2018 Health Care Cost and Utilization Report State Spending Trends
Average annual health care spending for individuals with employer-sponsored insurance increased to $5,892 in 2018 - 18.4% higher than in 2014. That spending reflects expenditures for medical services and prescription drugs (but excludes manufacturer rebates for drugs).
Some states, however, had much higher per-person spending – Alaska topped the list in 2018 at $7,974. Others had much lower spending – average per-person spending in Arkansas was $4,734.
This tool was designed as a companion to our annual Health Care Cost and Utilization Report to help you understand the health care spending in your state, and how it compares to the rest of the country.
Take some time to:
1. Explore state-by-state variation in average spending per person.
2. Compare growth in spending, utilization, and average prices from 2014 to 2018.
3. See what categories of services drove spending growth in each state.
4. Understand how inpatient, outpatient, professional services, and prescription drugs each contributed to differences in spending across the country.
2018 Health Care Spending per Person by State
SPENDING PER PERSON IN 2018
$4,700National average of per-person spending was $5,892 in 2018. This total includes $1,128 for inpatient admissions, $1,662 for outpatient visits and procedures, $1,985 for professional services, and $1,118 for prescription drugs.
Spending on prescription drugs reflects the amount paid on the pharmacy claim, which includes discounts from the wholesale or list price, but does not account for manufacturer rebates.
per person in 2018
States Ranked by Spending
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Growth in Spending per Person Varied by State
At the national level, spending growth between 2014 and 2018 was primarily driven by growth in average prices (15.0%), while the utilization of health care services increased slightly (3.1%). Spending increased in every state, but the growth varied from 9.7% in Maine to 28.4% in New York.
Average prices also increased in every state between 2014 and 2018, with the highest price growth in the District of Columbia (20.6%) and the lowest in Louisiana (9.5%). Utilization increased in 45 states over 5 years. The change in quantity of health care services used ranged from a 6.0% decline in Maine to a 9.5% increase in Kansas.
Use the chart below to see how the changes in your state’s health care spending, utilization, and average prices compared to the national average.
The chart also includes trends of state and national GDP per capita, to provide additional context for comparing state level changes in health care spending.
Cumulative Growth in Spending per Person by State since 2014
The measures of average prices presented here are adjusted for changes in the mix or intensity of services used for three of the four categories (the exception being prescription drugs, for which measures of intensity are not available).
Correspondingly, measures of utilization for those three categories were adjusted to capture both changes in the number of services used and changes in the mix and intensity of services provided.
Our measures of prescription drugs prices, however, include both spending on the same drugs, as well as spending on new, potentially innovative products, adopted over the report period.
Prescription drug spending is the amount paid on the pharmacy claim, which reflects discounts from the wholesale price, but not manufacturer rebates.
saw an increase of 50% in spending between 2014 and 2018.
U.S. Average
saw an increase of 50% in spending between 2014 and 2018.
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States’ Spending Growth Varied by Service Category
We split overall health care spending into four service categories: inpatient, outpatient, professional (clinician) services, and prescription drugs. These service categories had different levels of spending growth between 2014 and 2018. Nationally, prescription drug spending had the highest growth at 25.8%, while inpatient spending experienced the lowest growth at 11.4%. Prescription drug spending is estimated from point-of-sale payments, which reflect discounts from the wholesale price, but not manufacturer rebates.
The charts below show how much per-person spending grew for each of the four service categories between 2014 and 2018. The inpatient spending is shown at the top, outpatient on the right, prescription drugs on the bottom, and professional services to the left. The blue shape represents the spending growth in the state, and the black line shows the national average. Larger shapes correspond to higher spending growth. See how service category spending in your state and others grew since 2014.
Cumulative Spending Growth by Service Category in Each State since 2014
in inpatient costs
This was the national average.
State
State
State
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Service Category Spending per Person Varied by State
The state-level geographic variation in per-person spending varies by service category. States that have high spending on one category may have relatively low spending on another. West Virginia, for example, has some of the highest inpatient and outpatient spending, but low spending per person on professional services.
In contrast, New York has high inpatient, prescription drug and professional services spending, but low outpatient spending. See how your state’s spending compares on each of the four health care service categories and how that spending has changed over time.
2018 Spending per Person by Service Category
per person in 2018 on
Average Annual Spending per Person on Inpatient Services in
spent per person in on
The U.S. Average was per person.
