In fiscal year 2022, Medicaid spent 8,813 U.S. dollars per full-year equivalent enrollee. However, spending per enrollee varied by state with North Dakota spending the most per enrollee at 13,001 U.S. dollars, while in South Carolina each Medicaid enrollee cost 5,199 U.S. dollars. This statistic illustrates Medicaid benefit spending per full-year equivalent (FYE) enrollee in the United States in FY 2022, by state.

2023 saw the largest expenditures on Medicaid in U.S. history. At that time about 894 billion U.S. dollars were expended on the Medicaid public health insurance program that aims to provide affordable health care options to low income residents and people with disabilities. Medicaid was signed into law in 1965. By 1975 around 13 billion U.S. dollars were spent on the program. Groups covered by Medicaid There are several components of the Medicaid health insurance program. The Children’s Health Insurance Program (CHIP) was started in 1997 to provide health coverage to families and children that could not afford care. As of 2021, children represented the largest distribution of Medicaid enrollees. Despite having the largest proportion of enrollees, those that were enrolled in Medicaid as children had the lowest spending per enrollee. As of 2021, disabled Medicaid enrollees had the highest spending per enrollee. Medicaid expenditures Currently, Medicaid accounts for 19 percent of all health care expenditure in the United States. Expenditures on Medicaid programs vary among the U.S. states and depend heavily on whether Medicaid expansion was accepted after the Affordable Care Act was enacted. California and New York are the top states with the highest Medicaid expenditures. It is projected that Medicaid expenditure will continue to increase at both the state and federal levels.

In 2023, Medicaid spending on Novo Nordisk's blockbuster drug Ozempic stood at around ***** U.S. dollars per beneficiary. This statistic illustrates Medicaid spending per beneficiary on top drugs in the United States in 2023.

The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare patient treated in a specific hospital in Utah, compared to how much Medicare spends per patient nationally. This measure includes any Medicare Part A and Part B payments made for services provided to a patient during the 3 days prior to the hospital stay, during the stay, and during the 30 days after discharge from the hospital.

In fiscal year 2021, Medicaid spent 8,651 U.S. dollars per full-year equivalent enrollee. However, spending per enrollee varied by eligibility group with disabled enrollees costing the most per enrollee at 23,935 U.S. dollars. States also show large variations in Medicaid spending per enrollee. This statistic illustrates Medicaid benefit spending per full-year equivalent (FYE) enrollee in the United States in FY 2021, by eligibility group.

The Medicare Part B by Drug dataset presents information on spending for drugs administered in doctors’ offices and other outpatient settings by physicians and other healthcare providers to Medicare Part B enrollees. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes consumer-friendly descriptions of the drug uses, clinical indications, and manufacturer(s). Drug spending metrics for Part B drugs represent the full value of the product, including the Medicare payment and beneficiary liability. All Part B drug spending metrics are calculated at the HCPCS level.

The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves. The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications. Drug spending metrics for Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

Also known as Medicare Spending per Beneficiary (MSPB) Spending Breakdowns by Claim Type file. The data displayed here show average spending levels during hospitals’ Medicare Spending per Beneficiary (MSPB) episodes. An MSPB episode includes all Medicare Part A and Part B claims paid during the period from 3 days prior to a hospital admission through 30 days after discharge. These average Medicare payment amounts have been price-standardized to remove the effect of geographic payment differences and add-on payments for indirect medical education (IME) and disproportionate share hospitals (DSH). CMS uses the information on this webpage to calculate a hospital’s MSPB Measure value, which is reported on Hospital Compare. Specifically, the MSPB Measure methodology risk-adjusts the values on this webpage to account for beneficiary age and severity of illness. This data set provides the pre-risk-adjusted values to help the public understand the MSPB Measure and its composition.

In 2020, Medicaid spending per female enrollee amounted to ***** U.S. dollars, and for per male enrollee, it amounted to approximately eight thousand U.S. dollars. Medicaid per-person spending on males was higher than that on females during the provided time interval. This statistic displays Medicaid per enrollee spending in the U.S. from 2002 to 2020, by gender.

This dataset contains counts for Medicaid recipients served by month in Iowa, starting with month ending 1/31/2011.

Eligibility groups are a category of people who meet certain common eligibility requirements. Some Medicaid eligibility groups cover additional services, such as nursing facility care and care received in the home. Others have higher income and resource limits, charge a premium, only pay the Medicare premium or cover only expenses also paid by Medicare, or require the recipient to pay a specific dollar amount of their medical expenses. Eligible Medicaid recipients may be considered medically needy if their medical costs are so high that they use up most of their income. Those considered medically needy are responsible for paying some of their medical expenses. This is called meeting a spend down. Then Medicaid would start to pay for the rest. Think of the spend down like a deductible that people pay as part of a private insurance plan.

The CMS Data Compendium provides key statistics about CMS programs and national health expenditures. The CMS Data Compendium contains historic, current, and projected data on Medicare enrollment and Medicaid recipients, expenditures, and utilization. Data pertaining to budget, administrative and operating costs, individual income, financing, and health care providers and suppliers are also included. National health expenditure data not specific to the Medicare or Medicaid programs are also included. The CMS report was published annually in electronic form and is available for each year from 2002 through 2011. The 2011 version is the last version of this publication. Similar information is available in the Medicare and Medicaid Statistical Supplement and the CMS Statistics, which are both published annually.

The CMS Data Compendium provides key statistics about CMS programs and national health expenditures. The CMS Data Compendium contains historic, current, and projected data on Medicare enrollment and Medicaid recipients, expenditures, and utilization. Data pertaining to budget, administrative and operating costs, individual income, financing, and health care providers and suppliers are also included. National health expenditure data not specific to the Medicare or Medicaid programs are also included. The CMS report was published annually in electronic form and is available for each year from 2002 through 2011. The 2011 version is the last version of this publication. Similar information is available in the Medicare and Medicaid Statistical Supplement and the CMS Statistics, which are both published annually.

Children accounted for 36.5 percent of Medicaid enrollees in 2021, which was the largest share of all enrollment groups. The elderly and persons with disabilities had the smallest shares, but together they accounted for more than half of all Medicaid expenditure.

Medicaid expenditures per enrollee Medicaid is a joint federal and state health care program in the United States. The program provides medical coverage to millions of Americans and supports a variety of enrollment groups, particularly senior citizens and individuals with disabilities. Medicaid per enrollee spending is significantly higher for these two groups because they require more frequent and costly long-term care in the community and nursing homes. In 2022 of the total U.S. health expenditure on home health care, Medicaid paid one-third.

Millions of Americans are uninsured The United States has a multi-payer health care system, meaning that some Americans will be covered by private health insurance, and others will be covered by a government program such as Medicaid. However, approximately 27.6 million people in the U.S. had no health insurance in 2021, and should they require health care, they would have to pay the full price out of their own pocket. This becomes a real problem for many because the United States has the most expensive health care system in the world.

Medicaid continues to provide comprehensive long-term care in the United States. In 2022, the program was estimated to have paid for 34.2 percent of all home health care and nearly 30 percent of nursing home care. In addition, Medicaid covered over 58 percent of other health, residential, and personal care, which includes payments for intermediate care facilities and other home- and community-based services.

Health care spending in the U.S. Medicaid expenditure accounted for around 16 percent of all U.S. health expenditures in 2021. Overall, health spending in the United States totaled 4.1 trillion U.S. dollars in 2020 – hospital care continues to be the largest spending category. Around 1.3 trillion U.S. dollars was spent on hospital care in 2020, and expenditures are projected to continue on an upward trajectory.

The high price of hospital care Medicare and Medicaid spend significant amounts of money on national health services, and for both programs, hospital care is the largest expense category. Hospital care spending by both Medicare and Medicaid grew by around 20 percent between 2013 and 2019. During the same period, private health insurance spending in this service category accelerated, rising by approximately 90 billion U.S. dollars.

BackgroundPrevious research used data through 2008 to estimate a model for the effect of the California Tobacco Control Program (CTCP) that used cumulative real per capita tobacco control expenditure to predict smoking behavior (current adult smoking prevalence and mean cigarette consumption per current smoker). Predicted changes in smoking behavior due to the CTCP were used to predict its effect on health care expenditure. This research updates the model using the most recently available data and estimates CTCP program effect through 2019.MethodsThe data used in the previous research were updated, and the original model specification and a related predictive forecast model were re-estimated. The updated regression estimates were compared to those previously published and used to update estimates of CTCP program effect in 2019 dollars.ResultsThere was no evidence of structural change in the previously estimated model. The estimated effect of the CTCP program expenditures on adult current smoking prevalence and mean consumption per adult current smoker has remained stable over time. Over the life of the program, one additional dollar per capita of program expenditure was associated with a reduction of current adult smoking prevalence by about 0.05 percentage point and mean annual consumption per adult current smoker by about 2 packs. Using updated estimates, the program prevented 9.45 (SE 1.04) million person-years of smoking and cumulative consumption of 15.7 (SE 3.04) billion packs of cigarettes from 1989 to 2019. The program produced cumulative savings in real healthcare expenditure of $544 (SE $82) billion using the National Income and Product Accounts (NIPA), and $816 (SE $121) billion using the Center for Medicare and Medicaid Services (CMS) measure of medical costs. During this time, the CTCP expenditure was $3.5 billion.ConclusionA simple predictive model of the effectiveness of the CTCP program remained stable and retains its predictive performance out-of-sample. The updated estimates of program effect suggest that CTCP program has retained its effectiveness over its 31-year life and produced a return on investment of 231 to 1 in direct CMS medical expenditure.

This profile shows a summary of recipients, paid claims, and claim dollars spent for services reimbursed by Medicaid Fee for Service billing as well as Medicaid Managed Care Plans (beginning with SFY 2016-2017) for chemical dependence and non-chemical dependence services received per state fiscal year.

Estimated California smoking prevalence, cigarettes per capita, and per capita healthcare expenditure.

In the fiscal year 2022, Medicaid expenditure in California amounted to a total of about 119 billion U.S. dollars, of which 81 billion U.S. dollars were federal-funded and approximately 38 billion U.S. dollars were state-funded. California had, as expected, the highest spending and also the largest number of people enrolled in Medicaid in the United States. The Federal Medical Assistance Percentage (FMAP) varies by state depending on the state's per capita income compared to the national average.

A list of hospitals participating in the Hospital VBP Program and their performance ratios and scores for the Efficiency Medicare Spending per Beneficiary (MSPB) measure.

In 2023, just four in ten Medicaid/CHIP enrollees were White, non-Hispanic. In comparison, roughly three-quarters of Medicare beneficiaries were White. The Affordable Care Act (ACA) Medicaid expansion in 2014, has helped reduce racial disparities in access to healthcare in the United States. Medicaid eligibility Medicaid provides health coverage to certain low-income individuals, families, children, pregnant women, the elderly, and persons with disabilities. Each state has its own Medicaid eligibility criteria in accordance with federal guidelines. As a result, Medicaid eligibility and benefits differ widely from state to state. Medicaid expansion provision under the Affordable Care Act (ACA) allows states to provide coverage for low-income adults by expanding eligibility for Medicaid to 138 percent of the federal poverty line (FPL). Medicaid coverage gap Uninsured individuals who live in states that have chosen not to expand Medicaid under the Affordable Care Act (ACA) are referred to as being in the Medicaid coverage gap. As of January 2021, 12 states have not adopted the Medicaid expansion provision under the Affordable Care Act (ACA). More than two million uninsured adults fall into this coverage gap, and among them, more than 60 percent are people of color.