Chartbook:Connecticuthealthcarespending

CTHealthPolicyProjectNovember2017 1

November2017

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Earlierthisyear,theUSCentersforMedicareandMedicaidServicesreleasedupdatedStateHealthExpendituresthroughtheNationalHealthExpenditureAccounts.Thedataincludesaggregateandpercapitapersonalhealthcarespendingbystatebythetypeofgoodorservice(hospitalcare,physicianandclinicalservices,retailprescriptiondrugs,etc.)andbysourceoffunding(MedicareandMedicaid).Thenewdatareleasecoversspendingfrom1991to2014.AnalysisofthedatawasalsopublishedinJuly2017-- DLassman,et.al.,HealthSpendingbyState1991– 2014:MeasuringPerCapitaSpendingbyPayersandPrograms,HealthAffairs.

TheCTHealthPolicyProject’sanalysisofthedatafocusesonhealthspendinginConnecticuttoprovideinsightintohowresourcesareusedandtosupportinformedpolicymaking.

KeyFindings

• ConnecticutresidentsspendmoreperpersononhealthcareacrosspayersthanmostAmericans.• However,perpersonhealthcostsarerisingmoreslowlyinConnecticutthaninmoststates,particularlyforMedicaidmembers.

• In2014Connecticutdevoted14.4%ofthestate’seconomytopersonalhealthcareservices,veryclosetothenationalaverageof14.8%

• OverhalfofhealthspendinginConnecticutisconsumedbyhospitals,physiciansandclinics.• DrugcostsarethemaindriverofrisinghealthcostsinConnecticut,growingfasterthananyothersector.

• Since2003,drugcostshavegrownfasterinConnecticutthantherestofthenation• Beginningin2009,MedicareandMedicaid’scombinedshareofConnecticut’shealthspendingoutpacedprivatehealthinsurance.Andthegapisgrowing.

• MedicareandMedicaidpayforthemajorityofhomehealthandnursinghomecareinConnecticut,aswellasalmosthalfofhospitalbills.

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Percapitahealthspending

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KeyFindings

HealthspendingisrisingforbothConnecticutresidentsandallAmericans

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

HealthcareshareofGDP

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KeyFindings

In2014Connecticutdevoted14.4%ofitseconomytohealthcare,slightlybelowtheUSrateof14.8%

0%

2%

4%

6%

8%

10%

12%

14%

16%

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

UnitedStates Connecticut

Percapitahealthspending,2014

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KeyFindings

ConnecticutresidentsspendmoreonhealthcareacrosspayersthanmostAmericans

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

Allpayers Medicaid Medicare privateinsurance

Connecticut UnitedStates

Percapitaspending,averageannualgrowth2001to2014

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KeyFindings

ConnecticutMedicaidperpersonspendingfrom2001through2014decreasedwhilenationallycostshaverisen

-1

0

1

2

3

4

5

6

Total Medicaid Medicare Privatehealthinsurance

percen

tgrowth

Connecticut UnitedStates

ShareoftotalhealthspendingConnecticut,2014

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KeyFindings

PrivateinsuranceisthemainpayerofhealthcareinConnecticut

0%

5%

10%

15%

20%

25%

30%

35%

40%

Medicaid Medicare Privateinsurance

Medicarepercapitaspending

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KeyFindings

MedicareperpersonhealthcostsforConnecticutresidentsaresimilartothenationalaverage

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

Medicaidpercapitahealthspending

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KeyFindings

Until2009ConnecticutMedicaidcostsweremuchhigherthantheUSaverage

Sincethenthegaphasnarrowed

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

Privatehealthinsurancespendingpercapita

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KeyFindings

CostsofcareforprivatelyinsuredConnecticutresidentsarehigherthanformostAmericansandarerisingslightlyfaster

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

ShareoftotalConnecticuthealthspendingbypayer

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KeyFindings

In2014,privatehealthinsurance’sshareoftotalConnecticuthealthspendingwas34%

Medicaid’ssharewas20%

Medicare’ssharewas21%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Y1991 Y1992 Y1993 Y1994 Y1995 Y1996 Y1997 Y1998 Y1999 Y2000 Y2001 Y2002 Y2003 Y2004 Y2005 Y2006 Y2007 Y2008 Y2009 Y2010 Y2011 Y2012 Y2013 Y2014

Medicare Medicaid Privatehealthinsurance

ShareoftotalConnecticuthealthspendingMedicare+Medicaid,Privatehealthinsurance

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KeyFindings

In2009,publiccoverageprograms’shareoftotalCThealthspendingbegantooutpaceprivateinsurance

Andthatgapisgrowing

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Y1991 Y1992 Y1993 Y1994 Y1995 Y1996 Y1997 Y1998 Y1999 Y2000 Y2001 Y2002 Y2003 Y2004 Y2005 Y2006 Y2007 Y2008 Y2009 Y2010 Y2011 Y2012 Y2013 Y2014

Privatehealthinsurance Medicare+Medicaid

Staterank

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KeyFindings

WhileConnecticut’srelativepercapitahealthcarecostsarehighamongstates,therateofgrowthismuchlower,particularlyforMedicaid

Percapita– 2014

Averageannualgrowth–1991to2014

PercapitaspendingbyserviceConnecticut,2014

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KeyFindings

OverhalfofConnecticuthealthspendinggoestohospitalsandphysicians,clinics

hospital 33.74%

physicians,clinics22.17%

Otherprofessionals3.27%

dental 4.76%

homehealthcare3.00%

nursinghomes8.66%

drugs,nondurableproducts 14.97%

DME 1.43% Other 8.01%

ShareofConnecticutpercapitaspendingbyservice

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KeyFindings

DrugsconsumeagrowingshareofConnecticut’shealthcarespending,surpassingnursinghomecarein2001

0%

5%

10%

15%

20%

25%

30%

35%

40%

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

hospital physicians,clinics dental homehealthcare nursinghomes drugs,nondurableproducts

PercapitaaverageannualgrowthbyserviceConnecticut,1991to2014

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KeyFindings

DrugsandothernondurableproductsarethemaindriverofgrowinghealthcostsinConnecticut

0%

1%

2%

3%

4%

5%

6%

7%

8%

total hospital physicians,clinics dental homehealthcare nursinghome drugs,nondurableproducts

ShareoftotalspendingbyserviceConnecticut,2014

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KeyFindings

MedicareandMedicaidpayforthemajorityofhomehealthandnursinghomecareinConnecticutandalmosthalfofhospitalbillsinourstate

0%

10%

20%

30%

40%

50%

60%

70%

80%

hospital physician,clinic

otherprofessionals

dental homehealth drugs,nondurableproducts

DME nursinghomes other

Medicaid Medicare

Drug,nondurableproductspendingpercapita

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KeyFindings

DrugandothernondurableproductspendingishigherforConnecticutresidentsthanmostAmericans

Andthegapisgrowing

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

Drugs,nondurableproductsshareoftotalpercapitaspending

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KeyFindings

Since2003spendingondrugsandothernondurableproductshavegrownfasterinConnecticutthannationally

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

14.00%

16.00%

18.00%

20.00%

1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

UnitedStates Connecticut

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November 2017Source: National Health Expenditure Data, cms.gov, https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/index.html

Connecticut Health Policy Projectwww.cthealthpolicy.org@cthealthnotesPhone 203-427-8242