Spending growth

Read it this way The solid segment shows the share already rose 1.1 percentage points from 2013 to 2024, and the dashed segment shows CMS expects another 2.6-point climb by 2034. Everything past 2024 is a projection revised annually, so read the dashed slope as a direction, not a locked-in number. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat The 2025 through 2034 points are CMS projections, not actuals, and are revised every year. NHE shares are also restated as BEA revises GDP.

CMS NHE Projections Table 1, National Health Expenditures and Selected Economic Indicators · 2013-2034 · source

Read it this way By 2024, health spending had compounded to 184.6 on a base of 100, well ahead of GDP's 173.3 and wages' 155.6, so the gap between the top and bottom lines is the share of the economy health care absorbs that wages have not kept pace with. The chart shows relative growth from a shared starting point only, not dollar amounts or any single year's actual spending level. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Index levels are derived at authoring time by chaining the CMS Table 1 annual growth rates. Wage growth uses the SSA National Average Wage Index, a different concept and data source included for a directional comparison.

CMS NHE Projections Table 1, National Health Expenditures and Selected Economic Indicators · 2013-2034 · source

Read it this way Look for years where the health spending bar clears both the GDP and wages bars, such as 2015, 2016, and 2024, since those are the years the spending gap widened. 2020 and 2021 are pandemic-distorted outliers where GDP swung more than health spending did, so a single year of health spending trailing GDP does not mean the multi-year trend has reversed. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Wage growth uses the SSA National Average Wage Index, a different concept and data source from NHE or GDP, included for a directional comparison rather than as a component of the accounts.

CMS NHE Projections Table 1, National Health Expenditures and Selected Economic Indicators · 2013-2034 · source

Read it this way The height of each band is that payer's dollar spending, so the widening total area from 2018 through 2034 shows spending growing across every payer at once, not just one. This view is about dollar scale, not growth rate, and 2025 onward is a CMS projection, not measured spending. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Other combines CHIP, DoD, VA, worksite care, workers compensation, public health activity, and investment. 2025 through 2034 are projections.

CMS NHE Projections Table 3, National Health Expenditures by Source of Funds · 2018-2034 · source

Read it this way Medicare's projected 110.6 percent growth roughly doubles the 49 to 63 percent projected for every other payer, which is what an aging population does to a program tied to age eligibility. These are ten-year projections computed from CMS's first and last modeled years, not a measured trend, so read the ranking as directional. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Computed from the first (2024) and last (2034) rows of the CMS projection. Projected years are modeled estimates, revised annually.

CMS NHE Projections Table 3, National Health Expenditures by Source of Funds · 2018-2034 · source

Read it this way Darker states, led by New York at $15,008, spend well above the $12,023 national average per Medicare beneficiary. Find your state's shade to see roughly where it lands. This map reflects Medicare fee-for-service Parts A and B only, so it says nothing about what commercially insured patients pay in the same states. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat This is Medicare fee-for-service Parts A and B per beneficiary in 2022, a subset of the population, not all-payer spending.

CMS Medicare Geographic Variation Public Use File, by National, State and County · 2022 · source

Read it this way The dots sitting farthest right of the average line, led by New York at $15,008, spend the most per beneficiary. The 1.66-times gap between New York and Montana ($9,027) is the distance between the two ends of the strip. Rank order here does not explain why a state spends more, only that it does. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Medicare fee-for-service Parts A and B per beneficiary, 2022, a subset of all payers. Includes DC, so 51 rows.

CMS Medicare Geographic Variation Public Use File, by National, State and County · 2022 · source

Read it this way States sitting well above the diagonal, like New York and California, spend more mainly because local prices are higher: removing price differences on the horizontal axis pulls their point down closer to the pack. States that sit close to the diagonal are spending roughly what their price-standardized quantity of care would predict, meaning volume and mix, not price, explain their level. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Both measures are Medicare fee-for-service Parts A and B per beneficiary, 2022. Price-standardized spending removes geographic price differences to approximate the quantity of care.

CMS Medicare Geographic Variation Public Use File, by National, State and County · 2022 · source

Read it this way States further right, like DC and New York with the most inpatient days per 1,000 beneficiaries, also tend to sit higher on price-standardized spending, and the dashed trend line traces that upward relationship. The caveat on this chart is explicit that the line is directional, not a causal estimate of how much utilization drives spending. Use this chart to determine whether the spending pressure is price, utilization, geography, or payer mix, and to connect that diagnosis to the right cost-control lever.

Caveat Inpatient days per 1,000 beneficiaries and price-standardized spending are both from the CMS Geographic Variation file, 2022. The trend line is directional, not a causal estimate.

CMS Medicare Geographic Variation Public Use File, by National, State and County · 2022 · source