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Spending Growth

Dashboard Overview

Average annual expenditures growth rate select service types, 1970-2021
In the last decade, spending growth on hospitals has slowed
  • During the 1970s, growth in hospital expenditures outpaced other services, while prescriptions and physicians/clinics saw faster spending growth during the 1980s and 1990s. From 2020 to 2021, retail prescription drugs experienced the fastest growth in spending at 7.8%, following 3.3% annual average growth from 2010 to 2020. Hospitals and physicians/clinics average spending growth between 2020 and 2021 was 4.4% and 5.6%, respectively.

Source: KFF analysis of National Health Expenditure (NHE) data

Relative contributions to total national health expenditures, by service type, 2021
Hospital and physician services represent half of total health spending
  • Hospital spending represented close to a third (31.1%) of overall health spending in 2021, and physicians/clinics represented 20.3% of total spending. Prescription drugs accounted for 8.9% of total health spending in 2021.

Note: ‘Other Health’ includes spending on durable and non-durable products; residential and personal care; administration; net health insurance; and other state, private, and federal expenditures. Other professional services’ includes spending for services provided by chiropractors, optometrists, physical, occupational, and speech therapist, podiatrist, private-duty nurses, and others. Nursing care represents expenditures for nursing care facilities and continuing care retirement communities.

Source: KFF analysis of National Health Expenditure (NHE) data

Per capita out-of-pocket expenditures, 1970-2021
Per capita out-of-pocket expenditures increased in 2021
  • Out-of-pocket expenditures increased in 2021, averaging $1,315 per capita. (Out-of-pocket medical costs do not include the amount individuals contribute toward health insurance premiums.)

Note: A constant dollar is an inflation adjusted value used to compare dollar values from one period to another

Source: KFF analysis of National Health Expenditure (NHE) data

Total national health expenditures, by source of funds, 1970 and 2021
Health insurance is a growing share of total health expenditures and out-of-pocket spending is a smaller portion than in 1970
  • Private insurance expenditures now represent 28.5% of total health spending (up from 20.4% in 1970), and public insurance (which includes Medicare, Medicaid, CHIP, and the Veterans Administration and Department of Defense), represented 42.5% of overall health spending in 2021 (up from 22% in 1970). Although out-of-pocket costs per capita have also been rising, compared to previous decades, they now make up a smaller share of total health expenditures.

Notes: Public insurance in 1970 includes Department of Veterans Affairs, Departement of Defense, Medicare, and Medicaid. In 2021, public insurance includes the same categories listed for 1970, with the addition of CHIP. ‘Other’ includes spending on public health activities, invesment, and third party payers and programs llike worksite health care, the Indian Health Service, and other state and local programs

Source: KFF analysis of National Health Expenditure (NHE) data

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