Transcript Trends in Growth: 1996-2006

Vermont
Legislative Joint Fiscal Office
Growth in Health Care Spending:
A comparison of Vermont and the U.S.
January 18, 2008
Nolan Langweil, Legislative Joint Fiscal Office
Vermont
Legislative Joint Fiscal Office
Data
• CMS, Office of the Actuary (2006 data)
• BISHCA, Expenditure Analysis (2006 data)
– Note: FY2005 and earlier uses unadjusted numbers
Vermont
Legislative Joint Fiscal Office
Per Capita Spending
2006
UNITED STATES
VERMONT
$7,092 Per Capita
$6,321 Per Capita
Vermont
Legislative Joint Fiscal Office
Trends in Growth:
1996-2006
UNITED STATES
• ↑ from $910B to $1.76T
• 6.8% average annual
growth
VERMONT
• ↑ from $1.7B to $3.9B
• 8.6% average annual
growth
Vermont
Legislative Joint Fiscal Office
Trends in Growth:
1996-2006
Overall health care expenditure trends for Vermont and
the U.S. are fairly comparable.
Vermont
Legislative Joint Fiscal Office
Trends in Growth:
1996-2006
1)
2)
3)
Hospital care
Physicians & Clinical svcs
Drugs & Supplies
1)
2)
3)
Hospital care
Physicians & Clinical svcs
Drugs & Supplies
Vermont
Legislative Joint Fiscal Office
Trends in Growth:
1996-2006
Growth when comparing third-party payer by sector
(EXCLUDES DRUGS)
Vermont
Legislative Joint Fiscal Office
Trends in Growth:
1996-2006
Growth when comparing third-party payer by sector
(INCLUDES DRUGS)
Vermont
Legislative Joint Fiscal Office
PAYER$
(By % of total expenditures)
U.S
PAYER
VERMONT
21.6%
Medicare
18.1%
16.2%
Medicaid
23.7%
14.6%
Out-of-pocket
12.5%
36.0%
Private
Insurance (total)
41.4
Other payers include: State & Local, Other Federal, etc.
Vermont
Legislative Joint Fiscal Office
MEDICARE
Trends in Growth: 1996-2006
• Largest single payer of health care services in
the U.S.
– 21% of personal health care spending
– Medicaid was second largest (16%)
• 2nd largest payer in Vermont
– 18% of health spending
– Medicaid was largest (24%)
Vermont
Legislative Joint Fiscal Office
MEDICARE
Trends in Growth: 1996-2006
2006
• Both US and VT: Largest increase in $ spent
were in 1) Hospital care, 2) physician &
clinical svs and 3) Drugs (in that order)
Combined they represent:
– US = 84% of total Medicare Spending
– VT = 77% of total Medicare Spending
– Hospital Care accounted for half of Medicare
spending in both VT and the U.S.
Vermont
Legislative Joint Fiscal Office
MEDICARE
Drugs as % of overall Medicare spending:
U.S.
VT
2005
2006
1.2%
10.3%
($4B)
($39.4B)
<1%
11%
($4,000)
(78.8M)
Vermont
Legislative Joint Fiscal Office
MEDICARE
Medicare Part D
Overall Spending on DRUGS by Payer (Vermont):
Before Part D
After Part D
Vermont
Legislative Joint Fiscal Office
MEDICARE
Medicare Part D
Medicaid & Out-of-pocket drug spending saw decreases
2005
2006
MEDICAID
VT = $146M
US = $37B
VT* = $78M
US = $19B
OUT-OFPOCKET
VT = $191M
US = $48.7B
VT = $168M
US = $47.6B
*NOTE: This does not include clawback.
Vermont
Legislative Joint Fiscal Office
MEDICAID
2006
United States
• Medicaid spending decreased by 0.9%
• First drop in Medicaid spending since program
was created in 1965
• Exclude Drugs, and Medicaid PHC spending ↑
5.6%
– Still slower than 8% in 2005
• 10 yr avg growth (1996-2006) = 7.1%
Vermont
Legislative Joint Fiscal Office
MEDICAID
2006
Vermont
• 10 yr avg growth (1996-2006) = 9.6%
• Medicaid spending increased by 2%
– Down from 7% growth in 2005
• Drug spending decreased 44% from 2005
– Again exclude Drugs, and Medicaid spending
↑ 11%
Vermont
Legislative Joint Fiscal Office
MEDICAID
2006
Vermont (continued)
• In 2005, Drug spending was 16.9% of
Medicaid costs ($146M)
• In 2006, Drug spending was 8.4% of
Medicaid costs ($78.7M)
• Does not include add’l $15.8M “state &
local” spending on drugs
Vermont
Legislative Joint Fiscal Office
PRIVATE HEALTH INSURANCE
2006
• U.S. - spending ↑ $598.6B to 634.5B
– 6% increase (2005 to 2006)
– 7.7% - 10 yr avg annual growth (1996-2006)
– 36% of personal health care spending
• VT - spending ↑ $1.4 to 1.6B
– 16% increase (2005 to 2006)
– 9.1% average annual growth
– 41% of health care spending
Vermont
From:
Legislative Joint Fiscal Office
Insurance Premiums (2006)
Vermont
Legislative Joint Fiscal Office
QUESTIONS?