Concentration of Healthcare Expenditures in the U.S., 2019

Authors: Meng Chen, Research Associate, HCCI, and Aaron Yao, Research Director, HCCI

Introduction

Medical Expenditure Panel Survey (MEPS) data show that about 14% of the U.S. civilian, noninstitutionalized population had no personal healthcare expenditures in 2019. At the same time, only 5% of the population accounted for nearly half of healthcare spending (48.8%, Figure 1). This spending includes all sources of payments for medical care, including private insurance payments, Medicare, Medicaid, out-of-pocket expenses, and other sources.

Concentration of healthcare expenditures

In 2019, the top 1% of persons ranked by their healthcare expenditures accounted for 20.8% of total healthcare expenditures (Figure 1), with an annual mean expenditure of $129,911 (Figure 2). The group within the top 1% is defined as persons who spent $78,080 or more during the year (Table 2). The top 5% of the population accounted for 48.8% of total expenditures (Figure 1), with an annual mean expenditure of $60,989. The bottom 50 accounted for only 3% of total healthcare expenditures. Every person in this group spent less than $1,313 during the year (Table 2), with an average annual expenditure of $374 (Figure 2).

Figure 1. Concentration curve of healthcare expenditures,
U.S. civilian, noninstitutionalized population, 2019

Figure 1

Table 1. Data for concentration curve of healthcare expenditures,
U.S. civilian, noninstitutionalized population, 2019

Table 2. Percentile of population ranked by spending and amount spent during 2019

Figure 2. Mean total expenditures per person by percentile of spending, 2019

Figure 2

Health expenditures in older adults

Older adults made up 16.3% of all the U.S. civilian, noninstitutionalized population, but their expenditures accounted for 33.4% of total healthcare spending (Figure 3).

In 2019, the top 1% of older persons ranked by their healthcare expenditures accounted for 12% of total healthcare expenditures (Figure 3), with an annual mean expenditure of $157,215. The group within the top 1% is defined as persons who spent $105,463 or more during the year (Table 4). The top 5% of the population accounted for 33.5% of total expenditures (Figure 3), with an annual mean expenditure of $85,940. The bottom 50% accounted for only 8.6% of total healthcare expenditures (Figure 3). Every person in this group spent less than $5,602 during the year (Table 4), with an average annual expenditure of $2,216.

Figure 3. Concentration curve of healthcare expenditures, older U.S. population, 2019

Figure 3

Table 3. Data for concentration curve of healthcare expenditures, older U.S. population, 2019

Table 4. Percentile of older population ranked by spending and amount spent during 2019

Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey, Household Component, 2019