The Social Security Bulletin is for sale by the Superintendent of Documents, U. S. Government Printing Office, Washington, D. C. 20402. Price: $2.75 a year in the United States, Canada, and Mexico; $3.50 in all other countries; single copies, 25 cents. Price of the 1955 Supplement, 40 cents; 1956 Supplement, 45 cents; 1957 Supplement, 50 cents; 1959 Supplement, 55 cents; 1960 Supplement, 60 cents; 1962 Supplement, 60 cents; 1963 Supplement, 60 cents; 1964 Supplement, 50 cents. Use of funds for printing this publication has been approved by the Director of the Bureau of the Budget (April 7, 1964). NOTE: Contents of this publication are not copyrighted; any items may be reprinted, but citation of the Social Security Bulletin as the U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE SOCIAL SECURITY ADMINISTRATION OFFICE OF RESEARCH AND STATISTICS Advisory Committee on Research Development E. CARY BROWN, JACOB FELDMAN JAMES MORGAN, EUGENE SMOLENSKY, FREDERICK F. STEPHAN At the end of January 1967 monthly cash benefits under the old-age, survivors, disability, and health insurance (OASDHI) program were being paid to more than 22.8 million persons an increase of almost 80,000 from the December 1966 level. About 34,000 of this rise represents additions to the number receiving the special benefits for noninsured persons aged 72 and over. The number of retired-worker benefits was 24,000 higher than the number at the end of December, and benefits to widows and to disabled workers rose 12,000 and 8,000, respectively. The monthly rate of benefits in January 1967 topped $1,646 million-nearly $7.6 million more than the December rate. Monthly benefit awards in January totaled about 277,000, roughly 49,000 less than the number in December. The decline reflects not only a drop of about 25,000 awards in the "special age-72" benefit category but also fewer awards for practically all beneficiary categories except that for disabled workers. Awards to all types of beneficiaries except disabled workers were fewer in January than in any other month since September 1965, when the 1965 amendments to the Social Security Act became effective. Moreover, for most beneficiary categories, January awards were even fewer than those in the early months of 1965. Currently payable benefit awards to retired workers continued to rise-from a low of 50 percent in April and May 1966 to a high of 75 percent in January 1967, an indication that the backlog of aged individuals applying for benefits primarily to establish eligibility for hospital benefits has largely been exhausted. The sharp impact of the 1965 amendments has also diminished with respect to benefit awards to the groups newly provided eligibility (students aged 18-21 and widows aged 60-61). Lump-sum death payments totaling $17.1 million were made in January to 83,000 persons on the accounts of 77,000 deceased workers. These payments averaged $221.26 per deceased worker. persons recently discharged from the hospital who continue to need full-time skilled nursing care for a relatively short duration. The benefits do not cover custodial care provided in nursing and residential homes. During January, more than 32,000 extended-care admission notices were received by the Social Security Administration from the approximately 3,350 extended-care facilities (with more than 243,000 beds) participating in the health insurance program. In January, almost 509,000 hospital admission notices and 22,500 "start of care" notices for home health services following hospitalization had been received from providers of services. Since the beginning of the program in July 1966, more than 3,000,000 hospital admission notices and almost 130,000 notices indicating the start of care for home health services under the hospital insurance part of the program have been received by the Social Security Administration. More than $210 million was drawn in January from the hospital insurance trust fund by intermediaries for benefit payments to institutions such as hospitals, extended-care facilities, and home health agencies providing care to beneficiaries. During the same period, more than $68 million was drawn from the supplementary medical insurance trust fund to pay for benefits provided under the medical insurance program. Since the beginning of the program, more than $1.1 billion has been drawn from the hospital insurance trust fund and more than $196 million has been drawn from the supplementary medical insurance trust fund to pay for benefits under the health insurance program for the aged. payments have risen $591 million, slightly more than 17 percent. Most influential in the year-toyear growth were the larger payments under OASDHI, public assistance, and the public employee retirement programs that were primarily the result of program liberalizations. AFDC AND GA CASELOADS RISE AT SLOWER RATE The number of persons receiving money payments under aid to families with dependent children and under general assistance continued to rise in January but at a slower rate than in December. In aid to families with dependent children, 38,700 or nearly half the total increase was in the unemployed-parent segment of the program and 3 States accounted for much of the rise. There were 25,200 more recipients of general assistance-a 4-percent increase from the number reported in December. A slight rise occurred in aid to the permanently and totally disabled. For old-age assistance and aid to the blind, the recipient count was less than 1 percent below the number a month earlier. Persons for whom medical bills were paid under medical assistance for the aged were 3,100 (Continued on page 38) JANUARY RISE IN PUBLIC INCOME MAINTENANCE PAYMENTS Income-maintenance payments under public programs reached the $4-billion mark in January 1967, with an increase of $78 million from the December amount. Unemployment insurance benefits comprised $69 million or nearly ninetenths of the total growth from the preceding month. The total amount paid out in unemployment benefits in January was $236 million, and there were, on the average, 385,000 more weekly beneficiaries during the month. Since January 1966, public income-maintenance Health Insurance for the Aged: Claims Reimbursed For Hospital and Medical Services* CLAIMS FOR reimbursement of part of the cost of hospital and medical services under the health insurance program for the aged are recorded in the central records of the Social Security Administration. The data on these claims provide a means of measuring the extent of utilization of covered services, as well as information on the total charges and amounts reimbursed for these services. The January 1967 issue of the BULLETIN presented data on inpatient hospital claims for the first 3 months of the operation of the health insurance program for the aged. More complete inpatient claims data covering the first 6 months of the program's operation are now available and are presented here. Also included are the first available figures on the bills reimbursed and recorded in the Social Security Administration central records during the first 8 months of the medical insurance program. INPATIENT HOSPITAL CLAIMS For July-December 1966, approximately 1.7 million inpatient hospital claims were reported by intermediaries as approved for payment under the hospital insurance program as of February 24, 1967. Claims approved are reported in table 1 according to the specific month of intermediary approval and include those recorded in the central utilization record as of the February date. Because of lags in the reporting and processing of claims under the hospital insurance program, the number of monthly claims reported here probably do not represent all the claims for services approved in any given month. As more time elapses, claims data for the earlier months will became more nearly complete. For example, claims approved for payment during the first 3 months of the program and recorded in the Social Division of Health Insurance Studies, Office of Research and Statistics. Security Administration tape record as of February 24, 1967, totaled 629,833, or about threefifths more than the number recorded for the same period 4 months earlier.1 The number of claims approved by intermediaries and recorded in the tape record each month only partially reflects actual inpatient hospital utilization under the program. Delays in submission of claims by hospitals, in claims processing by intermediaries, and in recording the data in the central utilization record result in understating the number of cases receiving inpatient hospital care during the month. Distribution of the 1.7 million claims by month approved shows only 2 percent recorded in July, a sharp increase in the following month, a continued monthly upward trend to a peak of 381,355 in November, followed by an 8-percent drop in December. The small number reported for July reflects the delay in transmittal of forms and claims at the beginning of the program. The drop in December from the previous month may be the result of the lag in reporting and recording the data as of February 24, 1967, the date of summarization. The 1.7 million claims account for 21.8 million days of care covered under the hospital insurance program, or an average of 12.6 days per claim. A claim is defined here as the submission of a bill requesting reimbursement for inpatient hospital care. Claims are generally submitted after a person is discharged from the hospital. Interim bills or claims requesting payment for part of an inpatient hospital stay may, however, be submitted. The average length of stay per claim is therefore less than the average per discharge, especially for long-stay hospitals, which are more likely to submit interim bills when the stay covers an extended period. The average number of days of covered care increased monthly from 7.0 days in July to 13.6 1 See Howard West, "Health Insurance for the Aged: The Statistical Program," Social Security Bulletin, January 1967, page 13, table 6. |