5 percent of patients account for nearly half of U.S. healthcare spending

Five percent of patients account for nearly half of U.S. healthcare spending, according to a new report by the Agency for Healthcare Research and Quality.

In the report, "The Concentration and Persistence in the Level of Health Expenditures over Time: Estimates for the U.S. Population, 2008-2009," authors Stephen B. Cohen, PhD, and William Yu, stated that "in both 2008 and 2009, five percent of the population accounted for nearly 50 percent of healthcare expenditures, with a mean expenditure of nearly $36,000."

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Other key study findings include:

• The bottom half of the expenditure distribution accounted for 3.1 percent of spending in 2008; about three out of four individuals in the bottom 50 percent retained this ranking in 2009.
• Those who were in the top decile of spenders in both 2008 and 2009 differed by age, race/ethnicity, sex, health status and insurance coverage (for those under 65) from those who were in the lower half in both years.
• Those in the bottom half of healthcare spenders were more likely to report excellent health status, while those in the top decile of spenders were more likely to be in fair or poor health relative to the overall population.
• While 15.5 percent of persons under age 65 were uninsured for all of 2009, the full-year uninsured comprised 25.9 percent of those in the bottom half of spenders for both 2008 and 2009. Only 3.6 percent of those under age 65 who remained in the top decile of spenders in both years were uninsured for all of 2009.
• Relative to the overall population, those who remained in the top decile of spenders were more likely to be in fair or poor health, elderly, female, non-Hispanic whites and those with public-only coverage. Those who remained in the bottom half of spenders were more likely to be in excellent health, children and young adults, men, Hispanics and the uninsured.
• In both 2008 and 2009, the top 30 percent of the population accounted for nearly 89 percent of healthcare expenditures.

Follow HFN editor René Letourneau on Twitter @ReneLetourneau.