Spending on care in nursing facilities and continuing care retirement communities (CCRCs) totaled $155.8 billion in 2013, according to data released this afternoon by the Centers for Medicare & Medicaid Services (CMS). The data on national health expenditures are detailed in an article forthcoming in the January issue of Health Affairs that is available online now.
Spending for nursing and CCRC care increased by 2.4 percent in 2013, compared with 2.0 percent in 2012, according to the latest calculations from the CMS Office of the Actuary. Medicare spending, which represents about 20 percent of total nursing care and CCRC spending, increased 2.2 percent in 2013, said Aaron Catlin, deputy director of the office’s National Health Statistics Group, during a conference call with the press. This increase follows a decline of 5.2 percent in 2012, he added.
Spending on home healthcare was $79.8 billion in 2013, according to the CMS report. Home healthcare spending growth slowed last year, when the rate was 3.4 percent; the rate in 2012 was 4.5 percent.
Overall spending on healthcare in the United States grew at historically low levels from 2009 to 2013, according to the CMS data. Overall healthcare spending growth increased 3.6 percent in 2013, totaling about $2.9 trillion, or $9,255 per person.
From 2010 to 2013, growth in healthcare spending mirrored the overall economy and has represented 17.4 percent of the gross domestic product, Micah Hartman, a statistician in the Office of the Actuary, told members of the press on the conference call. “The 0.5 percentage point slowdown in overall spending growth, from 4.1 percent [in 2012] to 3.6 percent growth in 2013, was due to the slower annual trends for private health insurance, Medicare and investment in structures and medical equipment, as well as from slower growth in spending for hospital care and for physician and clinical services,” he added.
The Affordable Care Act (ACA) played a role in some trends, Hartman said, adding, however, that the act’s “most prominent provisions” were implemented in 2014 and therefore are not reflected in the data released today. CMS expects to release a report that includes those data next year, he said.
One area affected by the ACA, however, was Medicare spending growth, which was 3.4 percent in 2013, down from 4.0 percent in the previous year. “The ACA affected Medicare spending through lower fee-for-service payment updates and adjustments in Medicare Advantage benchmark payment rates,” the report authors stated. The federal budget sequestration also contributed to the deceleration, they said.
Medicare spending, at $585.7 billion, accounted for 20 percent of national health spending in 2013, according to the report.
Medicaid spending accounted for 15 percent of all health expenditures last year, when federal, state and local Medicaid spending totaled $449.4 billion, according to the report. Medicaid spending increased 6.1 percent in 2013 compared with spending growth increases of 2.5 and 4.0 percent in 2011 and 2012, respectively, the report authors noted.
In the “other health, residential and personal care” category (which includes school health, worksite health, Medicaid home- and community-based care waivers, ambulance services, residential mental health and substance abuse facilities), spending growth increased at the same rate in 2013 as in 2012, 5.8 percent, Catlin said.