BenchmarksSpending and Utilization Benchmarks

State Health Spending and Utilization Benchmarks

Price

$5,000

Years

2018, 2019, 2020, 2021, 2022

Geography

State

Included

  • State Health Spending and Utilization Benchmarks – Years 2018-2022 Data (.csv)

  • State Health Spending and Utilization Benchmarks by Age Band and Sex – Years 2018-2022 Data (.csv)

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

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

Description

State estimates of health care spending, utilization, and prices from 2018 to 2022 by health care service category, broken out by age band and by sex, for the ESI population younger than 65 in each state. Estimates are weighted by geography, age, and sex to be representative of each state’s ESI population. *Reference the Data Dictionary for a complete list of states represented in the dataset.

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 this data is 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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