hospitalizations for the four conditions would have totaled slightly more than $1 billion in 2007.

“Chronic conditions are a key driver of health care costs,” said Joe Martin, PHC4’s Executive Director. “The opportunity for positive change lies in the fact that most hospitalizations for these four conditions could have been avoided with lifestyle changes, earlier intervention and ongoing disease management.”

The report found significant variations in hospitalization rates for the four conditions exist based on race/ethnicity. Black (non-Hispanic) residents tended to have higher rates than white (non-Hispanic) and Hispanic residents. Among Pennsylvania residents age 65 and older, approximately one in 24 white (non-Hispanic) residents were likely to be hospitalized for one of the four conditions in 2008, compared to one in 15 black (non-Hispanic) or Hispanic residents.

Additionally, more than 25% of the individual patients admitted for any one of the four conditions were readmitted to the hospital for the same condition within one year. Nearly 10% of these patients were readmitted more than once for the same condition.

PHC4 is an independent state agency charged with addressing the cost and quality of health care in Pennsylvania. Copies of Chronic Health Conditions in Pennsylvania are free and available online at

Editor’s Note

Hospitalization Rates* Pennsylvania and United States
Note: The most recent U.S. rates available from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project are for 2007.
*Per 1,000 residents. Diabetes and asthma hospitalization rates are for residents of all ages, while COPD and heart failure hospitalization rates are for adults age 18 and older.
2004 2007 2008
Diabetes 1.88 1.75 1.96 1.77 1.96
Asthma 1.79 1.43 1.84 1.33 1.92
COPD 3.26 2.51 3.23 2.59 3.84
Heart Failure 6.96 5.02 6.16 4.50 5.83