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Economy puts damper on healthcare spending growth

By Mary Mosquera

U.S. healthcare spending was up 3.9 percent in 2010, just slightly more than the 3.8 percent growth seen in 2009, according to numbers released in January by the Centers for Medicare & Medicaid Services.

The rate of growth in healthcare spending in 2009 and 2010 marked the two slowest rates in the 51 years that the Centers for Medicare & Medicaid Services has been tracking it. Total 2010 health spending rose to $2.6 trillion, or $8,402 per person, the agency said.

Persistently high unemployment, a substantial loss of private health insurance coverage, lower median household income and increased cost-sharing resulted in individuals declining care or seeking less expensive treatment options, CMS analysts said in a telephone briefing with reporters.

This translated into lower use of hospitals, physician and clinical services and retail prescription drugs in 2010. That also meant reduced growth in private health insurance and out-of-pocket, Medicare and Medicaid spending than in 2009, according to the federal government’s annual snapshot of health spending trends based on the most current data.

“Even though the recession officially ended in 2009, its impact on the health sector appears to have continued in 2010, and individuals remain cautious about their spending,” said Anne Martin, an economist in CMS’ Office of the Actuary and lead author of the study.

The deceleration was offset by faster growth in net costs of private health insurance and investment in structures and equipment, she added.

Although some provisions of the Patient Protection and Affordable Care Act were established in 2010, their overall effect on spending was minimal. The most prominent provisions of the health reform law – expansion of Medicaid and the creation of health insurance exchanges – will not be operational until 2014.

Lower growth in benefits came with reduced use. For the first time in seven years, growth in total premiums exceeded growth in total benefits, and as a result, the private health insurance net cost ratio increased to 12.1 percent in 2010 from 11.4 percent in 2009.

“Since 2007, the recession and legislation led to a noticeable change in the share of healthcare spending that were financed by businesses, households and government,” Martin said.

The federal government financed 29 percent of total health spending in 2010, a substantial increase from the 23 percent in 2007. Meanwhile, the shares of the total healthcare bill financed by state and local government at 16 percent, private businesses at 21 percent, and households at 28 percent, declined slightly during the same time period.

Health spending typically increases with the economy following a downturn, said Steve Heffler, director of the national health statistics group in the Office of the Actuary. This was a very deep and significant recession, more so than in the past, and that is one of the reasons for the historically low growth rates.

“They have rebounded in the past, but that doesn’t mean that this cycle and the future will be like it has been in the past,” he said.