Health Care Spending Highly Concentrated Among a Small Group of People Interview with:

Emily Mitchell, Ph.D., Statistician Agency for Healthcare Research and Quality

Emily Mitchell,

Emily Mitchell, Ph.D., Statistician
Agency for Healthcare Research and Quality What is the background for this study?

Response: The data for this study come from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC), a nationally representative survey that is conducted annually by the Agency for Healthcare Research and Quality (AHRQ). The survey collects detailed information on health care utilization and expenditures, health insurance, and health status, as well as a wide variety of social, demographic, and economic characteristics for the U.S. civilian non-institutionalized population. What are the main findings?

Response: This study used data from MEPS to explore the concentration of expenditures among the U.S. civilian non-institutionalized population in 2014. The main findings of this study are that the top 5 percent of persons ranked by their health care expenditures accounted for over half of total health care expenditures in the U.S. in 2014. Conversely, the bottom 50 percent accounted for only 2.8 percent of expenditures. What should readers take away from your report?

Response: Health care spending in the U.S. is highly concentrated among a small group of people. Older adults (45+) and adults with public insurance tend to have higher healthcare expenditures on average. Expenditures among uninsured adults are lowest on average; nearly half of this group had no expenditures in 2014. What recommendations do you have for future research as a result of this study?

Response: Future research could include considering the impact of various health conditions on the concentration of expenditures, or comparing the degree of concentration in the U.S. versus other countries that have different populations and health care systems. Is there anything else you would like to add?

Response: While this study was conducted on data obtained during 2014, similar studies from previous years suggest that this characteristic of highly concentrated expenditures has been a persistent characteristic of health care expenditures in the U.S. Thank you for your contribution to the community.


Mitchell E. Concentration of Health Expenditures in the U.S. Noninstitutionalized Population, 2014. Statistical Brief #497. November 2016. Agency for Healthcare Research and Quality, Rockville, MD.

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on December 2, 2016 by Marie Benz MD FAAD