A recent report released by the Centers for Medicare & Medicaid Services gave insight into the variation of healthcare spending by state. Overall, it found throughout the past decade, New England and the Mideast regions exhibited the highest per capita personal healthcare spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending.
Here are eight additional healthcare spending trends identified in the report.
1. New England and the Mideast regions have the highest levels of spending. According to the report, the 10 states that had the highest levels of total personal healthcare spending per capita, as of 2009, were mainly in the Northeast. States included Massachusetts, Connecticut, Maine, New York, Rhode Island, New Hampshire, and Pennsylvania. However, states such as North Dakota, Alaska, and Delaware were also included. "The per capita spending for these 10 states ranged from 13 to 36 percent higher than the average U.S. per capita spending level," the report read. Additionally, eight of the top 10 states, including Massachusetts, Connecticut, and New York, are ranked in the top third of the nation for annual personal income per capita.
2. The Rocky Mountains and Southwest Regions have the lowest levels of spending. In 2009, the 10 states with the lowest levels of total personal healthcare spending per capita included Utah, Arizona, Idaho, Nevada, Texas, Arkansas, and Alabama. "Personal healthcare spending per capita for these states ranged from 8 to 26 percent below the national average," the report read. Spending ranged from $6,272 for Alabama and $5,031 for Utah. "The lower income per capita was coupled with higher rates of uninsured residents in those bottom 10 spending states," said the report. "Six of the bottom 10 states in spending per capita were in the bottom third in the nation in personal income per capita, including Utah, which had the second lowest annual personal income per capita."
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3. The national average of Medicare spending was heavily influenced by a small group of states. And these states had a higher-than-average spending per enrollee, the report noted. Just 14 states had per-enrollee Medicare spending levels greater than the national average in 2009. These states also had a higher concentration of elderly residents, with the combined enrollment for these states accounting for more than half of all Medicare enrollees in the nation. "These states were generally located in the eastern Unites States in high population density areas," read the report. "The states with the highest Medicare spending per enrollee were New Jersey and Florida, with each state's spending levels at nearly $12,000 per enrollee in 2009, or 15 percent above the national average."
4. The distribution of per-enrollee Medicaid personal healthcare spending contrasts with that of per-enrollee Medicare spending. According to the report, 30 states showed per-enrollee Medicaid spending that exceeded the national average. "However, these states represented just 41 percent of total Medicaid enrollment, suggesting that spending per enrollee and enrollment are not always positively correlated," the report read. "In fact, the factors contributing to variation in per enrollee Medicaid spending, as well as to the characteristics of the states with the highest and lowest per enrollee Medicaid spending, reflect a complex mix of policy, economic, and demographic factors."
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5. Spending growth in hospital care grew fastest in New England and slowest in the Southeast. According to the report, from 1998 to 2009, spending per capita on hospital care grew fastest in New England and slowest in the Southeast. "In New England, hospital spending per capita grew roughly one-percentage point faster than the U.S. average for both the 1998-2004 and 2004-2009 periods," the report read. In particular, New Hampshire, Vermont, and Maine grew more than two percentage points faster than the national average in hospital spending per capita between 2004 and 2009. "The Southeast grew the slowest of any region, mainly due to the low 4.3-percent growth from 2004 to 2009 that was heavily influenced by the impacts of the recent recession."
6. Spending growth in physician and clinical services varied significantly. According to the report, New England, between 1998 and 2004, grew 6.3 percent and experienced the fastest growth of any region from 2004 to 2009. "Given that spending on physician and clinical services in Massachusetts comprised roughly half of spending for the region for these services, this trend in New England from 2004-2009 was likely influenced by Massachusetts health reform legislation," the report read. Conversely, the Southeast, which had the fastest spending growth for physician and clinical services per capita from 1998 to 2004 at 7 percent, grew the slowest at 3.2 percent from 2004-2009.
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7. Spending growth on prescription drugs slowed significantly. At the national level, growth in spending per capita on prescription drugs slowed significantly between the 1998 to 2004 and 2004 to 2009 periods, averaging 12.5 percent and 4.6 percent, respectively. "Though spending growth for prescription drugs slowed for all regions related to increased use of generic drugs and the recent recession, the slowdown was much steeper for some regions in the eastern U.S. and less steep for regions in the western U.S." According to the report, this shift in annual growth trends was influenced by the implementation of the Medicare Part D program.
8. For the most part, spending trends have remained the same. The report examined regions and states from 1998 to 2009 to gauge the persistency of certain trends over the past decade, and during this time, it found the New England and Mideast regions consistently had the highest levels of spending per capita, whereas the Southwest and Rocky Mountain regions consistently had the lowest levels. "In fact, eight out of the 10 highest spending states in 2009 (all from New England and the Mideast) were among the highest for every year between 1998 and 2008," the report read. Similarly, the majority of the 10 lowest spending states in 2009 were in the Southwest and Rocky Mountain regions, with Idaho, Arizona, Utah, and Nevada among the lowest every year between 1998 and 2009.
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