5 Percent Of Americans Account For More Than Half Of Healthcare Costs

The top five percent of Americans accounted for nearly half of all healthcare expenditures in the United States, a report from the Agency for Healthcare Research and Quality (AHRQ) says. In contrast, half of the population spends little or nothing on healthcare, statistics show.

The 15 most expensive health conditions (the top five being heart disease, cancer, trauma, mental disorders, and pulmonary conditions) account for nearly half of total healthcare expenses, and patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition.

Key findings from the report include the following:

  • In 2008, 1 percent of the population accounted for 20.2 percent of total healthcare expenditures and 20.0 percent of the population in the top 1 percent retained this ranking. In 2009, the bottom half of the expenditure distribution accounted for 3.1 percent of spending in 2008; about three out of four individuals in the bottom 50 percent retained this ranking in 2009.
  • Those who were in the top decile of spenders in both 2008 and 2009 differed by age, race/ethnicity, sex, health status, and insurance coverage (for those under 65) from those who were in the lower half in both years.
  • Those in the bottom half of healthcare spenders were more likely to report excellent health status, while those in the top decile of spenders were more likely to be in fair or poor health relative to the overall population.
  • While 15.5 percent of persons under age 65 were uninsured for all of 2009, the full-year uninsured comprised 25.9 percent of those in the bottom half of spenders for both 2008 and 2009. Only 3.6 percent of those under age 65 who remained in the top decile of spenders in both years were uninsured for all of 2009.
  • Relative to the overall population, those who remained in the top decile of spenders were more likely to be in fair or poor health, elderly, female, non-Hispanic whites and those with public-only coverage. Those who remained in the bottom half of spenders were more likely to be in excellent health, children and young adults, men, Hispanics, and the uninsured.

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on healthcare utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the U.S. civilian noninstitutionalized population. It is cosponsored by the AHRQ and the National Center for Health Statistics.

Source: AHRQ, January 2012

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Comorbidity Care Models: Integrated Action Plans for Complex Healthcare Needs presents emerging models of care for comorbidity, with a special focus on the needs of aging multi-morbid patients as well as those whose comorbidity encompasses physical and behavioral health conditions.

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