Concentration of Healthcare Expenditures and Selected Characteristics of High Spenders, U.S. Civilian Noninstitutionalized Population, 2018

In 2018, spending on healthcare accounted for 17.7 percent of the United States gross domestic product, yet the majority of this spending was concentrated in a small percentage of the population. Medical Expenditure Panel Survey (MEPS) data show that about 13 percent of the U.S. civilian noninstitutionalized population had no personal healthcare expenditures in 2018. On the other hand, only 5 percent of the population accounted for nearly half of healthcare spending. This spending includes all sources of payments for medical care, including private insurance payments, Medicare, Medicaid, out-of-pocket spending, and other sources. In this Statistical Brief, data from the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey Household Component (MEPS-HC) are used to describe the overall concentration of healthcare expenditures across the U.S. civilian noninstitutionalized population in 2018. In addition, the most commonly treated conditions among top spenders are identified, and the shares of spending by age group, race/ethnicity, type of medical service, and source of payment are compared across the distribution. All differences discussed in the text are statistically significant at the 0.05 level.