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2023-32 年全国卫生支出预测:随着大流行相关政策的消退,支付方趋势出现分化。

National Health Expenditure Projections, 2023-32: Payer Trends Diverge As Pandemic-Related Policies Fade.

机构信息

Jacqueline A. Fiore (

Andrew J. Madison, CMS.

出版信息

Health Aff (Millwood). 2024 Jul;43(7):910-921. doi: 10.1377/hlthaff.2024.00469. Epub 2024 Jun 12.

DOI:10.1377/hlthaff.2024.00469
PMID:38865652
Abstract

Health care spending growth is expected to outpace that of the gross domestic product (GDP) during the coming decade, resulting in a health share of GDP that reaches 19.7 percent by 2032 (up from 17.3 percent in 2022). National health expenditures are projected to have grown 7.5 percent in 2023, when the COVID-19 public health emergency ended. This reflects broad increases in the use of health care, which is associated with an estimated 93.1 percent of the population being insured that year. In 2024, Medicaid enrollment is projected to decline significantly as states continue their eligibility redeterminations. Simultaneously, private health insurance enrollment is projected to increase because of the extension of enhanced subsidies for direct-purchase health insurance under the Inflation Reduction Act (IRA) of 2022, as well as a temporary special enrollment period for qualified people losing Medicaid coverage (after eligibility redeterminations). Over the course of 2024-26, the IRA expands Medicare's drug benefit generosity and implements drug price negotiations for beneficiaries; concurrently, the extended enhanced subsidies for direct-purchase health insurance expire in 2026. During 2027-32, personal health care price inflation and growth in the use of health care services and goods contribute to projected health spending that grows at a faster rate than the rest of the economy.

摘要

在未来十年,医疗保健支出的增长预计将超过国内生产总值(GDP)的增长,导致到 2032 年医疗保健占 GDP 的比例达到 19.7%(高于 2022 年的 17.3%)。预计 2023 年,当 COVID-19 公共卫生紧急情况结束时,国家卫生支出将增长 7.5%。这反映了医疗保健使用的广泛增加,当年约有 93.1%的人口参保与之相关。2024 年,由于各州继续进行资格重新认定,医疗补助参保人数预计将大幅下降。同时,由于 2022 年《降低通胀法案》(IRA)延长了直接购买医疗保险的额外补贴,以及有资格的人在失去医疗补助覆盖范围后的临时特殊参保期(在资格重新认定后),私人医疗保险参保人数预计将增加。在 2024-26 年期间,IRA 扩大了医疗保险的药物福利慷慨程度,并为受益人实施药物价格谈判;同时,2026 年延长的直接购买医疗保险额外补贴到期。在 2027-32 年期间,个人医疗保健价格通胀以及医疗保健服务和商品使用的增长导致预计的医疗支出增长速度快于经济的其他部分。

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