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Social Security in Review:

PROGRAM OPERATIONS

OASDI Benefits

IN JUNE, for the first time in 4 months, the number of monthly benefits awarded under the old-age, survivors, disability, and health insurance program (OASDHI) dropped below 300,000. The 290,000 awards made in that month were nearly 48,000 fewer than the number in the previous month. For every beneficiary category a smaller number of awards were made.

The number of persons to whom monthly cash benefits were payable continued to rise as a net increase of 158,000 beneficiaries brought the total to 23.2 million at the end of June. More than two-thirds of the rise came from additions to the number of retired workers and dependents receiving benefits.

The average monthly benefit amount awarded in June to disabled workers and their dependents and to survivors exceeded by varying amounts the corresponding awards in June 1966. By contrast the monthly benefit amounts awarded to retired workers and their dependents in June 1967 were lower, on the average, than those awarded a year earlier. This decline was mainly attributable to the large number of conditional and deferred benefit awards in 1966. Retired-worker awards declined to 96,000 in June 1967 from 193,000 in June 1966, when an unusually large number of persons aged 65 and over who had not yet retired in fact filed application to establish entitlement to hospital insurance benefits effective July 1966. The average amounts associated with conditional and deferred awards have generally been higher than those associated with currently payable awards. Another factor depressing the average benefit award to retired workers this June was the increase in the proportion of workers taking reduced benefits before age 65.

In June, monthly cash benefit payments topped $1.8 billion, an increase of $17 million over May's total. Payments to retired workers and their dependents increased by $19 million, but payments to disabled workers and dependents were $2 million less than they had been a month earlier. Lump-sum death payments for the month dipped to $22.6 million, a 6-percent decline from May. Though the number of lump-sum death payments was 7 percent lower, the average lump-sum amount per deceased worker rose by more than $3 to $224.73.

More than 2 out of 3 persons who were receiving monthly cash benefits at the end of June were aged 65 or over, and there were 15.8 million beneficiaries in this age group in June. Beneficiaries aged 62-64 numbered almost 2 million and represented nearly 9 percent of all beneficiaries in current-payment status.

In current-payment status; excludes lump-sum and retroactive payments

HI Benefits

On June 30, 1967, the health insurance program for the aged had been in operation for 1 year. During this period the Social Security Administration received almost 5.0 million hospital admission notices and about 228,000 home health "start of care" notices for aged individuals covered under this program. During the 6-month period since the start of extended-care benefits in January 1967, almost 199,000 admission notices for care in extended-care facilities were received. For June, about 433,000 hospital admission notices, 21,000 "start of care" notices, and 32,000 admission notices for extended-care facilities were received by the Social Security Administration.

The most current data recorded by the Social Security Administration on claims approved for payment by intermediaries and carriers under the hospital and medical insurance programs for the aged appear in tables M-17 to M-20 of the Current Operating Statistics section of this issue. These tables provide information on the number and amount of such requests for payment for the various types of benefits covered under the programs that had been recorded in the Social Security Administration central records.

As of June 30, 1967, the Social Security Administration records indicated that 4.5 million hospital insurance claims, amounting to $1.9 billion in payments to providers of care, had been approved by intermediaries through the end of May 1967. More than 87 percent of the claims and 96 percent of the payments had been rendered in connection with inpatient hospital care. The amount reimbursed represented about 80 percent of total charges, the remainder went for deductibles, coinsurance amounts, and noncovered services that are not reimbursable under the law. The number of covered days of inpatient hospital care per approved claim averaged 13.2 days in all hospitals, 12.9 in short-stay hospitals, and 36.1 in long-stay hospitals. Other claims and payments under the hospital insurance program were for outpatient hospital diagnostic care, home health services and extended-care benefits. The average amount paid per recorded claim was $475 per inpatient hospital claim, $12 per outpatient hospital claim, $62 per home health claim and $296 per extended care claim.

As of June 29, 1967, bills for physicians' and

ance

related medical services under the medical insurprogram numbered 10.1 million million and amounted to $735.4 million in total reasonable charges or an average of $73 per recorded bill.

Physicians' services accounted for 86 percent of the bills and for 94 percent of the total reasonable charges. The remaining bills and charges were for other services, such as home health, outpatient hospital, and independent laboratory services covered under the medical insurance program. For all bills approved for payment through June 29, 1967, 69 percent of the reasonable charges for services covered under the medical insurance program were reimbursed.

and Confidentiality

AS A RESULT of the significant involvement of the American people with the Social Security Administration, either directly or through third parties, large masses of information are recorded for the purpose of administering the program. Collateral uses of social security data for statistical research and analysis have begun to have increasing value. The potential of these data has increased in the last decade, as coverage under the OASDHI program has expanded to include all earners except Federal employees and some other groups. Information collected is available to the Social Security Administration through applications for social security numbers, the reports of earnings, and other types of administrative actions such as the filing of claims for cash benefits.

The new service benefits in the health area have made available significant amounts of demographic data concerning aged persons not otherwise beneficiaries under the cash benefits program. For all persons aged 65 and over, data on utilization of hospital services, as well as information on providers of the services, are part of the ongoing information flow for administration. For persons enrolled for supplementary medical benefits, data on significant uses of doctors' services have become available.

Earnings are reported to the Social Security Administration for about 80 million persons each year under OASDHI. About 1 person in 8 either receives a cash benefit or is entitled to receive health service benefits. The social security number is used to assure that earnings are recorded for the holder of the number. When cash or service benefits under the program are claimed, the social security number becomes an essential identifier. In day-to-day activities, it has also become commonplace to use the number for a variety of other purposes. For most people this number is used as an identifier for data to be made available by banks and corporations to the Internal Revenue Service, as well as on their tax forms. At an early point in the history of the Social

* Office of Research and Statistics.

by JOSEPH STEINBERG and HEYMAN C. COOPER*

Security Administration, policies on the confidentiality of identifiable data were established. Because this area is of such significance in relation to the availability and use of the data, a substantial portion of the article is devoted to the topic.

GENERAL OVERVIEW OF SOCIAL
SECURITY STATISTICAL DATA

Social security statistical data are collected and recorded for individuals as well as for business establishments and providers of health services. Though the data are integrated in relation to specific administrative missions of the Social Security Administration, it may be instructive to discuss the statistics for each of the following general categories: (a) demographic and economic data for individuals, (b) economic data for business establishments, (c) health service utilization data for individuals, and (d) data on characteristics of hospitals and other providers of health services.

Demographic and Economic Data for Individuals

Basic information about individuals comes from the application for a social security number. Date of birth, sex, race, and place of birth are the primary information of statistical interest on this form. The data on the application initiate the establishment of a machine-readable record for the individual.

1 Primarily, Form SS-5-Application for Social Security Number. For a short span of time, IRS Form 3227 —Application for Account Number, was used in cooperation with the Internal Revenue Service in providing numbers for taxpayer identification; that form made no provision for recording race. U.S. Civil Service Commission Form BRI 49-262 was used for a special group for whom social security numbers have been assigned and is the source of basic demographic information. Other persons in groups aged 65 and over for whom information is available supplied such information to the Railroad Retirement Board for their administrative use or to the Social Security Administration in connection with application for a health insurance claim number.