Medicare expenses soars for artificial feet, obesity-related coverage

Medicare has seen steep cost increases in providing artificial feet and obesity-related coverage for its members, according to two new studies.

Its insurer's bill for artificial feet has soared by more than half, despite a dramatic decrease in foot and leg amputations. Medicare paid $94 million for artificial feet in 2010--almost $35 million more than in 2005--even though Medicare covered 1,900 fewer prostheses in 2010. That's a 58 percent cost increase over five years, reported the Associated Press.

Data analysis conducted by Avalere for the AP suggests this sharp spending rise is a result of a shift in the types of prosthetics given to Medicare beneficiaries. Instead of providing prosthetics that cost several hundred dollars, Medicare beneficiaries are getting more sophisticated prosthetics costing thousands of dollars.

For example, Medicare has almost tripled its coverage for a foot prosthesis model that features a shock absorber and costs about $6,500. The public insurer also has begun covering a $15,000 computer-controlled ankle/foot prosthesis that even some major private insurers still consider too experimental to routinely cover, the AP noted.

This isn't the only time lower-limb prosthetics has been an issue for Medicare. A report last year from the Department of Health and Human Services Office of Inspector General found that in 2009 Medicare inappropriately paid $43 million for lower-limb prostheses that didn't meet certain standards for accurate claims.

Medicare officials say they're concerned. Medicare "is aware of and shares the concerns this research raises about lower limb prosthetics," Spokesman Brian Cook told the AP.

The insurer's spending woes also expand into obesity programs. Not only is Medicare spending more money every year to cover each of its members, but it spends an extra $149 per year for obese members, Reuters reported.

The cost of insuring a normal-weight person increases $122 annually, but the cost has increased by $230 per overweight person and $271 per obese person, according to a new University of Maryland School of Medicine study.

"Not only do we have more obese Americans, but the obese population appears to be in worse health today than they were in the past," said Dawn Alley, the lead author of the study and a professor at the University of Maryland School of Medicine.

The study suggested that obesity-related chronic conditions, including high blood pressure and diabetes, are causing the steep cost increase.

To learn more:
- read the Reuters article
- see the Medicare obesity study (subscription required)
- read the Associated Press article
- check out the HHS OIG report