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Expenditures by Type of Payer

Dashboard Overview

Cumulative growth in per enrolled person spending by private insurance, Medicare, and Medicaid, 2008-2021
On a per enrollee basis, private insurance spending has typically grown much faster than Medicare and Medicaid spending
  • Per enrollee spending by private insurance grew by 54.1% from 2008 to 2021 — much faster than both Medicare and Medicaid spending growth per enrollee (36.9% and 18.9%, respectively). Generally speaking, private insurance pays higher prices for healthcare than Medicare and Medicaid.

Source: KFF analysis of National Health Expenditure (NHE) data

Average annual growth rate of spending per enrolled person in private insurance, Medicare, and Medicaid
Per enrollee spending varied in 2021 after decades of growth for all major payers
  • On a per enrollee basis, the average annual growth of Medicare spending was similar to that of private insurance over the course of the 1990s and 2000s. Average annual spending growth per enrollee in Medicaid was similar to growth for Medicare and private insurance in the 1990s but slowed in the 2000s while spending growth accelerated for the other major payers. After a decade of slower growth for all major payers in the 2010s, per enrollee spending increased for Medicare and private insurance and decreased for Medicaid between 2020 and 2021.

Source: KFF analysis of National Health Expenditure (NHE) data

Net cost of health insurance and goverment administration, as a share of total health expenditures, 1970-2021
Health insurance and administrative costs have been increasing for several decades
  • In 2021, administrative expenses – which include the cost of administering private insurance plans and public coverage programs but not the administrative costs of health providers – represented 7.2% of total national health expenditures, up from 3.5% in 1970, and down from 8.3% in 2020.

Source: KFF analysis of National Health Expenditure (NHE) data

Total national health expenditures, US $ Trillions, 1987-2021
Public spending on health nearly matched private spending in 2021
  • Public and private health spending have both grown substantially in the past few decades. In 1987, public sector spending accounted for just under one third (32%) of total health spending. Public spending in 2021 represented just under half (49%) of overall spending after briefly exceeding private spending the previous year. Public sector spending includes spending on insurance programs, such as Medicare and Medicaid, as well as other government spending, such as spending on public health and research.

Source: KFF analysis of National Health Expenditure (NHE) data

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