Transcript New ACGME Requirements on Duty Hours Published June 23

National Health Expenditures
2009
AAMC Contact:
Jane Eilbacher
Health Care Affairs
[email protected]
National Health Spending, 2005-2009
National Health Expenditures
(billions)
% Growth From Prior Year
8.0%
$3,000
$2,500
$2,000
$2,021
$2,152
$2,284
$2,391
$2,486
7.0%
6.0%
5.0%
4.0%
$1,500
6.7%
6.5%
6.1%
4.7%
4.0%
3.0%
$1,000
2.0%
$500
1.0%
$0
2005
2006
2007
2008
2009
0.0%
2005
2006
2007
2008
2009
Source: CMS, Office of the Actuary, National Health Statistics Group, Table 1, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
National health spending grew 4.0% in 2009, to $2.5 trillion dollars,
the slowest recorded rate of growth.
Health Spending and the GDP
20.0%
17.6%
16.0%
16.1%
16.2%
16.6%
15.0%
10.0%
% Growth GDP
NHE as % of GDP
5.0%
6.5%
6.0%
4.9%
2.2%
0.0%
2005
2006
2007
2008
2009
-1.7%
-5.0%
Source: CMS, Office of the Actuary, National Health Statistics Group, Table 1, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
Health care spending rose 1 percentage point, to 17.6% of the GDP in
2009, the largest one-year increase in history. This is mainly attributable
to a 1.7% decline in the GDP, the largest decline since 1938.
National Health Expenditures (NHE) by
Source of Funds ($ billions) in 2009
Total NHE=
$2.5 trillion
4%
12%
Out-of-pocket 12%
15%
Other third-party payers * 11%
11%
Investment 6%
Private health insurance 32%
6%
20%
Medicare 20%
Medicaid-Federal & State 15%
32%
Other health insurance
programs 4%
Sources: CMS, Office of the Actuary, National Health Statistics Group, Table 3, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
Martin, et al. Recession Contributes To Slowest Annual Rate Of Increase In Health Spending In Five Decades. Health Affairs, 30, no.1 (2011): 13
(For Other Third-Party Payers)
* Includes health-related spending for worksite health care, other private revenues, Indian Health Service, workers’
compensation, general assistance, maternal and child health, vocational rehabilitation, other federal programs, Substance
Abuse and Mental Health Services Administration, other state and local programs, and school health.
National Health Spending
Average Annual Growth from Prior Year, by Payer
25.0%
22.0%
20.0%
15.0%
Private Health
Insurance
10.0%
7.9%
Medicare
5.0%
1.3%
0.0%
2005
2006
2007
2008
2009
-5.0%
-9.8%
-10.0%
-15.0%
Medicaid-Federal
Medicaid-State &
Local
Source: CMS, Office of the Actuary, National Health Statistics Group,
Table 3, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
Total Medicare spending grew at the same rate in 2009 as in 2008: 7.9%.
Rising unemployment contributed to both a decrease in private health
insurance spending, as well as an increase in federal Medicaid spending.
The disparity in growth between federal and state Medicaid spending is
largely due to an increase in the Federal Medicaid Assistance Program (FMAP)
under the American Recovery and Reinvestment Act (ARRA).
Hospital and Physician Payments,
as a share of NHE, 2009
Hospital care 31%
6%
Total NHE=
$2.5 trillion
10%
Physician and clinical services 20%
31%
Dental and other professional services 7%
Other health, residential, and personal care 5%
13%
Home health care 3%
Nursing and continuing care facilities 5%
5%
Retail outlet sales of medical products 13%
3%
5%
20%
7%
Other expenditures* 10%
Investment 6%
Source: CMS, Office of the Actuary, National Health Statistics Group, Table 2, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
Hospital care and physician services accounted for the largest portions
of NHE, approximately 31% and 20% respectively. Retail sales of
medical products, 13% of NHE, consisted largely of prescription drug
sales, which individually represented 10% of NHE ($249.9 billion).
*Includes government administration, net cost of health insurance, and government public
health activities.
Hospital and Physician Services, 2005-2009
Expenditures ($ billions)
$800.0
$759.1
8.0%
% Growth from Prior Year
7.4%
6.9%
7.0%
$700.0
$606.5
6.0%
$600.0
5.9%
6.6%
5.2%
$505.9
5.0%
$500.0
5.3%
$419.6
5.2%
4.8%
4.0%
$400.0
5.1%
4.0%
$300.0
3.0%
$200.0
2.0%
$100.0
1.0%
$0.0
0.0%
2005
2006
Hospital care
2007
2008
2009
Physician and clinical services
2005
2006
Hospital care
2007
2008
2009
Physician and clinical services
Source: CMS, Office of the Actuary, National Health Statistics Group, Table 2, http://www.cms.gov/NationalHealthExpendData/downloads/tables.pdf
Hospital care in 2009 grew at nearly the same rate as in 2008. In
2009, physician payments alone increased 3.3%, while clinical
services grew 7.3%; in recent years, spending for clinical services
has outpaced that for physician services.
Summary
 Health care spending, including hospital and
physician spending, has slowed, but still
above inflation
 Despite slower growth in health care
spending, it is consuming an increasing share
of GDP
 Significant changes to care delivery and
payment will be required to both slow payment
growth and reset the spending curve