Health, United States SpotlightHealth Care Expenditures & Payers September 2016

ABOUT HEALTH, UNITED STATESHealth, United States is the annual report on health, produced by the National Center for Health Statistics and submitted by the Secretary of the Dept. of Health and Human Services to the President and Congress.

The report uses data from government sources as well as private and global sources to present an overview of national health trends. This infographic features indicators from the report’s Health Care Expenditures & Payers subject area.

For more information, visit the Health, United States website at:http://www.cdc.gov/nchs/hus.htm.

Health care resources

Four Subject Areasof Health, United States

Health status& determinants

Utilization of health resources

Health care expenditures& payers

MEDICAID COVERAGE

ABOUT THE DATA

Source: NCHS/National Health Interview Survey (NHIS)

Respondents: Noninstitutionalized civilians.

Methodology: Coverage for adults was respondent-reported. Coverage for children was reported by a parent or a knowledgeable adult.

Notes: Medicaid includes coverage by Medicaid, state-sponsored plans, or the Children’s Health Insurance Program.Type of coverage represents coverage at the time of interview.

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•

2005 2015

Perc

ent

60

50

40

30

20

10

0

Medicaid coverage among persons under age 65, by age: 2005–2015

Under 18 years

18–64 years

Under 65 years

39.9%

13.2%

20.6%

How has Medicaid coverage among persons under 65 changed from 2005 to 2015?

Increase Stable

Increase

Increase

Under 18

Under 65

18–64

In 2015, approximately

21 OUT OF 100people under age 65 had Medicaid coverage.

= 55.4 MILLION PEOPLE under 65 with Medicaid

Children under age 18 were

3 TIMES MORE LIKELYthan adults aged 18–64 to have Medicaid coverage in 2015.

Under 18 39.9%

13.2%18–64

UNDER 18 YEARS

CHANGE IN MEDICAID COVERAGE BETWEEN 2005 AND 2015

18–64 YEARS

2005 200527.2% 7.2%

2015 201539.9% 13.2%

46.7% 83.3%

UNDER 65 YEARS

200512.9%

201520.6%

59.7%

MEDICARE MANAGED CARE

ABOUT THE DATA

Source: Centers for Medicare & Medicaid Services (CMS)

Methodology: Data are derived from the CMS Enrollment Database. Enrollment data include all persons enrolled in the Medicare program as of July 1.

Note: State data are based on the residence of the Medicare beneficiary.

What is MEDICARE MANAGED CARE?

MEDICARE MANAGED CARE is optional. Enrollment reflects managed care availability in each state as well as the enrollee’s choice to enroll.

Medicare managed care plans contract with a network of providers to administer care to, and coordinate care for, managed care enrollees. Plan types include health maintenance organizations (HMOs) and preferred provider organizations (PPOs).

In 2014, 3 out of every 10 Medicare enrollees were inmanaged care.

The % of Medicare enrollees in managed care was 2.3 timesgreater in 2014 than in 2004.

2004 13.0%

2014 29.9%

Medicare enrollees in managed care, by state: 2014

Percent0.9–16.016.1–24.724.8–32.933.0–51.8

Lowest % of Medicare enrollees in managed care

DE7.9%

VT7.3%

NH7.2%

WY3.9%

AK0.9%

Highest % of Medicare enrollees in managed care

MN51.8%

HI46.4%

OR43.2%

PA39.6%

CA39.3%

PRESCRIPTION (RX) DRUG SPENDING

ABOUT THE DATA

Source: Centers for Medicare & Medicaid Services (CMS)/National Health Expenditure Accounts (NHEA)

Notes: Medicaid includes the Children’s Health Insurance Program.Other includes the Department of Defense, Department of Veteran Affairs, and third party payers and programs (e.g., worksite health care, school health).

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PRESCRIPTION DRUG SPENDING has grown more rapidly in recent years.

Prescription drug spending: 2004–2014

2004 2014

Am

ount

, in

billi

ons

350

300

250

200

150

100

50

0

$297.7

$192.8

average annual growth from 2004–2014

4.4% 12.2%growth from 2013–2014

How have FUNDING SOURCES changed for Rxdrug spending between 2004 and 2014?

2004SOURCE 2014

Out-of-pocket 25.0% 15.0%

Private 49.3% 42.8%

Other 4.9% 3.5%

19.1% 9.7%Medicaid

1.7% 29.0%Medicare

All sources 100.0% 100.0%

For additional information on Health, United States, seehttp://www.cdc.gov/nchs/hus.htm.

For further information about NCHS and its programs, see http://www.cdc.gov/nchs.