The National Health Expenditure Accounts (NHEA)

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The National Health Expenditure Accounts (NHEA) estimates health care spending over time, including everything from health care goods and services to public health activities, government administration to health care investment. For this assignment, we will focus on health spending by major sources of funds. Please see below for a summary:

Medicare: Medicare spending, which represented 20 percent of national health spending in 2012, grew 4.8 percent to $572.5 billion, a slight slowdown from growth of 5.0 percent in 2011. A one-time payment reduction to skilled nursing facilities in 2012, after a large increase in payments in 2011 due to implementation of a new payment system contributed to the slower growth.

Medicaid: Total Medicaid spending grew 3.3 percent in 2012 to $421.2 billion, an acceleration from 2.4-percent growth in 2011. The relatively low annual rates of growth in Medicaid spending in 2011 and 2012 can be explained in part by slower enrollment growth tied to improved economic conditions and efforts by states to control health care costs. Federal Medicaid expenditures decreased 4.2 percent in 2012, while state and local Medicaid expenditures grew 15.0 percent—a result of the expiration of enhanced federal aid to states in the middle of 2011.

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Private Health Insurance: Overall, premiums reached $917.0 billion in 2012, and increased 3.2 percent, near the 3.4 percent growth in 2011. The net cost ratio for private health insurance —the difference between premiums and benefits as a share of premiums —was 12.0 percent in 2012 compared with 12.4 percent in 2011. Private health insurance enrollment increased 0.4 percent to 188.0 million in 2012, but still 9.4 million lower than in 2007.

Out-of-Pocket: Out-of-pocket spending grew 3.8 percent in 2012 to $328.2 billion, an acceleration from growth of 3.5 percent in 2011, reflecting higher cost-sharing and increased enrollment in consumer-directed health plans.

Source: Centers for Medicare & Medicaid Services. (2014). ational Health Expenditure Data Highlights. Retrieved from https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf

Download the National Health Expenditures [NHE] by type of service and source of funds, NHE2012.zip file. Summarize in a table the total NHE (in millions) for the following years: 1960, 1970, 1980, 1990, 2000, 2010. Present the data visually by creating a line graph or a bar diagram depicting changes in values.

Comment on the changes in the categories of expenditure sources, i.e., out-of-pocket, health insurance, third party payers, etc. with respect to both year-to-year changes and across the entire period.

Include specific interpretations of why such changes are apparent [social, political, economic, etc. factors] and what strategies may be necessary to curb healthcare expenditure in the coming years.;

Support your responses with examples.

Cite any sources in APA format.

No Plagiarism!

NHE2012

NATIONAL HEALTH EXPENDITURES BY TYPE OF SERVICE AND SOURCE OF FUNDS: CALENDAR YEARS 1960 to 2012
LEVELS in $Millions 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Total National Health Expenditures 27359 29229 31907 34727 38544 41957 46254 51780 58755 66215 74853 83240 93141 103365 117157 133585 153011 173979 195528 221658 255784 296739 334699 368986 406512 444608 476891 519116 581697 647465 724277 791524 857909 921491 972686 1027431 1081848 1142623 1208934 1286463 1377167 1493352 1637958 1778017 1905746 2035377 2166731 2302925 2411693 2504235 2599000 2692781 2793394
Out of pocket 13051 13422 14299 15361 16981 18262 18647 18587 20628 22657 25015 26380 28724 31716 34467 37372 40767 44996 48169 52473 58396 65629 72739 78924 86824 95977 104034 110161 120828 127313 138643 141689 144215 145301 143458 146356 152194 163789 179387 190427 201725 208997 221878 238223 251679 267254 277346 293647 300708 300669 305551 316128 328156
Health Insurance 7464 8187 8935 9827 10900 11951 15600 21039 24302 27490 31688 36644 42519 47918 55848 66213 78938 92960 106407 122553 142155 167534 190437 212507 237236 259152 274647 300069 338359 387493 439458 492819 543976 594268 638025 682911 724242 761223 795329 848239 920393 1015193 1122318 1222758 1322367 1416685 1520783 1611780 1703189 1798526 1873866 1943432 2014409
Private Health Insurance 5779 6419 7113 7887 8982 10000 10223 10382 11754 13287 15424 17757 20593 22884 25972 30461 37295 45538 52347 60768 69047 81608 94012 104893 118884 131190 136025 149210 175906 204997 234230 255603 275578 296285 309497 326771 345802 362458 387934 419622 459233 502520 561424 615741 659957 703218 740217 777652 807811 833074 859624 888765 916959
Medicare 0 0 0 0 0 0 1842 4924 6218 7045 7672 8443 9325 10730 13428 16336 19694 22891 26668 30922 37387 44769 52351 59559 66207 71829 76829 83081 88965 101137 110182 120617 135996 149965 167670 184393 198750 210376 209420 213173 224829 247686 265381 282697 311162 339801 403728 432833 467867 499903 520158 546246 572484
Medicaid (Title XIX) 0 0 0 0 0 0 1304 3141 3541 4174 5290 6695 8314 9423 11073 13446 15188 17464 19465 22332 26032 30307 32011 35266 38233 40937 45383 50339 55080 61952 73661 93211 108186 122373 134414 144862 152170 160849 169029 183534 200483 224236 248218 269105 290917 309538 306865 326157 344916 375395 398116 407728 421199
Federal 0 0 0 0 0 0 632 1525 1835 2298 2842 3810 4547 4933 6277 7409 9153 9896 10919 12705 14521 16902 17843 19587 21096 22594 25187 27868 30995 35077 42607 56847 68602 76961 81052 85945 91099 94954 98661 107200 116919 132288 145339 160895 172437 177644 174074 185751 203526 248109 267455 248309 237854
State and Local 0 0 0 0 0 0 672 1616 1707 1877 2447 2886 3766 4490 4797 6037 6036 7568 8547 9627 11511 13405 14168 15679 17137 18343 20196 22471 24085 26876 31054 36364 39585 45412 53363 58917 61071 65896 70368 76334 83564 91948 102878 108210 118480 131895 132792 140406 141390 127286 130662 159419 183345
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 1723 3012 4167 5485 6296 7167 7566 8366 9117 10210 11106 11552 11988 12624
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 1199 2097 2913 3832 4410 4982 5254 5756 6317 7126 7812 8061 8376 8793
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 524 915 1253 1653 1887 2185 2313 2610 2801 3084 3293 3492 3613 3832
Department of Defense 788 836 860 925 861 831 1078 1324 1445 1499 1582 1766 1997 2235 2475 2590 2695 2922 3067 3457 3949 4588 5158 5393 5842 6864 7634 8202 8778 9272 10446 11536 11621 12025 11833 12045 11953 12052 12214 12679 13753 15502 19027 22402 25213 26759 29746 32173 34033 36653 38353 39829 40522
Department of Veterans Affairs 897 933 961 1015 1058 1119 1153 1268 1344 1484 1719 1983 2291 2646 2900 3381 4066 4146 4859 5073 5740 6261 6905 7396 8070 8332 8775 9236 9629 10134 10939 11852 12594 13621 14612 14840 15567 15488 16333 17509 19082 21083 22782 26517 27951 29802 31861 33848 38353 42396 46063 48877 50620
Other Third Party Payers and Programs 3906 4347 4723 5227 5682 6359 6252 6023 6871 7789 9012 9666 10277 11365 13025 14609 16440 18238 20952 24247 28685 32958 36494 39043 41614 47025 53316 59323 67076 70908 77494 82842 88450 93965 97687 101310 105299 110598 117339 121564 124457 131100 139672 152928 159173 167804 176591 187390 181852 184716 194899 202087 215803
Worksite Health Care 64 68 74 81 90 99 112 132 150 174 200 221 250 285 331 377 452 534 621 723 829 954 1043 1157 1306 1392 1520 1681 1859 2024 2214 2325 2463 2588 2707 2839 2950 3084 3190 3291 3483 3619 3740 3893 4066 4242 4347 4488 4496 4520 4648 4860 5115
Other Private Revenues 310 346 384 441 509 595 689 805 1017 1218 1501 1684 1952 2072 2387 2623 3742 4146 5161 6189 8614 10685 12696 14081 15613 18498 20830 22985 26936 28262 29554 31918 34341 36886 38724 42837 46495 51099 56143 58243 57446 56403 58675 64136 66251 70469 77551 86441 81255 86146 93848 95812 103778
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 255 307 375 412 448 509 506 559 645 721 713 757 806 798 996 1213 1444 1487 1507 1654 1633 1740 1754 1837 1982 2201 2196 2333 2458 2488 2591 2686 2822 3175 3557 3589 3813
Workers’ Compensation 615 644 705 742 807 870 991 1100 1244 1372 1532 1570 1715 2051 2382 2669 3031 3506 4026 4945 5606 6189 6929 7285 7661 8937 10083 11957 13816 15519 17530 18958 21100 22607 22189 21914 22050 22140 22364 23931 26198 29724 33402 37750 38982 41264 41398 41126 38914 35294 35156 38007 42025
General Assistance 102 110 102 103 112 122 182 240 299 359 417 477 582 691 827 1000 1131 1281 1358 1548 1899 2226 2437 2649 2875 3189 3422 3552 3742 4138 5032 5187 5531 5037 5451 5437 5414 5167 4928 3874 3940 4819 5138 5591 5904 6195 6721 6928 7146 7155 7071 6669 6423
Maternal/Child Health 116 172 180 201 220 244 291 324 377 435 409 453 482 467 525 565 619 665 701 775 864 879 935 1081 1111 1290 1391 1510 1580 1604 1649 1821 1978 2064 2151 2189 2244 2359 2418 2529 2686 2681 2668 2661 2626 2643 2660 2797 2837 2686 2583 2473 2351
Federal 27 44 48 50 60 80 114 142 167 190 148 191 234 204 243 276 297 311 330 339 344 339 343 398 348 407 395 433 459 476 478 518 565 578 594 587 580 582 588 603 609 619 636 634 635 622 598 600 594 591 591 581 566
State and Local 89 127 133 150 159 164 176 182 210 244 261 263 248 264 282 290 322 354 371 436 520 540 593 683 763 883 996 1078 1121 1128 1171 1303 1413 1485 1558 1602 1664 1777 1830 1926 2077 2062 2032 2027 1992 2022 2062 2196 2243 2095 1992 1892 1785
Vocational Rehabilitation 20 22 25 29 33 41 58 88 115 131 155 180 184 190 202 210 210 219 220 224 223 229 233 246 257 262 270 289 300 308 318 332 343 338 360 360 352 367 378 389 421 449 463 469 468 461 498 497 489 518 558 552 531
Federal 12 14 15 18 20 27 42 66 86 100 121 140 144 149 158 164 163 170 168 171 170 172 172 183 195 200 207 223 232 238 246 257 264 253 271 271 263 276 286 293 317 342 355 359 361 355 377 373 374 398 435 432 412
State and Local 8 8 10 11 13 15 16 22 29 31 34 40 40 41 44 46 48 49 52 53 53 57 61 62 62 62 63 66 68 70 72 75 79 85 89 89 89 91 92 96 104 107 108 110 106 106 121 124 115 120 122 120 120
Other Federal Programs* 337 447 598 715 750 831 653 463 489 621 927 1102 963 980 1086 695 823 854 948 1116 1343 1334 1184 1044 1065 1108 1133 1197 1271 1331 1556 1844 2050 2265 2472 2552 2841 3118 3395 3855 4462 5295 5676 6015 6272 6363 6421 6721 6924 7301 7740 9550 10229
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 537 581 689 663 825 799 636 599 607 515 533 644 884 698 1372 1656 1685 1714 1889 2067 1783 1500 2026 2395 2564 2812 3006 3093 3125 3219 3153 3166 3206 3309 3385 3447 3448
Other State and Local Programs** 2221 2398 2510 2772 3012 3389 3090 2656 2937 3217 3580 3671 3827 4282 4906 5303 5205 5636 6293 7052 7369 8446 9141 9547 9628 10193 12436 13712 14782 15041 15981 16224 16099 17426 18536 17676 17648 17986 18547 18890 18791 20408 21821 23955 25827 27098 27683 28641 29674 30406 32073 32823 33692
School Health 122 140 147 143 151 168 187 215 242 263 290 308 321 346 377 400 433 509 559 600 663 708 753 795 847 919 986 1040 1099 1185 1293 1363 1416 1553 1701 1785 1890 2037 2197 2330 2483 2689 2888 3032 3193 3363 3567 3898 4088 4205 4279 4305 4399
Public Health Activity 371 409 456 509 572 621 733 861 969 1174 1356 1676 1855 2123 2584 2967 3213 3815 4588 5375 6445 7531 8621 9251 9842 11212 12387 13572 15267 17775 19996 22127 24371 26776 29591 30993 32373 34827 37455 40729 43047 46789 52047 54107 55122 57195 60868 65925 71519 74096 75287 73293 74991
Federal 102 108 140 208 226 214 294 401 470 564 594 791 893 854 969 1043 1110 1152 1154 1108 1235 1216 1141 1232 1298 1326 1340 1529 1795 2030 2262 2605 2912 3164 3626 3655 3755 3926 4063 4544 4876 5775 8013 8892 8957 9125 9482 9652 9824 11916 13993 10314 10844
State and Local 269 302 316 301 347 407 439 460 499 610 762 885 962 1269 1615 1924 2104 2663 3434 4267 5210 6316 7480 8019 8544 9886 11047 12043 13472 15745 17734 19522 21459 23613 25964 27338 28618 30901 33392 36185 38170 41013 44035 45215 46165 48070 51386 56274 61695 62180 61294 62979 64147
Investment 2566 2863 3493 3802 4408 4765 5021 5269 5984 7105 7783 8874 9765 10244 11233 12425 13653 13970 15411 17009 20103 23087 26409 29261 30996 31241 32507 35991 40168 43977 48686 52047 56898 61180 63926 65861 67740 72185 79424 85504 87546 91274 102042 110000 117405 126438 131143 144183 154425 146227 149397 157841 160035
Research 694 886 1068 1219 1366 1521 1624 1775 1877 1924 1953 2109 2357 2502 2767 3372 3707 3864 4438 4805 5429 5705 6025 6543 7608 8320 9002 10025 10836 11738 12678 13819 15091 16472 17758 18670 17808 19640 21506 23369 25465 28510 32016 34863 38508 40322 41481 42438 44044 45369 49066 49669 48136
Structures & Equipment 1872 1977 2425 2582 3042 3244 3397 3495 4107 5181 5830 6765 7408 7741 8466 9053 9945 10105 10974 12204 14674 17383 20384 22718 23389 22921 23504 25967 29332 32238 36008 38228 41806 44708 46168 47192 49932 52545 57917 62135 62080 62764 70026 75137 78897 86116 89663 101745 110381 100858 100331 108172 111899
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 3146 8065 9759 11220 12962 15138 17639 20153 24501 29782 34883 40354 46133 53254 63419 75077 84361 94825 104440 112766 122212 133420 144045 163089 183842 213827 244183 272338 302084 329255 350919 371226 378848 398429 428324 476089 519084 558098 609246 656906 718959 768108 822993 886404 929827 965962 1006307
POPULATION 186 189 192 195 197 200 202 204 206 208 210 213 215 217 218 220 222 224 226 228 230 233 235 237 239 242 244 246 248 251 254 257 260 263 266 269 271 274 277 280 282 285 288 290 293 295 298 301 304 307 309 311 313
Health Consumption Expenditures 24793 26366 28414 30925 34136 37193 41233 46511 52771 59110 67070 74365 83376 93121 105924 121160 139358 160009 180116 204649 235681 273652 308290 339725 375515 413366 444385 483125 541530 603488 675591 739477 801012 860310 908760 961570 1014108 1070437 1129510 1200959 1289621 1402079 1535916 1668017 1788341 1908939 2035587 2158742 2257268 2358007 2449603 2534940 2633359
Out of pocket 13051 13422 14299 15361 16981 18262 18647 18587 20628 22657 25015 26380 28724 31716 34467 37372 40767 44996 48169 52473 58396 65629 72739 78924 86824 95977 104034 110161 120828 127313 138643 141689 144215 145301 143458 146356 152194 163789 179387 190427 201725 208997 221878 238223 251679 267254 277346 293647 300708 300669 305551 316128 328156
Health Insurance 7464 8187 8935 9827 10900 11951 15600 21039 24302 27490 31688 36644 42519 47918 55848 66213 78938 92960 106407 122553 142155 167534 190437 212507 237236 259152 274647 300069 338359 387493 439458 492819 543976 594268 638025 682911 724242 761223 795329 848239 920393 1015193 1122318 1222758 1322367 1416685 1520783 1611780 1703189 1798526 1873866 1943432 2014409
Private Health Insurance 5779 6419 7113 7887 8982 10000 10223 10382 11754 13287 15424 17757 20593 22884 25972 30461 37295 45538 52347 60768 69047 81608 94012 104893 118884 131190 136025 149210 175906 204997 234230 255603 275578 296285 309497 326771 345802 362458 387934 419622 459233 502520 561424 615741 659957 703218 740217 777652 807811 833074 859624 888765 916959
Medicare 0 0 0 0 0 0 1842 4924 6218 7045 7672 8443 9325 10730 13428 16336 19694 22891 26668 30922 37387 44769 52351 59559 66207 71829 76829 83081 88965 101137 110182 120617 135996 149965 167670 184393 198750 210376 209420 213173 224829 247686 265381 282697 311162 339801 403728 432833 467867 499903 520158 546246 572484
Medicaid (Title XIX) 0 0 0 0 0 0 1304 3141 3541 4174 5290 6695 8314 9423 11073 13446 15188 17464 19465 22332 26032 30307 32011 35266 38233 40937 45383 50339 55080 61952 73661 93211 108186 122373 134414 144862 152170 160849 169029 183534 200483 224236 248218 269105 290917 309538 306865 326157 344916 375395 398116 407728 421199
Federal 0 0 0 0 0 0 632 1525 1835 2298 2842 3810 4547 4933 6277 7409 9153 9896 10919 12705 14521 16902 17843 19587 21096 22594 25187 27868 30995 35077 42607 56847 68602 76961 81052 85945 91099 94954 98661 107200 116919 132288 145339 160895 172437 177644 174074 185751 203526 248109 267455 248309 237854
State and Local 0 0 0 0 0 0 672 1616 1707 1877 2447 2886 3766 4490 4797 6037 6036 7568 8547 9627 11511 13405 14168 15679 17137 18343 20196 22471 24085 26876 31054 36364 39585 45412 53363 58917 61071 65896 70368 76334 83564 91948 102878 108210 118480 131895 132792 140406 141390 127286 130662 159419 183345
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 399 1723 3012 4167 5485 6296 7167 7566 8366 9117 10210 11106 11552 11988 12624
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 276 1199 2097 2913 3832 4410 4982 5254 5756 6317 7126 7812 8061 8376 8793
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 123 524 915 1253 1653 1887 2185 2313 2610 2801 3084 3293 3492 3613 3832
Department of Defense 788 836 860 925 861 831 1078 1324 1445 1499 1582 1766 1997 2235 2475 2590 2695 2922 3067 3457 3949 4588 5158 5393 5842 6864 7634 8202 8778 9272 10446 11536 11621 12025 11833 12045 11953 12052 12214 12679 13753 15502 19027 22402 25213 26759 29746 32173 34033 36653 38353 39829 40522
Department of Veterans Affairs 897 933 961 1015 1058 1119 1153 1268 1344 1484 1719 1983 2291 2646 2900 3381 4066 4146 4859 5073 5740 6261 6905 7396 8070 8332 8775 9236 9629 10134 10939 11852 12594 13621 14612 14840 15567 15488 16333 17509 19082 21083 22782 26517 27951 29802 31861 33848 38353 42396 46063 48877 50620
Other Third Party Payers and Programs 3906 4347 4723 5227 5682 6359 6252 6023 6871 7789 9012 9666 10277 11365 13025 14609 16440 18238 20952 24247 28685 32958 36494 39043 41614 47025 53316 59323 67076 70908 77494 82842 88450 93965 97687 101310 105299 110598 117339 121564 124457 131100 139672 152928 159173 167804 176591 187390 181852 184716 194899 202087 215803
Worksite Health Care 64 68 74 81 90 99 112 132 150 174 200 221 250 285 331 377 452 534 621 723 829 954 1043 1157 1306 1392 1520 1681 1859 2024 2214 2325 2463 2588 2707 2839 2950 3084 3190 3291 3483 3619 3740 3893 4066 4242 4347 4488 4496 4520 4648 4860 5115
Other Private Revenues 310 346 384 441 509 595 689 805 1017 1218 1501 1684 1952 2072 2387 2623 3742 4146 5161 6189 8614 10685 12696 14081 15613 18498 20830 22985 26936 28262 29554 31918 34341 36886 38724 42837 46495 51099 56143 58243 57446 56403 58675 64136 66251 70469 77551 86441 81255 86146 93848 95812 103778
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 197 255 307 375 412 448 509 506 559 645 721 713 757 806 798 996 1213 1444 1487 1507 1654 1633 1740 1754 1837 1982 2201 2196 2333 2458 2488 2591 2686 2822 3175 3557 3589 3813
Workers’ Compensation 615 644 705 742 807 870 991 1100 1244 1372 1532 1570 1715 2051 2382 2669 3031 3506 4026 4945 5606 6189 6929 7285 7661 8937 10083 11957 13816 15519 17530 18958 21100 22607 22189 21914 22050 22140 22364 23931 26198 29724 33402 37750 38982 41264 41398 41126 38914 35294 35156 38007 42025
General Assistance 102 110 102 103 112 122 182 240 299 359 417 477 582 691 827 1000 1131 1281 1358 1548 1899 2226 2437 2649 2875 3189 3422 3552 3742 4138 5032 5187 5531 5037 5451 5437 5414 5167 4928 3874 3940 4819 5138 5591 5904 6195 6721 6928 7146 7155 7071 6669 6423
Maternal/Child Health 116 172 180 201 220 244 291 324 377 435 409 453 482 467 525 565 619 665 701 775 864 879 935 1081 1111 1290 1391 1510 1580 1604 1649 1821 1978 2064 2151 2189 2244 2359 2418 2529 2686 2681 2668 2661 2626 2643 2660 2797 2837 2686 2583 2473 2351
Federal 27 44 48 50 60 80 114 142 167 190 148 191 234 204 243 276 297 311 330 339 344 339 343 398 348 407 395 433 459 476 478 518 565 578 594 587 580 582 588 603 609 619 636 634 635 622 598 600 594 591 591 581 566
State and Local 89 127 133 150 159 164 176 182 210 244 261 263 248 264 282 290 322 354 371 436 520 540 593 683 763 883 996 1078 1121 1128 1171 1303 1413 1485 1558 1602 1664 1777 1830 1926 2077 2062 2032 2027 1992 2022 2062 2196 2243 2095 1992 1892 1785
Vocational Rehabilitation 20 22 25 29 33 41 58 88 115 131 155 180 184 190 202 210 210 219 220 224 223 229 233 246 257 262 270 289 300 308 318 332 343 338 360 360 352 367 378 389 421 449 463 469 468 461 498 497 489 518 558 552 531
Federal 12 14 15 18 20 27 42 66 86 100 121 140 144 149 158 164 163 170 168 171 170 172 172 183 195 200 207 223 232 238 246 257 264 253 271 271 263 276 286 293 317 342 355 359 361 355 377 373 374 398 435 432 412
State and Local 8 8 10 11 13 15 16 22 29 31 34 40 40 41 44 46 48 49 52 53 53 57 61 62 62 62 63 66 68 70 72 75 79 85 89 89 89 91 92 96 104 107 108 110 106 106 121 124 115 120 122 120 120
Other Federal Programs* 337 447 598 715 750 831 653 463 489 621 927 1102 963 980 1086 695 823 854 948 1116 1343 1334 1184 1044 1065 1108 1133 1197 1271 1331 1556 1844 2050 2265 2472 2552 2841 3118 3395 3855 4462 5295 5676 6015 6272 6363 6421 6721 6924 7301 7740 9550 10229
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 569 537 581 689 663 825 799 636 599 607 515 533 644 884 698 1372 1656 1685 1714 1889 2067 1783 1500 2026 2395 2564 2812 3006 3093 3125 3219 3153 3166 3206 3309 3385 3447 3448
Other State and Local Programs** 2221 2398 2510 2772 3012 3389 3090 2656 2937 3217 3580 3671 3827 4282 4906 5303 5205 5636 6293 7052 7369 8446 9141 9547 9628 10193 12436 13712 14782 15041 15981 16224 16099 17426 18536 17676 17648 17986 18547 18890 18791 20408 21821 23955 25827 27098 27683 28641 29674 30406 32073 32823 33692
School Health 122 140 147 143 151 168 187 215 242 263 290 308 321 346 377 400 433 509 559 600 663 708 753 795 847 919 986 1040 1099 1185 1293 1363 1416 1553 1701 1785 1890 2037 2197 2330 2483 2689 2888 3032 3193 3363 3567 3898 4088 4205 4279 4305 4399
Public Health Activity 371 409 456 509 572 621 733 861 969 1174 1356 1676 1855 2123 2584 2967 3213 3815 4588 5375 6445 7531 8621 9251 9842 11212 12387 13572 15267 17775 19996 22127 24371 26776 29591 30993 32373 34827 37455 40729 43047 46789 52047 54107 55122 57195 60868 65925 71519 74096 75287 73293 74991
Federal 102 108 140 208 226 214 294 401 470 564 594 791 893 854 969 1043 1110 1152 1154 1108 1235 1216 1141 1232 1298 1326 1340 1529 1795 2030 2262 2605 2912 3164 3626 3655 3755 3926 4063 4544 4876 5775 8013 8892 8957 9125 9482 9652 9824 11916 13993 10314 10844
State and Local 269 302 316 301 347 407 439 460 499 610 762 885 962 1269 1615 1924 2104 2663 3434 4267 5210 6316 7480 8019 8544 9886 11047 12043 13472 15745 17734 19522 21459 23613 25964 27338 28618 30901 33392 36185 38170 41013 44035 45215 46165 48070 51386 56274 61695 62180 61294 62979 64147
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 3146 8065 9759 11220 12962 15138 17639 20153 24501 29782 34883 40354 46133 53254 63419 75077 84361 94825 104440 112766 122212 133420 144045 163089 183842 213827 244183 272338 302084 329255 350919 371226 378848 398429 428324 476089 519084 558098 609246 656906 718959 768108 822993 886404 929827 965962 1006307
Personal Health Care 23355 24797 26673 29091 32054 34736 38443 43518 49219 55531 63090 69473 77202 86197 98835 113283 129393 146760 164332 187234 217203 252045 283353 311981 342072 376931 409526 448538 499514 551629 616816 677651 733647 781171 823142 872857 921847 974619 1029218 1089699 1165389 1265324 1371925 1482141 1592284 1700956 1809229 1920978 2017148 2117434 2192907 2271244 2360432
Out of pocket 13051 13422 14299 15361 16981 18262 18647 18587 20628 22657 25015 26380 28724 31716 34467 37372 40767 44996 48169 52473 58396 65629 72739 78924 86824 95977 104034 110161 120828 127313 138643 141689 144215 145301 143458 146356 152194 163789 179387 190427 201725 208997 221878 238223 251679 267254 277346 293647 300708 300669 305551 316128 328156
Health Insurance 6606 7251 7911 8772 9744 10592 13984 19328 22211 25615 29582 33912 38712 43733 52012 61991 72940 84458 96377 112076 131942 155398 176188 195894 215143 235622 253911 281391 314212 355698 403238 455481 504092 546309 587320 630701 670031 705391 736711 782062 844922 932338 1020129 1103546 1194912 1281279 1370998 1454631 1545428 1639822 1699857 1762262 1829908
Private Health Insurance 4932 5495 6103 6845 7839 8655 8791 9003 10128 11940 13997 15755 17643 19710 23357 27634 33005 38804 44456 52594 61383 72390 82755 91636 100583 111999 119850 135428 157382 179538 205090 226081 244319 258224 270863 287986 304707 322597 347285 373465 406742 445340 488082 527181 566351 606469 639024 673029 705964 736053 753174 778912 807025
Medicare 0 0 0 0 0 0 1722 4731 5931 6735 7276 8036 8851 10182 12748 15610 18815 22136 25666 29900 36260 43457 51060 58116 64599 69795 74769 80951 86404 98277 107266 117273 132368 146235 163430 179858 193573 204204 202559 206035 216333 239111 256551 274030 300136 326317 382335 408790 442908 471349 489430 513483 538023
Medicaid (Title XIX) 0 0 0 0 0 0 1252 3019 3385 3984 5039 6411 7973 9013 10590 12839 14429 16520 18406 21134 24697 28795 30418 33486 36181 38761 43019 47719 52173 58651 69693 88921 103417 116453 126856 136250 144510 151352 158316 171281 186943 208435 230096 249447 270885 287720 283383 301715 318159 346831 366627 374593 386341
Federal 0 0 0 0 0 0 605 1461 1753 2195 2708 3643 4360 4697 5994 7048 8661 9317 10220 11906 13692 15930 16811 18527 19891 21270 23777 26376 29339 33168 40330 54409 66021 73680 77341 81742 86876 89651 92721 100296 109322 123488 135177 149729 161220 165533 161549 172191 188470 231145 248343 229159 218720
State and Local 0 0 0 0 0 0 647 1558 1632 1788 2331 2767 3612 4316 4596 5790 5768 7203 8186 9228 11006 12865 13608 14959 16289 17491 19242 21344 22834 25483 29364 34512 37396 42774 49515 54507 57635 61701 65594 70985 77622 84948 94919 99718 109665 122187 121834 129524 129688 115686 118285 145434 167621
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 349 1489 2530 3489 4561 5305 6162 6460 7194 7808 8695 9536 9735 10051 10634
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 241 1036 1762 2441 3191 3720 4283 4485 4948 5409 6070 6715 6796 7030 7413
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108 453 768 1048 1370 1585 1879 1975 2246 2399 2625 2821 2939 3021 3221
Department of Defense 786 834 858 923 859 830 1077 1319 1436 1489 1569 1749 1976 2210 2449 2563 2666 2890 3035 3423 3912 4546 5105 5320 5774 6796 7552 8103 8667 9144 10293 11406 11453 11853 11639 11842 11746 11819 11939 12357 13372 14970 18171 21223 23629 24725 27385 29570 31416 33740 34865 36379 37295
Department of Veterans Affairs 887 922 950 1004 1046 1108 1141 1256 1332 1468 1701 1962 2268 2619 2867 3344 4025 4108 4813 5026 5690 6210 6850 7336 8006 8271 8722 9189 9585 10088 10895 11800 12534 13544 14532 14765 15495 15420 16264 17436 19002 20993 22669 26359 27748 29587 31677 33719 38287 42313 46026 48845 50590
Other Third Party Payers and Programs 3698 4123 4463 4958 5329 5882 5812 5603 6380 7259 8493 9181 9766 10748 12356 13920 15685 17305 19786 22684 26864 31018 34426 37163 40105 45332 51580 56985 64475 68618 74935 80481 85340 89561 92364 95801 99623 105438 113121 117209 118742 123989 129918 140372 145692 152423 160886 172701 171012 176943 187499 192854 202367
Worksite Health Care 64 68 74 81 90 99 112 132 150 174 200 221 250 285 331 377 452 534 621 723 829 954 1043 1157 1306 1392 1520 1681 1859 2024 2214 2325 2463 2588 2707 2839 2950 3084 3190 3291 3483 3619 3740 3893 4066 4242 4347 4488 4496 4520 4648 4860 5115
Other Private Revenues 310 346 384 441 509 595 689 805 1017 1218 1501 1684 1952 2072 2387 2623 3742 4146 5161 6189 8614 10685 12696 14081 15613 18498 20830 22985 26936 28262 29554 31918 34341 36886 38724 42837 46495 51099 56143 58243 57446 56403 58675 64136 66251 70469 77551 86441 81255 86146 93848 95812 103778
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 190 247 297 363 399 435 495 493 544 629 706 699 742 789 777 970 1181 1409 1450 1469 1617 1590 1696 1706 1783 1923 2136 2129 2265 2390 2420 2523 2618 2754 3099 3464 3493 3704
Workers’ Compensation 435 460 495 525 565 600 681 751 830 922 1052 1131 1253 1482 1765 2038 2379 2687 2981 3512 3925 4400 5030 5570 6317 7421 8528 9805 11413 13432 15199 16846 18261 18508 17188 16728 16711 17311 18490 19951 20884 23044 24091 25640 25949 26327 26151 26909 28528 28007 28507 29884 30248
General Assistance 102 110 102 103 112 122 182 240 299 359 417 477 582 691 827 1000 1131 1281 1358 1548 1899 2226 2437 2649 2875 3189 3422 3552 3742 4138 5032 5187 5531 5037 5451 5437 5414 5167 4928 3874 3940 4819 5138 5591 5904 6195 6721 6928 7146 7155 7071 6669 6423
Maternal/Child Health 109 161 169 188 206 229 273 304 353 407 383 424 451 436 492 536 580 615 654 722 804 818 872 1009 1040 1209 1305 1417 1483 1505 1546 1708 1856 1936 2018 2054 2105 2213 2270 2373 2521 2518 2504 2498 2465 2480 2497 2624 2664 2523 2425 2322 2208
Federal 26 43 47 49 59 79 113 140 164 187 145 187 229 199 239 271 292 306 325 333 338 333 337 395 346 405 392 430 456 473 475 514 562 575 590 583 576 578 584 600 606 615 632 630 631 618 595 597 591 588 587 578 562
State and Local 83 117 123 139 147 150 160 163 189 220 238 237 222 237 254 265 289 310 329 389 466 486 535 614 694 804 912 987 1027 1032 1072 1193 1294 1361 1428 1471 1529 1635 1686 1773 1915 1902 1872 1868 1835 1862 1903 2027 2073 1935 1838 1744 1646
Vocational Rehabilitation 19 21 24 28 31 39 55 84 108 123 146 169 173 178 187 192 193 202 201 204 201 206 209 221 232 236 242 259 270 276 285 298 306 300 325 325 315 326 335 344 373 400 412 418 415 411 445 443 436 461 495 490 471
Federal 12 13 15 17 19 26 40 63 81 94 114 132 135 139 146 150 149 157 154 156 153 154 154 165 176 180 186 200 209 213 220 230 236 225 244 245 236 246 253 259 281 305 316 320 321 317 337 332 334 354 387 384 365
State and Local 7 8 9 11 12 14 16 21 28 29 32 37 38 38 41 43 44 45 47 48 47 51 55 56 56 56 57 59 61 63 65 68 70 76 80 80 80 81 81 85 92 96 96 97 94 94 108 110 103 107 108 106 106
Other Federal Programs* 327 432 577 693 709 760 606 438 463 597 923 1096 957 976 1084 695 793 824 913 1079 1309 1291 1124 996 1016 1058 1084 1154 1233 1292 1511 1800 2001 2206 2413 2487 2756 3049 3328 3781 4384 5209 5579 5908 6167 6256 6306 6606 6826 7177 7367 8819 8966
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 564 529 574 681 655 815 789 628 593 603 511 530 639 868 686 1350 1631 1657 1671 1832 2016 1748 1469 1988 2349 2514 2744 2941 3037 3064 3160 3094 3105 3144 3244 3321 3377 3364
Other State and Local Programs** 2211 2385 2491 2755 2956 3269 3028 2635 2916 3195 3580 3671 3827 4282 4906 5303 5205 5636 6293 7052 7369 8446 9141 9547 9628 10193 12436 13712 14782 15041 15981 16224 16099 17426 18536 17676 17648 17986 18547 18890 18791 20408 21821 23955 25827 27098 27683 28641 29674 30406 32073 32823 33692
School Health 122 140 147 143 151 168 187 215 242 263 290 308 321 346 377 400 433 509 559 600 663 708 753 795 847 919 986 1040 1099 1185 1293 1363 1416 1553 1701 1785 1890 2037 2197 2330 2483 2689 2888 3032 3193 3363 3567 3898 4088 4205 4279 4305 4399
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 2975 7750 9316 10719 12315 14447 16824 19194 23338 28449 33244 38656 44072 51034 60957 72252 81478 91602 100780 108556 117788 128671 138577 156928 176959 206194 235785 262688 290286 316108 338083 355556 361224 378805 405806 451035 491207 528783 577184 620497 672912 718312 769762 827716 865792 898126 934998
Total Hospital Expenditures 8985 9777 10432 11507 12501 13545 15298 17798 20537 23367 27168 30224 33846 37920 44139 51234 59402 67023 75621 86162 100517 117480 133647 144745 154366 164576 175629 189545 206455 225968 250439 275768 298477 315749 328366 339313 350799 363404 374917 393624 415531 449358 486479 526163 566013 609369 651921 692476 729000 776808 812562 840754 882269
Out of pocket 1855 1898 1953 2209 2505 2687 2306 1811 2160 2156 2452 2458 2976 3598 4005 4318 4534 4864 5020 5198 5392 6284 7224 7639 8119 8804 8508 9014 9819 10344 11208 11917 12358 12173 10705 10147 10302 11070 12014 12766 13493 13839 15218 16901 18156 19534 20886 22383 23341 25027 26095 27467 29761
Health Insurance 4553 5069 5509 6006 6548 7129 9279 12444 14323 16630 19410 22015 24485 27379 32220 38250 45178 51777 58983 67973 80059 93862 107332 117351 126167 133858 141894 152989 166162 184904 206772 229632 250947 267379 280318 292280 302815 312430 320381 337448 358016 390546 424433 457041 493503 532557 568023 601379 640133 680906 709422 734696 770087
Private Health Insurance 3200 3669 4108 4546 5083 5606 5592 5615 6358 7482 8833 9876 10906 12044 14400 17052 20207 23427 26965 31707 36867 42707 49391 53384 55953 58903 62637 68547 76429 86067 96904 102514 106102 107479 107476 107690 109939 114337 120950 129056 141565 153970 169995 185571 201005 217490 236965 249922 265118 280782 290073 303234 320889
Medicare 0 0 0 0 0 0 1255 3225 4108 4811 5359 5920 6537 7537 9388 11502 13902 16187 18639 21647 26278 31521 36662 40989 45415 48644 50822 53495 56337 62162 67403 73322 83068 91524 99879 108286 114540 119392 118145 121103 123371 135048 143531 150929 162772 176449 184730 193169 206313 216021 221482 229450 239785
Medicaid (Title XIX) 0 0 0 0 0 0 726 1624 1703 2031 2647 3316 3738 3990 4226 5014 5766 6602 7008 7774 9214 11062 11782 12947 13961 14624 15963 17773 19712 22269 26663 36545 43940 49458 53671 56800 58871 59630 61787 66913 71202 77697 84852 90730 97697 104813 110149 119389 125238 136960 147653 150225 156375
Federal 0 0 0 0 0 0 351 786 882 1120 1423 1882 2063 2065 2404 2747 3568 3708 3875 4347 5018 6028 6423 7075 7578 7931 8723 9707 10975 12505 15861 24955 31651 34615 35592 36732 37868 37762 38079 40966 42831 47179 50989 55559 59696 61070 63016 68607 74287 90654 99486 92418 88707
State and Local 0 0 0 0 0 0 375 838 821 912 1224 1434 1675 1926 1822 2267 2198 2893 3133 3427 4196 5034 5360 5872 6383 6693 7240 8066 8737 9764 10801 11590 12290 14843 18079 20068 21003 21868 23708 25948 28371 30518 33862 35171 38001 43743 47134 50782 50951 46307 48167 57807 67668
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149 465 932 1389 1813 2053 2611 2662 2352 2650 3136 3206 3169 3332 3425
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 103 324 645 958 1246 1411 1783 1813 1601 1811 2152 2217 2182 2299 2355
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 47 141 287 432 568 641 828 850 751 839 984 989 987 1033 1070
Department of Defense 543 559 533 542 508 519 684 869 988 1020 1067 1182 1325 1519 1708 1797 1852 2000 2220 2517 2819 3275 3694 3887 4200 4917 5441 5828 6034 6310 7053 7815 7847 8173 7855 7963 7629 7617 7579 7434 7641 8047 9036 10377 11447 12008 12890 13695 14225 15617 16581 17070 16948
Department of Veterans Affairs 810 842 867 918 957 1004 1021 1110 1165 1287 1504 1721 1979 2288 2498 2886 3452 3561 4151 4328 4879 5297 5804 6144 6637 6770 7031 7346 7650 8096 8749 9437 9990 10744 11436 11541 11836 11454 11771 12475 13304 14394 15206 17382 17972 19134 20938 22554 26104 28320 30464 31385 32666
Other Third Party Payers and Programs 2578 2810 2970 3293 3448 3728 3714 3542 4054 4581 5306 5751 6385 6944 7915 8665 9690 10382 11618 12991 15066 17334 19091 19755 20081 21915 25227 27543 30474 30720 32459 34219 35172 36198 37343 36885 37682 39904 42522 43411 44022 44973 46827 52220 54354 57279 63012 68714 65526 70874 77046 78591 82421
Worksite Health Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Private Revenues 110 134 157 190 224 261 314 392 510 640 881 1015 1178 1152 1302 1424 2313 2449 2949 3376 5066 6065 6942 7269 7322 8263 9029 9641 11258 10596 10324 11069 11532 12085 12821 14168 15559 17944 19899 21040 21645 20279 21011 24361 25127 26874 31590 35820 31251 36330 41210 41608 44013
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 125 162 193 229 241 239 279 286 320 365 409 403 421 447 437 535 647 767 783 786 860 849 902 902 943 1010 1110 1111 1185 1253 1273 1331 1380 1443 1647 1849 1866 1982
Workers’ Compensation 152 161 173 184 198 210 240 255 348 486 525 565 634 743 897 1048 1238 1386 1566 1842 2068 2325 2692 2945 3241 3637 4092 4605 5225 6096 6870 7608 8244 8340 7717 7431 7368 7547 7896 8486 8803 9685 10124 10781 10941 11201 11225 11605 12318 12318 12674 13294 13499
General Assistance 81 88 82 83 91 100 142 180 211 254 296 339 414 491 589 727 817 926 974 1093 1301 1536 1704 1833 1945 2104 2140 2141 2171 2487 3171 3367 3596 3100 3308 3091 3061 2836 2616 1641 1481 1928 1875 1730 1819 1730 1935 2159 2414 2123 2244 2129 2738
Maternal/Child Health 19 29 29 30 30 34 42 45 53 63 59 65 69 67 76 82 89 94 100 111 124 127 135 139 135 151 160 169 169 170 172 189 205 205 207 201 198 204 199 208 218 218 215 216 215 219 226 238 243 233 225 215 203
Federal 5 9 9 9 10 14 19 23 26 30 23 29 36 31 38 43 46 48 51 52 53 53 54 57 47 53 50 52 53 54 53 58 63 62 62 59 56 54 53 54 54 54 56 56 56 56 55 55 55 55 55 54 53
State and Local 14 20 20 21 20 20 23 22 27 33 36 36 33 35 38 40 43 46 49 58 71 74 81 82 88 99 111 117 117 116 119 131 142 143 145 142 142 149 146 154 164 163 160 161 159 164 171 183 188 178 169 160 150
Vocational Rehabilitation 7 8 10 13 15 19 26 46 64 72 82 94 97 103 100 99 92 96 92 91 89 96 96 93 90 86 84 83 82 83 90 90 83 74 86 82 73 70 72 82 107 120 123 124 120 116 131 118 108 118 132 134 131
Federal 4 5 6 8 9 13 19 34 48 55 64 73 76 80 78 77 71 75 71 70 68 73 72 70 69 66 65 65 64 64 70 70 66 56 65 63 55 52 55 61 80 92 94 95 93 89 99 89 82 90 103 105 102
State and Local 3 3 4 5 6 7 7 12 16 17 18 21 21 22 22 22 22 21 21 21 21 24 24 23 21 20 19 18 18 19 20 20 17 18 20 19 18 17 17 21 27 29 29 29 27 27 31 29 25 28 29 29 30
Other Federal Programs* 178 225 295 342 351 370 263 192 199 221 322 426 430 428 439 283 341 359 389 418 412 398 348 146 172 177 182 195 203 221 244 276 299 315 303 303 337 337 377 451 637 1012 1117 1156 1209 1220 1281 1282 1277 1342 1332 1714 1727
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 82 74 76 85 78 91 83 62 54 51 40 38 43 56 43 81 165 126 86 86 86 121 129 165 186 174 182 185 178 172 163 162 162 162 166 159 138 143
Other State and Local Programs** 2030 2165 2223 2451 2540 2734 2686 2433 2668 2845 3141 3248 3563 3961 4512 4795 4564 4804 5232 5741 5676 6424 6826 6956 6759 7047 9100 10245 10863 10588 10972 10810 10321 11208 12029 10663 10116 9936 10397 10374 9946 10438 11067 12490 13498 14482 15131 15950 16311 16597 17222 17493 17985
School Health 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 1981 4849 5811 6842 8006 9236 10275 11527 13614 16516 19668 22789 25647 29421 35492 42583 48444 53936 59376 63268 66785 71268 76049 84431 94066 109867 127008 140982 153550 165086 173411 179022 180081 188481 195505 214134 230196 243712 263080 283924 297231 315208 334687 356187 372304 383007 399585
Total Physician and Clinical Expenditures 5630 5842 6256 7075 8109 8587 9309 10448 11344 12716 14331 15917 17706 19559 22215 25309 28672 33112 35833 41192 47714 55606 61623 68644 77412 90857 100712 112909 128638 143294 158944 176530 191255 202747 212178 222278 231289 242861 258664 271883 290881 315716 340850 367987 393267 417199 438800 461768 486465 503176 518974 540141 564996
Out of pocket 3384 3438 3613 4049 4658 4897 4858 4843 5138 5780 6462 6883 7376 7805 8458 9092 10102 11387 11644 12913 14220 16160 17366 18642 20725 24268 26999 27998 29542 29874 30087 30738 30312 29314 27641 26044 26798 28322 30030 30848 32491 33876 35385 37602 39741 42652 44609 46838 48653 47906 50940 52251 54855
Health Insurance 1837 1952 2150 2497 2871 3049 3776 4896 5476 6203 6991 8026 9183 10399 12126 13976 16090 18853 20779 24191 28516 33527 37696 42483 47805 55755 61093 70179 82027 94377 107797 122678 135526 146683 157025 167358 174610 183076 194491 205380 222736 243689 265387 287732 310127 330231 349239 368030 390926 409872 420512 438090 455946
Private Health Insurance 1593 1677 1825 2117 2518 2735 2801 2881 3153 3655 4209 4775 5436 6099 6995 7944 9311 11055 12050 14216 16625 19524 21672 24018 27556 33285 35415 40814 49962 58163 66998 77872 86967 94877 100587 106252 110358 114636 122771 128334 138004 150557 163662 178005 189698 202390 211921 222392 233046 238144 241649 249426 258345
Medicare 0 0 0 0 0 0 443 1226 1457 1570 1643 1855 2027 2271 2854 3467 4100 4980 5872 6871 8315 9838 11757 13860 15401 17010 19460 22514 24426 27703 30460 32021 33700 35320 38798 42262 44649 47663 50240 53823 58729 63727 68041 73525 80543 85576 91345 95956 103794 111472 115103 121571 128081
Medicaid (Title XIX) 0 0 0 0 0 0 141 348 429 519 649 846 1093 1353 1539 1783 1822 1897 1991 2153 2432 2839 2793 3092 3190 3521 4028 4477 4913 5600 7026 9113 11152 12683 13695 14788 15241 16312 16735 17510 19246 21391 23916 25078 27732 29799 31527 33222 35594 39929 42580 44456 45624
Federal 0 0 0 0 0 0 68 169 223 286 349 481 594 706 873 976 1041 1075 1103 1215 1366 1603 1582 1761 1798 1977 2280 2540 2847 3272 4119 5305 6678 7658 8073 8628 8954 9491 9799 10256 11357 12666 14140 15508 16995 17818 18773 19621 21981 27598 29691 28213 27099
State and Local 0 0 0 0 0 0 73 180 207 233 300 365 499 647 666 807 780 822 888 937 1066 1235 1211 1331 1392 1544 1748 1937 2065 2327 2907 3808 4474 5025 5622 6160 6287 6821 6936 7254 7889 8725 9776 9570 10736 11981 12754 13601 13613 12331 12889 16243 18525
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 56 494 731 1001 1192 1435 1607 1656 2520 2654 2746 2966 3066 3046 3166
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39 338 506 702 840 1015 1127 1161 1718 1834 1906 2065 2121 2117 2193
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17 155 226 299 351 421 480 495 802 820 840 902 945 930 973
Department of Defense 218 248 298 352 324 284 359 408 403 420 448 502 568 605 659 681 728 798 717 797 971 1131 1250 1264 1389 1662 1872 2019 2351 2530 2893 3201 3198 3229 3303 3357 3551 3584 3700 4128 4718 5479 6820 7509 8161 8308 9226 10235 11441 12058 12336 13222 14163
Department of Veterans Affairs 25 27 27 28 29 30 31 32 34 39 41 48 59 70 80 100 129 123 148 154 173 195 224 248 268 277 318 354 376 382 419 471 510 574 642 698 810 881 988 1092 1307 1534 1757 2179 2386 2503 2700 3571 4305 5302 5779 6369 6567
Other Third Party Payers and Programs 409 452 493 529 579 641 675 709 730 733 878 1008 1147 1355 1631 2241 2480 2872 3409 4088 4977 5918 6561 7520 8883 10835 12620 14732 17069 19043 21061 23114 25417 26750 27512 28876 29881 31463 34143 35654 35654 38151 40079 42653 43399 44316 44952 46901 46885 45398 47522 49800 54195
Worksite Health Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Private Revenues 73 78 84 93 106 128 150 156 176 199 225 255 302 359 428 514 626 786 1061 1434 1848 2487 3009 3594 4534 5781 6880 8144 9409 10586 11306 12411 13781 14895 16174 17574 18822 20089 22060 22755 21980 22949 24219 25734 26208 26930 27689 29011 27982 26663 28438 29758 33587
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41 56 65 79 99 127 133 130 146 167 192 195 213 231 227 279 339 404 414 419 464 458 495 503 526 568 626 626 665 699 703 726 751 785 875 985 994 1060
Workers’ Compensation 252 267 288 305 328 348 393 443 424 370 454 486 530 634 747 853 985 1127 1222 1448 1612 1806 2032 2274 2652 3289 3853 4504 5346 6355 7175 8011 8689 8803 8183 7994 7980 8292 8966 9652 10132 11197 11668 12412 12523 12624 12425 12719 13490 13042 13153 13784 13939
General Assistance 9 10 9 9 9 9 19 24 32 41 51 62 79 99 123 152 176 202 224 245 313 354 380 422 473 524 604 665 712 610 625 576 645 656 613 633 625 638 625 464 469 504 498 607 623 638 696 790 897 993 979 614 808
Maternal/Child Health 4 7 8 10 11 14 20 25 31 38 33 38 43 40 46 51 55 58 62 66 72 72 74 79 76 94 100 109 114 118 118 131 142 142 144 140 138 141 142 148 155 156 155 155 154 154 154 159 161 151 145 140 133
Federal 2 3 4 4 5 8 13 18 22 26 20 26 32 27 33 37 40 42 45 46 47 46 46 50 43 53 52 57 60 63 62 68 74 73 74 71 68 67 67 69 69 70 72 72 72 70 68 68 67 66 65 64 62
State and Local 2 3 4 5 6 6 7 7 9 12 12 13 12 13 13 14 15 16 17 21 25 26 28 29 33 41 47 52 54 55 56 63 68 68 70 69 70 74 75 79 86 85 83 84 82 83 86 91 93 86 80 76 71
Vocational Rehabilitation 8 9 10 11 12 15 23 30 34 39 49 58 59 58 67 73 81 85 86 88 87 85 88 101 111 118 125 138 148 151 150 160 172 175 182 184 184 196 200 199 201 210 218 221 222 220 235 242 246 256 269 263 251
Federal 5 6 6 7 7 10 16 22 26 30 38 45 46 46 52 57 64 66 66 67 67 64 65 74 84 90 95 106 114 117 115 123 131 131 136 138 137 148 151 151 152 160 167 170 171 170 178 181 188 197 211 207 195
State and Local 3 4 4 4 5 5 6 8 9 9 11 13 13 13 15 16 18 19 20 21 21 21 24 26 28 29 30 32 34 34 35 37 41 44 46 46 47 48 49 48 49 50 51 52 51 50 57 61 58 59 59 57 56
Other Federal Programs* 29 39 49 54 52 52 31 14 18 29 53 93 119 149 204 184 155 179 242 299 419 504 469 550 515 540 558 577 595 590 660 715 782 809 858 874 898 931 979 1094 1256 1529 1673 1821 1913 1990 1982 2188 2288 2367 2532 3303 3403
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 355 328 351 410 388 476 454 356 330 330 274 281 355 484 373 717 740 769 829 914 982 743 644 635 785 864 942 969 985 1003 1002 988 983 975 989 959 878 947
Other State and Local Programs** 34 41 46 47 61 74 41 17 15 16 13 16 15 16 16 18 18 19 23 21 22 23 24 25 24 24 26 27 30 31 30 32 34 26 25 32 34 36 34 31 30 39 52 53 55 56 58 59 61 61 63 65 66
School Health 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 584 1574 1886 2089 2292 2701 3120 3624 4393 5250 5922 6877 7863 9024 10747 12677 14550 16952 18591 20531 23488 26991 29339 33303 37486 41134 44852 48003 52493 57050 59890 63975 67031 71827 78706 86119 93149 100038 109882 117031 125392 131832 142134 154367 160749 169073 176871
Total Dental Services Expenditures 1987 2103 2224 2371 2616 2818 2992 3446 3704 4216 4711 5226 5566 6379 7139 8023 9042 10129 11039 11984 13426 15817 17085 18408 19980 21819 23293 25455 27531 29517 31742 33545 37285 39160 41715 44775 47105 50457 53780 57448 62271 67821 73684 76279 82053 87017 91442 97338 102369 102482 105378 107656 110937
Out of pocket 1907 2018 2135 2275 2516 2704 2827 3150 3322 3789 4241 4671 4933 5605 6129 6532 6963 7584 7918 8237 8838 10084 10550 11010 11575 12242 12658 13118 13845 14485 15264 15757 17149 17493 18336 19369 20137 22138 23765 25232 27651 29332 32308 33758 36073 38301 40193 42976 45451 43058 43636 45000 46776
Health Insurance 64 64 66 71 71 81 146 284 362 403 449 530 604 739 965 1433 2009 2459 3026 3647 4475 5592 6388 7245 8245 9390 10446 12148 13501 14840 16298 17587 19913 21430 23125 25142 26680 28009 29708 31907 34271 38155 41060 42238 45669 48388 50898 53979 56498 58940 61196 62154 63623
Private Health Insurance 38 37 38 41 43 55 68 104 113 180 212 248 292 378 550 939 1486 1909 2502 3070 3813 4838 5730 6580 7618 8684 9680 11331 12647 13953 15269 16324 18391 19405 21029 22961 24417 25624 27122 29209 31284 34336 36554 37398 40514 42897 45117 47591 49061 49950 51297 52128 53370
Medicare 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 2 2 16 17 34 40 54 74 89 99 78 81 86 79 70 71 86 103 164 221 296 242 294 368
Medicaid (Title XIX) 0 0 0 0 0 0 43 138 201 168 162 179 183 228 295 364 390 424 392 440 503 581 485 501 456 510 554 591 617 638 756 945 1196 1675 1741 1807 1872 1975 2124 2141 2316 2990 3472 3748 3925 4147 4275 4555 5458 6751 7368 7260 7290
Federal 0 0 0 0 0 0 21 67 104 93 87 101 100 120 166 200 233 241 217 247 275 317 264 273 249 277 304 324 345 359 425 529 684 950 960 994 1042 1101 1187 1204 1311 1684 1954 2211 2303 2382 2454 2624 3282 4571 5078 4461 3919
State and Local 0 0 0 0 0 0 22 71 98 75 75 77 83 109 128 164 158 184 175 192 227 264 221 228 207 233 250 267 272 279 331 417 512 724 782 813 830 874 937 937 1004 1306 1518 1538 1622 1765 1821 1932 2176 2179 2290 2798 3371
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 32 146 234 328 452 391 401 464 489 665 702 770 1047 1166 1305
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 103 165 234 324 283 288 331 348 474 502 549 732 814 910
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 44 69 94 128 108 113 133 141 191 200 222 315 351 394
Department of Defense 25 26 27 29 27 26 34 41 44 46 50 60 78 80 76 77 77 81 87 97 111 127 142 146 157 183 200 213 225 239 263 292 294 305 303 309 305 309 321 323 346 403 491 614 733 750 847 941 990 1095 1169 1225 1215
Department of Veterans Affairs 1 1 1 1 1 1 1 2 3 9 26 43 51 52 44 53 56 44 45 40 49 45 30 18 13 12 11 10 10 8 8 10 14 12 11 12 12 12 11 10 11 12 13 17 26 44 68 62 65 77 73 80 75
Other Third Party Payers and Programs 16 21 23 25 30 32 19 12 20 23 21 24 29 35 45 58 70 86 94 101 113 141 147 154 161 187 189 189 185 192 180 201 223 237 255 263 288 310 307 308 348 335 316 283 311 328 351 383 420 485 546 502 537
Worksite Health Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Private Revenues 0 0 0 0 0 0 0 0 0 0 0 0 0 4 7 11 15 19 22 27 27 39 43 44 51 73 81 86 80 84 61 65 68 74 80 82 120 130 134 142 173 141 70 43 49 56 61 64 71 78 90 87 108
Indian Health Services 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 14 16 19 21 22 24 24 27 31 35 33 34 37 34 41 54 66 68 71 80 78 84 86 93 105 119 116 125 134 138 148 155 165 181 197 200 212
Workers’ Compensation 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
General Assistance 1 1 1 1 1 1 1 3 8 9 11 13 16 19 23 24 28 37 37 37 47 60 62 64 62 60 55 47 46 52 58 60 64 70 79 76 65 70 61 46 41 45 100 86 100 105 113 134 154 198 233 183 187
Maternal/Child Health 2 3 3 3 2 2 3 6 8 9 8 10 11 10 11 12 13 14 15 16 18 18 18 18 17 20 20 22 22 21 21 22 24 24 25 25 25 26 26 28 30 30 30 29 29 29 29 30 30 28 26 25 24
Federal 1 1 1 1 1 1 2 4 5 6 5 6 8 6 8 9 9 10 10 11 11 11 11 11 9 11 10 11 11 11 10 11 12 12 12 12 11 12 12 12 12 13 13 12 12 12 12 12 12 11 11 11 10
State and Local 1 2 2 2 1 1 1 2 3 3 3 3 3 3 4 4 4 4 5 5 7 7 7 7 8 9 10 11 11 11 11 11 12 12 13 13 13 15 15 16 17 17 17 16 16 16 17 18 19 16 15 14 13
Vocational Rehabilitation 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Federal Programs* 7 10 11 13 14 13 7 3 3 3 1 2 2 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 7
SAMHSA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other State and Local Programs** 6 8 8 9 13 16 7 1 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
School Health 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Total CMS Programs (Medicaid, CHIP and Medicare) 0 0 0 0 0 0 43 138 201 168 162 179 183 228 295 364 390 424 392 440 503 581 485 501 456 511 555 592 618 640 758 961 1213 1709 1781 1861 1946 2064 2255 2365 2631 3404 4003 4209 4397 4697 4867 5384 6381 7817 8657 8720 8963
Total Other Professional Services Expenditures 392 409 429 451 486 533 572 608 644 678 726 793 893 1022 1163 1337 1564 2058 2403 2847 3478 4276 4924 5663 7350 8143 9326 11389 13805 14597 17408 18713 21048 23181 24227 26973 29206 31677 33791 34994 37015 40612 43671 46729 50267 52671 54961 59492 63988 66788 69842 73076 76380
Out of pocket 341 343 351 361 383 395 389 375 364 348 324 287 310 393 440 643 743 1021 1200 1394 1699 2019 2248 2478 3196 3317 3618 4304 5174 5250 6202 6370 6969 7421 7427 7956 8269 9313 10051 10771 11279 11946 12549 13191 13899 14121 14713 16098 17230 17463 18293 18779 19371
Health Insurance 8 12 16 20 25 30 49 75 84 86 100 128 161 223 286 418 513 690 801 972 1207 1560 1866 2246 2996 3403 4035 5094 6311 6783 8412 9292 10686 12144 13033 15013 16718 17874 19236 19735 21281 24074 26323 28830 31364 33375 34914 37607 40675 43176 45148 47676 50122
Private Health Insurance 8 12 16 20 25 30 34 37 40 42 43 49 65 99 130 219 288 445 550 672 859 1134 1394 1686 2375 2682 3169 4072 5156 5505 6834 7367 8452 9428 9875 11060 12011 12728 12907 13540 14254 15650 17014 18519 19706 20086 20849 22796 24239 24589 25635 27049 28237
Medicare 0 0 0 0 0 0 3 10 13 15 18 22 27 34 47 63 74 87 106 131 167 201 259 332 383 465 568 680 794 913 1132 1376 1639 1882 2299 2937 3500 3835 5004 4727 5406 6461 6743 7468 8287 9448 10211 10956 12382 13766 14541 15706 16944
Medicaid (Title XIX) 0 0 0 0 0 0 11 28 31 29 40 56 69 90 108 136 150 158 144 169 181 225 214 228 238 256 298 342 362 366 445 549 594 834 859 1016 1207 1311 1319 1425 1565 1889 2446 2730 3264 3719 3682 3701 3891 4647 4804 4716 4719
Federal 0 0 0 0 0 0 6 14 16 16 21 32 37 47 61 75 86 89 80 95 98 121 115 123 128 138 162 187 202 204 249 304 344 502 499 579 693 748 758 822 899 1083 1404 1657 1942 2164 2131 2140 2369 3153 3312 2914 2461
State and Local 0 0 0 0 0 0 6 15 15 13 18 24 31 43 47 61 65 68 64 75 84 104 99 105 109 118 136 154 160 162 197 245 250 332 361 437 515 563 561 603 667 806 1043 1073 1323 1556 1551 1561 1521 1494 1493 1802 2258
CHIP (Title XIX and Title XXI) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 42 55 74 120 113 106 121 173 153 163 174 167 206 223
Federal 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 29 40 52 83 78 74 84 118 107 115 123 118 145 156
State and Local 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 13 15 22 37 34 32 37 55 47 49 51 49 61 67
Department of Defense 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Department of Veterans Affairs 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Third Party Payers and Programs 43 54 62 70 78 108 134 157 195 243 301 378 422 406 437 276 308 347 402 480 572 697 811 940 1158 1423 1672 1991 2319 2564 2794 3051 3394 3615 3767 4004 4218 4491 4503 4488 4455 4592 4799 4708 5004 5175 5334 5787 6082 6149 6402 6621 6887
Worksite Health Care 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other Private Revenues 11 12 13 14 16 19 22 23 26 3