In 2009, 1% of the nation's civilian population required healthcare spending that was slightly greater than in 2008, an increase from 20.2% to 21.8% of $1.26 trillion in treatment dollars, according to the latest Statistical Brief from the federal Agency for Healthcare Research and Quality.
That indicates that more than $1 in every $5 healthcare dollars went to treat one out of every 100 people. The annual mean expenditure was $90,061 for those in that 1%.
But over time, there has been "some decrease in this concentration at the upper tail of the expenditure distribution," according to AHRQ research experts, Steven B. Cohen and William Yu. In the 1996 version of this report, 1% of the population accounted for 28% of the total healthcare expenditures.
The periodic brief captures trend information that helps planners identify the biggest drivers of healthcare costs "and the characteristics of the individuals who incur them," the brief says.
The top 5% accounted for half of all healthcare expenditures, indicating that focusing on that segment may yield the biggest savings. On the other hand, according to the report, the bottom 50% of the U.S. population, those requiring the lowest amounts of healthcare spending, accounted for only 2.9% of healthcare dollars in 2009 and 3.1% in 2008. And those in the top 50% of the population accounted for 97% of all healthcare expenditures.
Among the brief's other findings:
Coverage Status May Influence Spending
In the under-age-65 population, health insurance coverage status seemed to influence spending. Individuals who were uninsured for all of 2009 were disproportionately represented among the population that remained in the lower half of health care spending.
While 15.5% of the overall population under age 65 was uninsured, the uninsured comprised 25.9% of all individuals in the bottom half of spenders. But only 3.6% of those under age 65 in the top 10% of spending were uninsured.
Older People Spend More
Not surprisingly, older people were more likely to be in categories of high healthcare spending, disproportionate to their percentages. For example, while 13.2% of the people in the nation were 65 or older in 2008 and 2009, 42.9% of those in the 10% percent of healthcare expenditures were 65 or older. Likewise, people age 45-64 made up 26.2% of the U.S. population, but 40.1% of those in the top decile of healthcare spending were in that age bracket.