Variation in State Health Care Expenditures

How have medical expenditures varied over time and across states? That is the question being asked by Johnson et al. (2022) in a recent Health Affairs paper. The authors use State Health Expenditure Accounts data between 1999-2014 and then extrapolate these trends forward with a regression-based approach to predict State spending through 2019. Using this approach, the authors find that:

In 2019 state-specific per person spending ranged from $7,250 to $14,500. After adjustment for inflation, annualized per person spending growth for each state ranged from 1.0 percent in Washington, D.C., to 4.2 percent in South Dakota between 2013 and 2019. The factors that explained the most variation across states were incomes (25.3 percent) and consumer prices (21.7 percent). Medicaid expansion was associated with increases in total spending per person, although the median of spending in expansion states showed slower growth in out-of pocket spending than the median in nonexpansion states.

The top 5 States with the highest per capita health care spending were Alaska, District of Columbia, New York, South Dakota and West Virginia. The 5 States with the lowest per capita health care spending were Utah, Arizona, Nevada, Georgia and Idaho. Interestingly, Alaska had the highest share of spending coming from out-of-pocket expenditures (40%).

Read the full paper for more interesting statistics.