U.S. health care spending per capita has risen at historically low rates recently, but is expected to pick up
Health spending in the U.S. had grown at historically low levels starting in 2008, likely due to a combination of the economic downturn and slow recovery and higher patient cost-sharing, as well as structural changes to the health system. Starting in 2014, health spending grew faster (4.4% per capita), particularly due to more people having health coverage from the ACA. Projections suggest that health-spending growth will continue at a moderate (averaging 5.5% per year on a per capita basis) but is unlikely to reach the double-digit growth of previous decades.
Growth in prescription spending has slowed again in 2017, after increasing rapidly in 2014 and 2015
In 2017, per capita prescription drug spending decreased (down 0.3%) for the first time since 2012. In 2015, pharmaceutical spending grew 8.1% on a per capita basis and in 2014 these costs had grown 11.5%, particularly because new specialty drugs came on the market. Looking ahead, CMS projections suggests growth in per capita drug spending will be moderate through 2027.
Per capita out-of-pocket spending has grown relatively slowly in recent years but may pick up again
The insurance coverage gains since 2014 have given more people access to health care, which is likely increasing overall spending, but having a moderating effect on out-of-pocket costs.
Out-of-pocket spending for Rx drugs remained flat in 2017, while out-of-pocket spending on physician and hospital services grew
In 2017, per capita out-of-pocket spending on prescription drugs was down slightly from the previous year ($144 per person in 2017 and $145 in 2016). However out-of-pocket spending on physician services increased (from $182 per person in 2016 to $185 in 2015), as did hospital out-of-pocket spending (from $99 per person in 2016 to $104 in 2017). While prescription drug spending is expected to remain stable in 2018, the amount that patients spend on pharmaceuticals will grow at an increasing rate from 2019 to 2027.
An annual percentage point difference in growth rates makes a very large difference in spending over time
What may seem to be small differences in growth rates are very meaningful over time. Per capita expenditures are projected to grow from $10,724 in 2017 to $16,907 in 2027, which is an average annual growth rate of 5.8 percent. If growth rates were 1 percentage point lower each year over that same period, per capita spending would be $1,548 lower than expected. If growth rates were 1 percentage point higher each year, spending would rise to $18,594 per person in 2027, which would increase total health spending by over $546 billion in 2027 alone and by nearly $2.6 trillion in the 10-year period.
Health spending projections are now lower than previous projections
Health spending projections are now lower than previous projections.