State-Level Health Care Expenditures Associated With Disability

Area of Science:

• Health Economics
• Public Health Policy
• Disability Studies

Background:

• National disability-associated health care expenditures (DAHE) are growing.
• There are shifts in the distribution of DAHE across different health insurance types.
• Updated state-level DAHE estimates are essential for informed policy and resource allocation.

Purpose of the Study:

• To provide updated state-level estimates of disability-associated health care expenditures (DAHE).
• To analyze the changes in DAHE from 2003 to 2015.
• To examine DAHE per person with a disability (PWD) across different states and insurance types.

Main Methods:

• Utilized data from the Medical Expenditure Panel Survey (2013-2015), Behavioral Risk Factor Surveillance System (2013-2015), and National Health Expenditure Accounts (2014).
• Calculated state-level DAHE for all US adults, per adult, and per person with a disability (PWD).
• Adjusted all expenditures to 2017 prices and assessed trends from 2003 to 2015.

Main Results:

• In 2015, national DAHE totaled $868 billion, representing 36% of total health care expenditures, with significant state variations.
• Total DAHE increased by 65% between 2003 and 2015.
• DAHE per PWD in 2015 ranged from $12,603 (Alabama) to $27,839 (District of Columbia), with substantial variation across Medicare, Medicaid, and nonpublic insurers.

Conclusions:

• Disability-associated health care expenditures are substantial and exhibit considerable state-level disparities.
• The public sector plays a significant role in financing the health care costs for individuals with disabilities.
• These updated state-level DAHE estimates can guide policymakers in developing effective public health programs for people with disabilities.