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Study to Estimate US State Health Spending Finds Immense Difference Between States that Spend Most, Least

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A first ever study to estimate US state health spending for 2015-2019 found that the difference between the states that spend the most and the least on health is immense and growing. The study, published in Health Affairs, combined data from the government’s State Health Expenditure Accounts, which have estimates through 2014, with other primary data on spending, to estimate health spending by state and payer.

In 2019 state-specific per person spending ranged from $7,250 to $14,500. After adjustment for inflation, annualized per person spending growth for each state ranged from 1.0 percent in Washington, D.C., to 4.2 percent in South Dakota between 2013 and 2019. The factors that explained the most variation across states were incomes (25.3 percent) and consumer prices (21.7 percent). Medicaid expansion was associated with increases in total spending per person, although the median of spending in expansion states showed slower growth in out-of-pocket spending than the median in nonexpansion states.

The study found that, in 2019, the state with the lowest modeled spending per person spent half as much per person as the state with the highest spending.

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