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 * 
 * Data & Research
 * Statistics, trends & reports
 * National health expenditure data
 * NHE Fact Sheet


NHE FACT SHEET





PAGES IN THIS SECTION

 * * * National health expenditure data
     * * Historical
       * Projected
       * Age and Sex
       * State (Residence)
       * State (Provider)
       * NIPA Reconciliation
       * MEPS Reconciliation
       * NHEA Related Studies
       * NHE Fact Sheet

NHE Fact Sheet


HISTORICAL NHE, 2023:

 * NHE grew 7.5% to $4.9 trillion in 2023, or $14,570 per person, and accounted
   for 17.6% of Gross Domestic Product (GDP).
 * Medicare spending grew 8.1% to $1,029.8 billion in 2023, or 21 percent of
   total NHE.
 * Medicaid spending grew 7.9% to $871.7 billion in 2023, or 18 percent of total
   NHE.
 * Private health insurance spending grew 11.5% to $1,464.6 billion in 2023, or
   30 percent of total NHE.
 * Out of pocket spending grew 7.2% to $505.7 billion in 2023, or 10 percent of
   total NHE.
 * Other Third Party Payers and Programs and Public Health Activity spending
   declined 3.1% in 2023 to $563.4 billion, or 12 percent of total NHE.
 * Hospital expenditures grew 10.4% to $1,519.7 billion in 2023, faster than the
   3.2% growth in 2022.
 * Physician and clinical services expenditures grew 7.4% to $978.0 billion in
   2023, faster growth than the 4.6% in 2022.
 * Prescription drug spending increased 11.4% to $449.7 billion in 2023, faster
   than the 7.8% growth in 2022.
 * The largest shares of total health spending were sponsored by the federal
   government (32 percent) and the households (27 percent).   The private
   business share of health spending accounted for 18 percent of total health
   care spending, state and local governments accounted for 16 percent, and
   other private revenues accounted for 7 percent.

For further detail see NHE Tables in downloads below.


PROJECTED NHE, 2023-2032:

 * Over 2023-32 average NHE growth (5.6%) is projected to outpace that of
   average GDP growth (4.3%), resulting in an increase in the health spending
   share of GDP from 17.3 percent in 2022 to 19.7 percent in 2032. 
 * NHE spending is expected to have grown 7.5% in 2023, faster than GDP growth
   of 6.1%.
 * Reflects broad increases in the use of care associated with the insured share
   of the population of 93.1% - an unprecedented high.
 * Largely related to a record-high level of Medicaid enrollment (91.2M) in
   2023, as well as gains in direct-purchase enrollment (8.3M) over 2023-25.
 * Health price growth remains modest, though faster than pre-pandemic.  
 * By 2032 the insured share falls to 90.7%.
 * Consistent with the President’s Budget, Medicaid enrollment is projected to
   decline to 81.0M in 2024 and slightly further to 79.4M by 2025 following the
   expiration of the continuous enrollment requirement. 
 * Direct-purchase enrollment is expected to decline by 7.3M in 2026 (-19.2%)
   due to expiration of the IRA’s temporary extension of enhanced subsidies and
   associated temporary Special Enrollment Period (SEP).
 * Over 2027-32, personal health care price inflation and growth in the use of
   health care services and goods contribute to projected health spending that
   grows at a faster rate than the rest of the economy.
 * Inflation Reduction Act (IRA) Impacts on NHE:
   * Initially, upward pressure on Medicare “retail” prescription drug spending
     is expected as a result of the IRA’s Part D benefit restructuring ($2,000
     cap on out-of-pocket spending on Part D; rebates shift from program to
     point of sale when drug negotiations begin). 
   * Conversely, downward pressure on Medicare spending is expected associated
     with (manufacturer discounts for the low-income population (starting in
     2025) and IRA provisions that are associated with drug price negotiations
     and the linking of price increases to the Consumer Price Index (CPI). 
   * Beginning in 2028, spending growth rates for Medicare outpatient hospital
     and physician and clinical services are expected to be lower than they
     otherwise would have been, mainly because the IRA’s drug negotiation
     provision will begin to apply to Medicare Part B drugs.
   * The NHE projections show lower out-of-pocket spending associated with the
     IRA due to more generous Medicare Part D benefits reflecting the
     elimination of the 5% coinsurance for catastrophic coverage in 2024, the
     implementation of a $2,000 cap on out-of-pocket spending on Part D drugs in
     2025, and the applicability of drug price negotiations beginning in 2026.

For further detail see NHE projections 2023-2032 in downloads below.


NHE BY AGE GROUP AND SEX, SELECTED YEARS 2002, 2004, 2006, 2008, 2010, 2012,
2014, 2016, 2018, AND 2020:

 * Per person personal health care spending for the 65 and older population was
   $22,356 in 2020, over 5 times higher than spending per child ($4,217) and
   almost 2.5 times the spending per working-age person ($9,154).
 * In 2020, children accounted for approximately 23 percent of the population
   and about 10 percent of all PHC spending.
 * The working-age group comprised the majority of spending and population in
   2014, 53 percent and over 60 percent respectively.
 * Older Adults (aged 65 and older) were the smallest population group, about 17
   percent of the population, and accounted for approximately 37 percent of all
   spending in 2020.
 * Per person spending for females ($10,887) was 14 percent more than males
   ($9,554) in 2020.
 * In 2020, per person spending for male children (0-18) was 10 percent more
   than females.  However, for working age adults per person spending for
   females was 20 percent more than for males.  For older adults, spending for
   males was 2 percent more than for females.

For further detail see health expenditures by age in downloads below.


NHE BY STATE OF RESIDENCE, 1991-2020:

 * In 2020, per capita personal health care spending ranged from $7,522 in Utah
   to $14,007 in New York.   Per capita spending in New York state was 37
   percent higher than the national average ($10,191) while spending in Utah was
   about 26 percent lower.  
 * Health care spending by region continued to exhibit considerable variation.
   In 2020, the New England and Mideast regions had the highest levels of total
   per capita personal health care spending ($12,728 and $12,577, respectively),
   or 25 and 23 percent higher than the national average.   In contrast, the
   Rocky Mountain and Southwest regions had the lowest levels of total personal
   health care spending per capita ($8,497 and $8,587, respectively) with
   average spending 17 and 16 percent lower than the national average,
   respectively.
 * Between 2014 and 2020, average growth in per capita personal health care
   spending was highest in New York at 6.1 percent per year and lowest in
   Wisconsin at 3.0 percent per year (compared with average growth of 4.3
   percent nationally).
 * The spread between the highest and the lowest per capita personal health
   spending across the states has remained relatively stable over 2014-20.
   Accordingly, the highest per capita spending levels were 90 to 100 percent
   higher per year than the lowest per capita spending levels during the period.
 * Medicare expenditures per beneficiary were highest in Florida ($13,652) and
   lowest in Vermont ($8,726) in 2020.
 * Medicaid expenditures per enrollee were highest in North Dakota ($12,314) and
   lowest in Georgia ($4,754) in 2020.

For further detail, see health expenditures by state of residence in downloads
below.


NHE BY STATE OF PROVIDER, 1980-2020:

 * Between 2014 and 2020, U.S. personal health care spending grew, on average,
   4.8 percent per year, with spending in Arizona growing the fastest (6.6
   percent) and spending in Vermont growing the slowest (2.7 percent).
 * In 2020, California’s personal health care spending was highest in the nation
   ($410.9 billion), representing 12.2 percent of total U.S. personal health
   care spending. Comparing historical state rankings through 2020, California
   consistently had the highest level of total personal health care spending,
   together with the highest total population in the nation. Other large states,
   New York, Texas, Florida, and Pennsylvania, also were among the states with
   the highest total personal health care spending.
 * Wyoming’s personal health care spending was lowest in the nation (as has been
   the case historically), representing just 0.1 percent of total U.S. personal
   health care spending in 2020. Vermont, North Dakota, Alaska, and Montana were
   also among the states with the lowest personal health care spending in both
   2020 and historically. All these states have smaller populations.
 * Gross Domestic Product (GDP) by state measures the value of goods and
   services produced in each state. Health spending as a share of a state’s GDP
   shows the importance of the health care sector in a state’s economy. As a
   share of GDP, West Virginia ranked the highest (28.7 percent) and Washington
   state the lowest (11.7 percent) in 2020.  

For further detail, see health expenditures by state of provider in downloads
below.


DOWNLOADS

 * Health expenditures by state of residence: summary tables (ZIP)
 * Health expenditures by state of provider: summary tables (ZIP)
 * NHE Tables (ZIP)
 * Age and Sex Tables (ZIP)
 * NHE Projections - Tables (ZIP)

Page Last Modified:
12/18/2024 04:12 PM
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