AHRQ Stats

Nearly 7.2 percent of the population (22.5 million) paid $2,000 or more in out-of-pocket medical expenses in 2012, compared with 6.9 percent (21.5 million) in 2011. In both 2011 and 2012, nearly 1.5 percent (4.8 million) of Americans paid $5,000 or more, and 0.4 percent (1.3 million) paid at least $10,000. (Source: Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey Statistical Brief #450,Differentials in the Concentration in Out-of-Pocket Health Expenditures across Population Subgroups in the U.S., 2012, and Statistical Brief #423, Differentials in the Concentration in the Level of Out-of-Pocket Health Expenditures across Population Subgroups in the U.S., 2011.)

STATISTICAL BRIEF #450:
Differentials in the Concentration in Out-of-Pocket Health Expenditures across Population Subgroups in the U.S., 2012

September 2014

Steven B. Cohen, PhD

Highlights

In 2012, the top 1 percent ranked by their out-of-pocket health care expenses accounted for 20.5 percent of total out-of-pocket health care expenditures with an annual mean out-of-pocket expenditure of $12,500. Overall, the top 50 percent of the population ranked by their out-of-pocket expenditures accounted for 97.8 percent of overall out-of-pocket health care expenditures while the lower 50 percent accounted for only 2.2 percent of the total.
In 2012, 7.2 percent of the population (22.5 million individuals) had out-of-pocket expenditures for medical care that were equal to or greater than $2,000. Nearly 4.8 million individuals (1.5 percent) paid $5,000 or more out of pocket for their medical care. When considering higher spending thresholds, approximately 1.3 million individuals (0.4 percent) incurred out-of-pocket expenditures of at least $10,000.
In 2012, only 3.9 percent of medical expenditures for inpatient hospitalizations were paid out of pocket. Alternatively, 12.3 percent of ambulatory care expenditures, 19.2 percent of prescribed medical expenditures, and 48.5 percent of dental expenditures were paid out of pocket.
Children under the age of 18 were characterized by substantially greater concentrated levels of out-of-pocket health care spending relative to their older counterparts. Alternatively, the elderly had the highest mean levels of out-of-pocket health care expenditures relative to younger population subgroups at the top quantiles of the expenditure distribution.
Non-Hispanic whites and other races had the highest mean levels of out-of-pocket health care expenditures at the top quantiles compared with other racial/ethnic groups.
The top 5 percent of the publicly insured population under age 65 ranked by their health care expenses accounted for 68.1 percent of the out-of-pocket health care expenditures incurred by this subpopulation with an annual mean of $2,682. Individuals with public insurance had the most concentrated levels of out-of-pocket health care expenditures and the lowest annual mean out-of-pocket expenses.