This paper profiles Medicare beneficiaries' costs for care in the last year
of life. About one-quarter of Medicare outlays are for the last year of li
fe, unchanged from twenty years ago. Costs reflect care for multiple severe
illnesses typically present near death. Thirty-eight percent of beneficiar
ies have some nursing home stay in the year of their death; hospice is now
used by half of Medicare cancer decedents and 19 percent of Medicare decede
nts overall. African Americans have much higher end-of-life costs than othe
rs have, an unexpected finding in light of their generally lower health car
e spending.