US Health Care Spending by Payer and Health Condition, 1996-2016

JAMA Network March 3, 2020
Joseph L. Dieleman, PhD; Jackie Cao, MS; Abby Chapin, BA; Carina Chen, MA; Zhiyin Li, MS; Angela Liu, MPH; Cody Horst, MPH; Alexander Kaldjian, MS; Taylor Matyasz, MS; Kirstin Woody Scott, MPhil, PhD; Anthony L. Bui, MD, MPH; Madeline Campbell, BS; Herbert C. Duber, MD, MPH,; Abe C. Dunn, PhD; Abraham D. Flaxman, PhD; Christina Fitzmaurice, MD,; Mohsen Naghavi, MD, MPH, PhD; Nafis Sadat, MA; Peter Shieh, MS; Ellen Squires, MPH; Kai Yeung, PharmD, PhD0; Christopher J. L. Murray, MD, DPhil

Key Points

Question How does spending on different health conditions vary by payer (public insurance, private insurance, or out-of-pocket payments) and how has this spending changed over time?

Findings From 1996 to 2016, total health care spending increased from an estimated $1.4 trillion to an estimated $3.1 trillion. In 2016, private insurance accounted for 48.0% (95% CI, 48.0%-48.0%) of health care spending, public insurance for 42.6% (95% CI, 42.5%-42.6%) of health care spending, and out-of-pocket payments for 9.4% (95% CI, 9.4%-9.4%) of health care spending. After adjusting for population size and aging, the annualized spending growth rate was 2.6% (95% CI, 2.6%-2.6%) for private insurance, 2.9% (95% CI, 2.9%-2.9%) for public insurance, and 1.1% (95% CI, 1.0%-1.1%) for out-of-pocket payments.

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