Trends in State Health Care Expenditures and Funding: 1980-1998

By Martin, Anne B.; Whittle, Lekha S. et al. | Health Care Financing Review, Summer 2001 | Go to article overview

Trends in State Health Care Expenditures and Funding: 1980-1998


Martin, Anne B., Whittle, Lekha S., Levit, Katharine R., Health Care Financing Review


INTRODUCTION

State health expenditure accounts (SHEA) are measures of personal spending for health care services and products by the State in which providers are located. Levels of spending, growth in spending over time, and the mix of services purchased with the health care dollar vary considerably among States and regions. The SHEA allow researchers and State and Federal policymakers to track broad historical trends in unique State health care systems, evaluate the effects of historical policy decisions on the delivery of health care services, and envision and model possible effects of future policy proposals (Long, Marquis, and Rodgers, 1999).

The SHEA follow the definitions and draw on many of the data sources used in producing national health expenditures (NHE), although SHEA are more limited than the NHE in that they include only personal health care (PHC) expenditures (refer to the Definitions and Methodology section). Expenditures for PHC include spending for hospital care, physician services, dentist services, other health professional services, home health care, nursing home care, and health care products purchased in retail outlets (such as prescription drugs or over-the-counter medicines sold in pharmacies and grocery stores, and eyeglasses sold in optical goods stores). Included in NHE, but not SHEA, are estimates of spending for public health programs, administration, research, and construction of health facilities.

In this article, we present the latest SHEA for calendar years 1980-1998 and update previously published estimates that contained data through 1993 only (Levit et al., 1995). Estimates by type of service and by Medicare and Medicaid are presented, as well as highlights of State-level variations in health care spending and financing. All State health expenditure estimates can be found at http://cms.hhs.gov/stats/ nhe-oact/stateestimates.

STATE EFFORTS TO MEASURE HEALTH SPENDING

At least 13 States (Alaska, Colorado, Delaware, Florida, Kansas, Maryland, Minnesota, New Mexico, New York, Oregon, Washington, Wisconsin, and Vermont) have created current and/or historical measures of health spending.

Several States have enacted legislation requiring State agencies to produce health spending reports for policymaking, and some have authorized data collection to provide source data for this activity. (Legislatures in the States of Florida, Maryland, Minnesota, and Vermont require regular reporting on State health expenditures. Maryland and Minnesota both enacted legislation requiring providers and/or health plans to report financial information.) Some States have initiated efforts to track health spending in an attempt to create policies to reign in the fast spending growth in their health care markets (Alaska State Legislature, 1993; Blewett et al., 1999). Other States noted reasons such as a desire to understand and analyze their own health care industry (Colorado Department of Health Care Policy and Financing, 1998), improve access to care for State residents (Ratledge and Mrozinski, 1998), improve health care budget forecasts (Insurance, Securities and Health Care Administration, 1999), and gain insight into the provision of care for special population groups (Agency for Health Care Administration, 1999).

For State policymakers, these individual State reports hold certain advantages over CMS's uniformly produced State estimates in that the State reports frequently present more detailed estimates of health spending designed to meet specific health policy needs of individual States (State of New York Department of Health, 1995; Washington State Office of Financial Management, 1997; Reynis, 1998; State of Maryland Health Care Access and Cost Commission, 1998). Most States, however, face severe resource and data constraints and lack staffing continuity, making it difficult to produce and maintain their own health spending accounts (Long, Marquis, and Rodgers, 1999).

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Trends in State Health Care Expenditures and Funding: 1980-1998
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.