5% of patients account for half of health care spending

By Kelly Kennedy, USA TODAY

WASHINGTON – Just 1% of Americans accounted for 22% of health care costs in 2009, according to a federal report released Wednesday.

That's about $90,000 per person, according to the Agency for Healthcare Research and Quality. U.S. residents spent $1.26 trillion that year on health care.

Five percent accounted for 50% of health care costs, about $36,000 each, the report said.

The report's findings can be used to predict which consumers are most likely to drive up health care costs and determine the best ways to save money, said Steven Cohen, the report's lead author.

While the report showed how a tiny segment of the population can drive health care spending, the findings included good news. In 1996, the top 1% of the population accounted for 28% of health care spending.

"The actual concentration has dropped," Cohen said. "That's a big change."

About one in five health care consumers remained in the top 1% of spenders for at least two consecutive years, the report showed. They tended to be white, non-

Hispanic women in poor health; the elderly; and users of publicly funded health care.

The report also showed these characteristics of patients in the top 10% of health care spenders in 2008 and 2009:

•Sixty percent were women
•Forty percent were 65 or older.
•Only 3% were ages 18 to 29.
•Eighty percent were white.
•Only 2% were Asian.

The study also found that Hispanics, 16% of the population in 2009, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, the report showed, while only 7% of Hispanics were in the top 10% of spenders.

Next, Cohen plans to look at whether cost-cutting measures make a difference.

Beginning in October 2012, the government has told hospitals with Medicare patients that it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released. Cohen said he'll look at whether that will change the spending averages for people in the top health care cost brackets.