the National Health Expenditure Accounts Team5

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the National Health Expenditure Accounts Team5 National Health Spending: Faster Growth In 2015 As Coverage Expands And Utilization Increases Anne B. Martin1,*, Micah Hartman2, Benjamin Washington3, Aaron Catlin4, the National Health Expenditure Accounts Team5 http://content.healthaffairs.org/content/early/2016/11/22/hlthaff.2016.1330.full

Growth in national health expenditures (NHE) and gross domestic product (GDP), and NHE as a share of GDP, 1989–2015. Growth in national health expenditures (NHE) and gross domestic product (GDP), and NHE as a share of GDP, 1989–2015 Anne B. Martin et al. Health Aff doi:10.1377/hlthaff.2016.1330 ©2017 by Project HOPE - The People-to-People Health Foundation, Inc.

Total nominal US health care spending increased 5 Total nominal US health care spending increased 5.8 percent and reached $3.2 trillion in 2015. On a per person basis, spending on health care increased 5.0 percent, reaching $9,990. The share of gross domestic product devoted to health care spending was 17.8 percent in 2015, up from 17.4 percent in 2014. Coverage expansions that began in 2014 as a result of the Affordable Care Act continued to affect health spending growth in 2015. In that year, the faster growth in total health care spending was primarily due to accelerated growth in spending for private health insurance (growth of 7.2 percent), hospital care (5.6 percent), and physician and clinical services (6.3 percent). Continued strong growth in Medicaid (9.7 percent) and retail prescription drug spending (9.0 percent), albeit at a slower rate than in 2014, contributed to overall health care spending growth in 2015.

Source of funds 2009a 2010 2011 2012 2013 2014 2015 Private health insurance Expenditure (billions) $832.60 $863.10 $895.10 $925.10 $944.90 $1,000.00 $1,072.10 Expenditure growth 3.70% 3.40% 2.10% 5.80% 7.20% Per enrollee expenditure $4,389 $4,647 $4,839 $4,925 $5,036 $5,200 $5,433 Per enrollee expenditure growth 7.10% 5.90% 4.10% 1.80% 2.20% 3.30% 4.50% Enrollment (millions) 189.7 185.7 185 187.8 187.6 192.3 197.3 Enrollment growth −3.2% −2.1% −0.4% 1.50% −0.1% 2.50% 2.60%

Medicare 2009a 2010 2011 2012 2013 2014 2015 Expenditure (billions) $498.90 $519.30 $546.30 $569.50 $590.40 $618.50 $646.20 Expenditure growth 6.80% 4.10% 5.20% 4.30% 3.70% 4.80% 4.50% Per enrollee expenditure $10,971 $11,146 $11,442 $11,462 $11,514 $11,702 $11,904 Per enrollee expenditure growth 1.60% 2.70% 0.20% 0.40% 1.70% Enrollment (millions) 45.5 46.6 47.7 49.7 51.3 52.8 54.3

Medicaid 2009a 2010 2011 2012 2013 2014 2015 Expenditure (billions) $374.40 $397.20 $406.70 $422.70 $445.40 $497.20 $545.10 Expenditure growth 8.80% 6.10% 2.40% 3.90% 5.40% 11.60% 9.70% Per enrollee expenditure $7,354 $7,361 $7,233 $7,271 $7,553 $7,585 $7,869 Per enrollee expenditure growth 0.90% 0.10% −1.7% 0.50% 0.40% 3.80% Enrollment (millions)b 50.9 54.0 56.2 58.1 59.0 65.5 69.3 Enrollment growth 7.80% 6.00% 4.20% 3.40% 1.40% 11.10% 5.70%

Uninsured and population 2010 2011 2012 2013 2014 2015 Uninsured (millions) 45.9 48.1 45.6 44.8 44.2 35.6 29.2 Uninsured growth 8.90% 4.70% −5.1% −1.9% −1.3% −19.5% −17.9% Population (millions)c 306.4 309.0 311.2 313.5 315.9 318.4 320.9 Population growth 0.90% 0.80% 0.70% Insured share of total population 85.00% 84.40% 85.30% 85.70% 86.00% 88.80% 90.90%

Factors accounting for growth in per capita national health expenditures (NHE), selected calendar years 2004–15. Factors accounting for growth in per capita national health expenditures (NHE), selected calendar years 2004–15 Anne B. Martin et al. Health Aff doi:10.1377/hlthaff.2016.1330 ©2017 by Project HOPE - The People-to-People Health Foundation, Inc.

Per Capita Spending Increase Per capita national health spending grew 5.0 percent in 2015 (Exhibit 1). Changes in the age and sex mix of the population accounted for 0.6 percent of the per capita spending growth in 2015 (Exhibit 5). Increases in medical prices and residual use and intensity of health care goods and services accounted for 1.2 percent and 3.2 percent, respectively, of the growth in 2015.