Abstract Body: Background: The direct medical costs of stroke in the United States were $84.4 billion in 2012 and were projected to rise by 157% to $217.3 billion by 2030. However, the 10-year trend in inpatient stroke care costs under Medicare, as well as the Medicare payment variation across different states, has yet to be thoroughly investigated.

Methods: This is a retrospective analysis of the 2013 to 2022 Medicare Inpatient Hospitals - by Provider and Service Data that provides inpatient hospital charges by Medicare Severity Diagnosis Related Group (DRG) in stroke admission (DRG: 61-66). Percentage change in stroke admission cost adjusted for healthcare inflation between 2013-14 to 2021-22 weighted for the number in each stroke DRG was included in the analysis.

Results: Between 2013 and 2022, nationwide there were a total of 2,007,005 unique stroke-related inpatient hospital claims, resulting in Medicare payments totaling $21.07 billion from the Medicare Services. In 2013, the mean Medicare payment, weighted per stroke DRG for each stroke admission, was $9,486.08 (95% CI: $9,448.98–$9,523.18) nationwide. By 2022, after adjusting for healthcare inflation, the mean Medicare payment, weighted per stroke DRG, increased to $10,047.34 (95% CI: $9,994.39–$10,100.30) nationwide (Figure 1). At the state level, the 10-year analysis of Medicare payment for stroke admissions revealed a 33% decrease in payment costs in Vermont, while Maryland experienced the highest increase, with a 23% rise in Medicare payment costs (Figure 2).

Conclusion: Nationwide, the overall Medicare payment for stroke-related DRG costs has increased by over $560 in the past decade after adjusting for healthcare inflation and weighted per-stroke DRGs. However, at the state level, certain states have experienced a reduction in Medicare payments for stroke admissions.