Current Awareness in Aging Research (CAAR) Report #96--August 9, 2001

CAAR (Current Awareness in Aging Research) is a weekly email report produced by the Center for Demography of Health and Aging at the University of Wisconsin-Madison that helps researchers keep up to date with the latest developments in the field. For more information, including an archive of back issues and subscription information see:


I. Data:

1. CENTERS FOR MEDICARE AND MEDICAID SERVICES: "Release of County Fee-for-Service Expenditure Data," (Centers for Medicare and Medicaid Services, Excel and comma delimited formats, August 3, 2001).

Scroll down to or "find in page" "Fee-for-Service Expenditure Data by County."

For a description of the data files, go to:

2. CENSUS BUREAU: "Census 2000 Supplementary Survey," (US Census Bureau, Excel and comma delimited format, August 2001).

Note: "The Census 2000 Supplementary Survey is a Decennial Census program designed to demonstrate the feasibility of collecting long form type information at the same time as, but separate from, the Decennial Census. It used the questionnaire and methods developed for the American Community Survey to collect demographic, social, economic, and housing data from a national sample of 700,000 households...

In this release, results are available for the United States as a whole, the 50 states, and the District of Columbia. The 107 tables provided for each of these areas present estimates on a variety of topics. This fall, similar tables will be released for most cities and counties with populations of 250,000 or more."

To view tabular or narrative profiles, go to:

To view summary tables, go to the American Factfinder:

You can access the quick tables on this page, or click "the Census 2000 Supplementary Survey Summary Tables" to view summary tables.

Finally, to download the Excel or comma-delimited versions of the tables, go to:

3. ICPSR: The Inter-University Consortium for Political and Social Research at the University of Michigan added eight studies to its holdings on August 6, 2001. Of possible interest to researchers in aging is:


Note: This is a temporary address. ICPSR studies can always be found at:

Search on title or study number.

4. HRS DATA ALERT: The University of Michigan Institute for Social Research Health and Retirement Study/Asset and Health Dynamics Among the Oldest Old (HRS/AHEAD) web site announced a correction to the SPSS statements for Section S of the HRS Wave 2 Full Public Release. For a complete description of the correction, go to:

5. IRS: "Individual Income Tax Returns: Selected Income and Tax Items for Specified Tax Years, 1980-1999," (US Internal Revenue Service, Statistics of Income Branch, August 2001, Microsoft Excel format). Note: This data file provides information about income reported on tax returns from a variety of sources, including Social Security, pensions, etc..

II. Reports and articles:


A. "Medicare Program; Payment Policies Under the Physician Fee Schedule for Calendar Year 2002," (Centers for Medicare and Medicaid Services, .pdf format, August 2, 2001). Note: The files linked to on this page appeared in the Federal Register on August 2nd.

B. "Hospital Inpatient Prospective Payment Systems and Graduate Medical Education Rates and Costs (2002 FY)," (Centers for Medicare and Medicaid Services, HTML format, August 2, 2001). Note: The files linked to on this page appeared in the Federal Register on August 1.

C. "Election Period Changes for 2002 (Lock-In)," (Centers for Medicare and Medicaid Services, rich text format, August 7, 2001).

7. DHHS OIG OAS REPORTS: Note: Click on "Complete Text of Report" to view the full-text of any of these reports.

A. "Follow-up Audit of Improper Medicare Payments to Hospitals for Nonphysician Outpatient Services Under the Inpatient Prospective Payment System," (US Department of Health and Human Services, Office of Inspector General, Office of Audit Services , A-01-00-00506, .pdf format, July 31, 2001, 21p.).

Executive Summary:

Based on the results of previous audits, the Office of Inspector General (OIG) initiated a joint project with the Centers for Medicare and Medicaid Services (CMS) and Department of Justice (DOJ) to recover duplicate payments made to hospitals that had not complied with Medicare requirements regarding the diagnosis related group (DRG) payment window. This report, points out that the joint project, as of July 2000, had resulted in the collection of approximately $73 million covering the period November 1990 through December 1996 from 2800 hospitals that had entered into settlement agreements with DOJ. Since that time, duplicate payments have decreased significantly, but we did identify approximately $5 million of potential duplicate payments for calendar years 1997 and 1998. We recommended to CMS financial adjustments, and additional procedural refinements to identify and preclude further duplicate payments. The CMS generally concurred with our recommendations.

B. "Medicare Part B Payments for Durable Medical Equipment Provided to Beneficiaries in Skilled Nursing Facilities," (US Department of Health and Human Services, Office of Inspector General, Office of Audit Services, A-01-00-00509, .pdf format, July 23, 2001, 14p.).

Executive Summary:

This final report points out a major flaw in the claims processing systems of the four durable medical equipment regional carriers (DMERC). Federal regulations prohibit Medicare Part B payments for durable medical equipment (DME) on behalf of a beneficiary who is in a Medicare Part A skilled nursing facility (SNF) for an entire month. In such cases the Medicare Part A reimbursement to the SNF would cover the DME services and the SNF would be responsible for paying the DME provider or supplier. Our final report points out, however, that the four DMERCs made improper Medicare Part B payments for such services during calendar years 1996 through 1998. We estimate the overpayments totaled approximately $35 million, and were due, in part, to lack of adequate edits in the DMERCs claims processing systems. In addition, coinsurance payments of approximately $9 million related to these DME items may have also been overpaid by the Medicaid program, supplemental insurance programs, or by the beneficiaries themselves. In addition to recovery of the overpayments, we recommended that the Centers for Medicare and Medicaid Services (CMS) work with the DMERCs to implement edits to identify and prevent such payments in the future. The CMS generally concurred with our recommendations and has agreed to take corrective action.

C. "Review of the Administrative Cost Component of the Adjusted Community Rate Proposals for a Southwest Medicare+Choice Organization for Contract Year 2000," (US Department of Health and Human Services, Office of Inspector General, Office of Audit Services, A-09-00-00120, .pdf format, July 19, 2001, 20p.).

Executive Summary:

Unlike other areas of the Medicare program, there is no statutory or regulatory authority governing the allowability of costs in determining adjusted community rates (ACRs) for Medicare+Choice organizations (M+CO). This review of six ACR proposals for 2000 submitted by a Southwest M+CO was made to determine if the administrative costs were reasonable, necessary, and allocable when compared to Medicare's general principle of paying only reasonable costs. We found, however, that the ACRs included $35.4 million in costs that; (1) were in excess of the amount that would have been allocated on the basis of enrollment, (2) were not allocable to Medicare, (3) would not be allowable if existing Medicare regulations (either for cost HMOs or in the fee-for-service arena) were applied to M+COs, and (4) pertained to unsupported related-party transactions and other unsupported costs. The results of this review, along with the results of similar reviews of other M+CO organizations are being shared with the Centers for Medicare and Medicaid Services so that appropriate legislative changes can be considered.

8. DHHS OIG OIE REPORT: "Physical, Occupational, and Speech Therapy for Medicare Nursing Home Patients: Medical Necessity, Cost and Documentation Under the $1500 Therapy Caps," (US Department of Health and Human Services, Office of the Inspector General, Office of Evaluation and Inspections, OEI-09-99-00560, HTML and .pdf formats, August 2001, 32p.).

Executive Summary:

Medicare allowed in error approximately $48.5 million for medically unnecessary, undocumented, and inadequately documented therapy during the first 6 months of 1999, according to this study. This represents an overall error rate of 24.7 percent. Assuming that the second half of 1999 was the same as the first 6 months, the inappropriate therapy allowances totaled $97 million. The CMS concurred with our recommendation regarding provider education, medical review, and reimbursement systems.



9. _LANCET_ ARTICLE: Note: _Lancet_ requires free registration before providing content.

A. "Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study," by Irwin J Schatz, Kamal Masaki, Katsuhiko Yano, Randi Chen, Beatriz L Rodriguez, J David Curb (_Lancet_, Vol. 358, No. 9279, HTML and .pdf formats, August 4, 2001, p. 351-355).


B. "Origins of the desire for euthanasia and assisted suicide in people with HIV-1 or AIDS: a qualitative study," by James V Lavery, Joseph Boyle, Bernard M Dickens, Heather Maclean, Peter A Singer (_Lancet_, Vol. 358, No. 9279, HTML and .pdf formats, August 4, 2001, p. 362-367).


10. _JAMA_ ARTICLE ABSTRACT: "Representation of Elderly Persons and Women in Published Randomized Trials of Acute Coronary Syndromes," by Patrick Y. Lee, Karen P. Alexander, Bradley G. Hammill, Sara K. Pasquali, and Eric D. Peterson (_Journal of the American Medical Association_, Vol. 286, No. 6, HTML and .pdf format, August 8, 2001, p. 708-713).

11. _NATURE_ LETTERS TO NATURE ABSTRACT: "Erythropoietin-mediated neuroprotection involves cross-talk between Jak2 and NF-B signalling cascades," by Murat Digicaylioglu and Stuart A. Lipton (_Nature_, Vol. 412, No. 6847, HTML and .pdf formats, August 9, 2001, p. 641-647).

12. _U.S. NEWS AND WORLD REPORT_ ARTICLE: "401(k)'s have lost a step," by Paul J. Lim (_US News and World Report_, August 13, 2001).

13. _TIME_ ARTICLE: "Better Than A Nursing Home?" by Andrew Goldstein (_Time_, Vol. 158, No. 6, HTML format, August 13, 2001).,9171,1101010813-170025-1,00.html

14. AARP's MODERN MATURITY: The September/October issue of "Modern Maturity" is now available. Selected articles, in HTML format, are available.

III. Working Papers:

15. NBER: Note: Click on "PDF" at the bottom of the abstract or submit your email address for full text. "Imperfect Knowledge, Retirement and Saving," by Alan L. Gustman and Thomas L. Steinmeier (National Bureau of Economic Research W8406, August 2001, .pdf format, 57p.).


Using data from the Health and Retirement Study, this paper creates variables measuring knowledge about future social security and pension benefits by comparing respondent reports of their expected benefits with benefits calculated from social security earnings records and employer provided descriptions of pension plans. The knowledge measures suggest that misinformation, imprecision and lack of information about retirement benefits is the norm. Those who are most dependent on social security are the least well informed about their social security benefits, while those who are most dependent on pensions are best informed about their pension benefits. Women and minorities are less well informed about both types of retirement benefits. Having documented the extent of misinformation, we turn to questions about the production of information, and the consequences of misinformation for real outcomes. Relating measures of information to planning activities, we find that those who plan are somewhat better informed than those who do not, but with the exception of having requested a social security earnings record, the effects of planning activities on knowledge are modest. In descriptive and reduced form equations for planned and actual retirement and saving, there is at best a modest relation of knowledge measures to planned and actual retirement and to nonpension, nonsocial security wealth as a share of lifetime earnings. Individuals who overestimate their benefits are likely to retire sooner than they planned, but the measured effects are relatively modest. Coefficients of measures of the increase in reward from postponed retirement are barely affected by the addition of measures of respondent knowledge of their retirement benefits to standard reduced form retirement and wealth equations.

16. CENTER FOR RETIREMENT RESEARCH AT BOSTON COLLEGE: "The Trend in Lifetime Earnings Inequality and Its Impact on the Distribution of Retirement Income," by Barry Bosworth, Gary Burtless and Claudia Sahm (_Center for Retirement Research at Boston College_, WP #2001-03, .pdf format, August 2001, 59p.).


This paper examines the trend in career earnings profiles and lifetime earnings inequality using a new data set that links micro-census information from a Census Bureau survey (the Survey of Income and Program Participation, or SIPP) with the summary earnings records (SER) maintained by the Social Security Administration. It then considers the implications of these trends for the trend of Social Security replacement rates and future changes in the inequality of pension income. The data set covers men and women born in successive years between 1926 and 1965 using a combination of observed and predicted earnings.

Our analysis finds that aggregate male wage and employment patterns have remained much more stable than is the case for women. Although less educated men in recent birth cohorts have fared worse than men in earlier cohorts who had the same schooling, the increase in average educational attainment has largely offset the employment and relative wage losses suffered by less educated men. Among women, while female employment rates and average earnings remain lower than those of men of the same age, the male-female gap is now much smaller than it was in earlier cohorts. The age pattern of employment and earnings among women is growing more similar to the pattern observed among men.

Our tabulations of historical earnings and forecast of future earnings patterns suggest that that lifetime earnings inequality will increase significantly among men. Compared with men born between 1936-1940, we predict that men born in 1961-1965 will experience 12 percent greater inequality in career earnings. Even though womens inequality has increased if we measure inequality among full-time, year-round workers who are employed during a particular year, inequality has fallen sharply if we widen the sample to include all women who are potentially available to work. The rising employment rate of women has increased the percentage of working-age years that women spend in jobs. It has dramatically reduced the fraction of women who earn extremely low lifetime wages because they are employed in only a few years of their potential careers. The noticeable increase in lifetime earnings inequality among men has thus been offset, at least in part, by a sizable reduction in career earnings inequality among women.

Click on the word "here" to view electronic full-text.

17. INTERNATIONAL INSTITUTE FOR APPLIED SYSTEMS ANALYSIS: "Microsimulation Modeling of Population, Economic Growth, and Social Security Systems," by Martin Spielauer (_International Institute for Applied Systems Analysis_, IR-01-026, .pdf and post-script format, July 2001, 35p.).


This paper is a first step in trying to develop a modeling and simulation framework that allows to incorporate the strengths of microsimulation in economic growth modeling in the context of demographic change. This is mainly done by restating and programming an existing neoclassical macroeconomic growth model in terms of microsimulation, which allows to explore and demonstrate some of the features microsimulation techniques can possibly "add" to this kind of modeling. The starting point of the analysis is the IIASA "Social Security Forecasting and Simulation Model", developed by the IIASA Social Security Reform (SSR) Project as described in MacKellar et al. (2000). This model was developed to study the influence of pension systems on the economy mainly by investigating long-run capital accumulation and economic growth as functions of the evolving age distribution of the population and the nature of pension schemes. Differently to most economic growth models, the IIASA macro-model explicitly introduces "realistic demography" by disaggregating the household sector (and all model outputs) by age cohorts. This kind of economic modeling is incorporated in a dynamic microsimulation framework by further disaggregation of the cohorts to the individual micro-level. Allowing for heterogeneous individual agents, economic and demographic behavior can be modeled taking into account a wide set of individual and household characteristics. As part of this research a "microSSR" software is developed, both as a tool for the testing of different behavioral theories and as a projection and forecasting tool.

Click on the "PDF" or "PS" icon to access the full-text of this paper.

IV. Journal Tables of Contents (check your library for availability):

18. INGENTA Tables of Contents: INGENTA provides fee based document delivery services for selected journals.

A. Point your browser to:

B. click on "Search Options"
C. Type the Journal Name in the "Publication title" search box and click
the radio button "Words in Title"
D. View the table of contents for the issue noted.

Journal of Aging and Physical Activity (Vol. 9, no. 3, 2001).

Journal of Health and Social Behavior (Vol. 42, no. 2, 2001). Note: This journal is available in full electronic text in the ProQuest Research Library. Check your library for the availability of this database and this issue.

Population Studies (Vol. 55, No. 2, 2001).

V. Books:

19. ELSEVIER SCIENCE: "Clinical Geropsychology: Comprehensive Clinical Psychology Volume 7," edited by B.A. Edelstein (Pergamon: New York, Amsterdam, ISBN: 0-08-044069-X, approximately 600 pages, 2001).

For more information about this book, including information about pricing and ordering, go to:

20. H-NET REVIEWS: "Women and Ageing in British Society Since 1500," edited by Lynn Botelho and Pat Thane (Longman: New York and London, ISBN: 0-582-32902-7, 2001) reviewed by Colleen Seguin (H-Albion, H-Net Reviews, July 2001).

VI. Funding Opportunities:

21. PROGERIA RESEARCH FOUNDATION: "The Progeria Research Foundation Medical Research Grant Application Guidelines," (_Progeria Research Foundation Inc., HTML format, 2001).

VII. Conferences:

22. AOA: "2nd Annual Tribal Listening Session," (US Department of Health and Human Services, Administration on Aging, August 9, 2001). The conference will be held August 15, 2001 in Washington DC. For more information about the session, go to:

VII. Websites of Interest:

23. MEDSCAPE JOURNAL SCAN: Note: Medscape requires free registration before providing articles.

"Medscape Women's Health Journal Scan -- Menopause," (_Medscape Women's Health Journal Scan via Medscape_, Vol. 4, No. 15, HTML format, updated August 3, 2001).



IX. Request for Information:


Subject: Request for syllabi in the demography, economics, and epidemiology of aging

Dear Colleagues,

The University of Michigan maintains a web site on behalf of the NIA P30 Centers on the Demography of Aging. A popular feature of the site is a collection of syllabi in the demography, economics and epidemiology of aging. The syllabi are a useful resource for anyone teaching, or planning to teach in the field.


The collection was originally assembled by Vicki Freedman and Bob Schoeni at RAND several years ago. Some people seeing this message have been past contributors.

As the Fall Semester approaches, we are again inviting anyone teaching a course in the demography of aging, broadly defined, to send their syllabus to us for posting on the site. Updated versions of syllabi already in the set and new courses are all welcome. Send as an electronic attachment to:

Lora Myers:

We hope that you will make use of the syllabi and alert your colleagues, especially junior faculty developing new courses, that it is available. Your comments and suggestions for the site are always welcome.

David Lam
Lora Myers




Charlie Fiss
Information Manager
Center for Demography and Ecology
Rm. 4470A Social Science Bldg
1180 Observatory Drive
Madison, WI 53706-1393
Phone: (608) 265-9240
Fax: (608) 262-8400