BenchmarksSpending and Utilization Benchmarks

National Health Spending and Utilization Benchmarks

Price

FREE

Years

2018, 2019, 2020, 2021, 2022

Geography

National

Included

  • National Health Spending and Utilization Benchmarks – Years 2018–2022 (.csv)

  • Health Spending and Utilization Benchmarks Data Dictionary (.xlsx)

  • Data Reference Guide: Measures, Methodology & End User License Agreement (PDF)

Description

National estimates of health care spending, utilization, and prices from 2018 to 2022 by health care service category, for the U.S. population younger than 65 with employer-sponsored insurance (ESI). This free introductory dataset reports national benchmarks by service category, weighted by geography, age, and sex to represent the full ESI population.

Data Dictionary

Measures

  • Total expenditures per person on medical and prescription drug claims (defined as the sum of payer paid and patient out-of-pocket amounts. The prescription drug component reflects point-of-sale expenditures and excludes manufacturer rebates provided through separate transactions, as these data are not readily available at the transaction level.

  • Total payments per person paid by patients for health care services (defined as the sum of deductibles, co-payments, and co-insurance amounts).

  • The volume of services used per 1,000 people is measured as inpatient admissions, outpatient facility procedures, professional services, and days covered by a filled prescription.

  • Spending per service (admissions, visits, procedures, or days supplied, depending on the service category). Spending and utilization were aggregated across all services in a category. The average price per service in a category was then calculated by dividing total spending by total utilization.

  • Out-of-pocket spending per service (admissions, visits, procedures, or days supplied, depending on the service category). Out-of-pocket spending and utilization were aggregated across all services in a category. The average out-of-pocket price per service in a category was then calculated by dividing total out-of-pocket spending by total utilization.

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