Peterson-Kaiser Health System Tracker How has U.S. spending on healthcare changed over time?

Peterson-Kaiser Health System Tracker

How has U.S. spending on healthcare changed over time?


Health services spending growth picked up slightly in 3rd Quarter 2014

Year over year growth in health services spending by quarter, 2010 - 2014

Source: Kaiser Family Foundation analysis of Quarterly Services Survey

Q1-2010

Q2-2010

Q3-2010

Q4-2010

Q1-2011

Q2-2011

Q3-2011

Q4-2011

Q1-2012

Q2-2012

Q3-2012

Q4-2012

Q1-2013

Q2-2013

Q3-2013

Q4-2013

Q1-2014

Q2-2014

Q3-2014

0%

1%

2%

3%

4%

5%

6%

7%

3.4% 3.4%

4.1%

5.1%

5.8%

5.2%

3.1%

4.0%

5.6%

4.5%

5.2%5.0%

2.8%

4.2%3.9%

4.9%

2.9%

3.7%

5.4%


Source: Kaiser Family Foundation analysis of National Health Expenditure (NHE) data from Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group

Total health expenditures have increased substantially over the past several decades

1970 1976 1982 1988 1995 2001 2007 2013$0.0

$0.5

$1.0

$1.5

$2.0

$2.5

$3.0

$359.9 BillionIn 2013 Dollars

$2.9 Trillion

$74.9 Billion

Total National Health Expenditures In Constant 2012 Dollars

Total national health expenditures, US $ Trillions, 1970-2013

In Constant 2013 Dollars



On a per capita basis, health spending has grown substantially

1970 1976 1982 1988 1995 2001 2007 2013$0

$2,000

$4,000

$6,000

$8,000

$10,000

$1,714 per capitaIn 2013 Dollars

$9,255 per capita

$356 per capita

Total National Health Expenditures In Constant 2012 Dollars

Total national health expenditures, US $ per capita, 1970-2013




Health spending growth has outpaced growth of the U.S. economy

1970 1976 1982 1988 1995 2001 2007 20130%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

7%

17%

Total national health expenditures as a percent of Gross Domestic Product, 1970-2013


Source: Kaiser Family Foundation analysis of 2013 OECD data: "OECD Health Data: Health expenditure and financing: Health expenditure indicators", OECD Health Statistics (database). doi: 10.1787/data-00349-en (Accessed on June 25, 2014).

Health spending increases have slowed, and is now on pace with economic growth

1970s 1980s 1990s 2000s 2010-20120%

2%

4%

6%

8%

10%

12%

14%

9.2%

6.6%

4.3%

2.9%3.4%

12.0%

10.0%

5.3% 5.6%

3.0%

GDP Health Spending

Average annual growth rate of GDP per capita and total national health spending per capita, 1970 - 2012



Spending on hospitals, physicians, and prescriptions has grown at varying rates

1970s 1980s 1990s 2000s 2010-20130.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

10.3%

7.6%

5.6%

3.8% 3.9%

8.2%

12.8%

11.6%

7.8%

1.9%

14.0%

9.6%

5.2%

7.0%

4.8%

12.8% 12.8%

6.2% 6.0%

4.2%

GDP Prescriptions Hospitals Physicians/Clinics

Average annual growth rate for select service types, 1970 - 2013



Hospital and physician services represent half of total health spending

Hospitals34%

Physicians/Clinics 21%

Prescriptions 10%

Nursing Homes, 6%

Other PersonalHealth

16%

Other Health10%

Relative contributions to total national health expenditures, 2013Home Health Care, 3%



Out-of-pocket spending represents a smaller portion of total expenditures than it did in 1970

Total national health expenditures, 1970 and 2013

Out-of-pocket33%

Private Insurance21%

Public Insurance22%

Other24%

1970

Out-of-pocket12%


Public Insurance39%

Other16%

2013



Per capita out-of-pocket expenditures have grown since 1970

1970 1976 1982 1988 1995 2001 2007 2013$0

$200

$400

$600

$800

$1,000

$1,200

$573Per capita

$1,076Per capita

$119Per capita

Out of pocket In Constant 2012 Dollars

Per capita out-of-pocket expenditures, 1970-2013



Source: Kaiser Family Foundation analysis of Consumer Expenditure Survey

On average, larger shares of household budgets are devoted to health expenses than 10 years agoAverage portion of household budget devoted to health (nonelderly families), 2002-2012

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20120.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

2.1%

3.1%

4.4%

5.2%

Out-of-pocket costs:

Insurance premiums:

Total health expenses:


Source: Kaiser Family Foundation analysis of Consumer Expenditure Survey

A larger portion of household spending on health is on insurance premiums, and smaller portion on OOP costsAverage household expenditures on health (nonelderly families with no Medicare beneficiaries), 2002 and 2012

Health insurance51%

Medical services32%

Prescription drugs14%

Med sup.3%

2002

Health insurance59%

Medical services28%

Prescription drugs10%

MedSup.3%

2012

$1,827 $2,754



Health insurance represents a growing share of total health expenditures, particularly public programsTotal national health expenditures, 1970 and 2013

Out-of-pocket33%


Public Insurance22%

Other24%

1970

Out-of-pocket12%


Public Insurance39%

Other16%

2013



Medicare and private insurance growth have been similar, but Medicare growth has slowed recently

1990s 2000s 2010 - 20130%

1%

2%

3%

4%

5%

6%

7%

8%

6.0%

7.0%

3.3%

5.7%

6.5%

0.7%

Private Insurance Medicare

Average annual growth rate of spending per enrolled person in Private Insurance vs. Medicare, 1970 - 2013


Public and private health spending have both grown substantially, but public spending has grown faster

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

$-

$0.2

$0.4

$0.6

$0.8

$1.0

$1.2

$1.4

$1.6

$1.8 Private Public

1987 2013

Total national health expenditures, US $Trillions, 1970-2013



1970 1976 1982 1988 1995 2001 2007 20130%

1%

2%

3%

4%

5%

6%

7%

8%

9%

4%

7%


Administrative costs have risen over time but have recently moderated

Net cost of health insurance and administration, as a share of total health expenditures, 1970-2013



Spending on public health has increased, particularly by state and local governments

Local and federal expenditures on public health, US $Millions, 1970-2013

19701972

19741976

19781980

19821984

19861988

19901992

19941996

19982000

20022004

20062008

20102012

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

Federal State and Local

2013


Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis data

Prices have historically driven health services spending growth, but it’s now a mix of price and useAnnual change in price and quantity indexes of health services, index numbers 2009=100

19811982

19831984

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

20112012

20130%

2%

4%

6%

8%

10%

12%

14%

Real personal consumption expenditure quantity index Price index for personal consumption expenditure


Source: Kaiser Family Foundation analysis of Bureau of Economic Analysis data

Growth in the use of pharmaceuticals has outpaced price growth for 2 decades

19811982

19831984

19851986

19871988

19891990

19911992

19931994

19951996

19971998

19992000

20012002

20032004

20052006

20072008

20092010

20112012

20130%

2%

4%

6%

8%

10%

12%

14%

Pharmaceutical and other medical products quantity indexesPharmaceutical and other medical products price indexes

Annual change in price and quantity indexes of pharmaceutical and other medical products, index numbers 2009=100

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Peterson-Kaiser Health System Tracker How has U.S. spending on healthcare changed over time?