Spending Trends for Common Medical Conditions.

By May 23, 2017 Commentary

A new Statistical Brief based on the MEPS data from 2013 and analyzing spending by medical condition for adults has been issued by the Agency for Healthcare Research & Quality.   (Stat. Brief)   Nine conditions were reported by at least 10% of the US population as a reason for seeking medical care.  The five most prevalent were hypertension at 25% of the population or 61 million adults, high cholesterol levels at 19.6%, mental health issues at 16%, COPD/asthma at 14.6% and osteoarthritis and other joint disorders at 15.8%.  We Americans are a pretty sick group.  The other four were trauma, gastro-intestinal issues, diabetes and heart conditions.  Altogether, these conditions were responsible for about half of all health spending.  About $90 billion in total was spent on each of heart conditions and trauma, while at the other end, only $34.5 billion was spent on high cholesterol and $41.6 billion on GI conditions.

The highest average per patient expenses were for the treatment of heart conditions at $3794; trauma at $3070, and diabetes at $2565.  High cholesterol at $728 and high blood pressure at $776 had the lowest average expenses, probably because they are treated primarily by generic drugs.  Heart conditions had the highest proportion of total expense related to inpatient stays, followed by trauma.  Hypertension at 43%, hyperlipidemia at 61%, mental disorders at 45% and diabetes at 60%, had very high percents of total costs being for drugs.  Osteoarthritis at 40% had the largest proportion devoted to outpatient visits.  In terms of payment source, out-of-pocket was modest for all conditions, but was lowest, 5.4% for heart conditions, and highest, 15.9% for mental health.  Private insurance paid for 45% of GI condition costs, but only 23.5% of high blood pressure ones.  Medicare covered 47% of heart condition expenses, and only 27% of those for mental disorders.  Medicaid paid for a whopping 23% of mental health costs and a modest 8% of trauma ones.

Kevin Roche

Author Kevin Roche

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com.

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