In 2019, Clackamas and Deschutes counties had the highest average health care spending in Oregon, at over $7,900 per person. Populations that are proactive in seeking medical attention when they feel ill and have the funds or insurance to do so are probably represented in the spending.
This is in line with a recent report on health care spending in the United States that was published last week by researchers at the Institute for Health Metrics and Evaluation at the University of Washington. Between 2010 and 2019, the study, which was published in the Journal of the American Medical Association, examined data from more than 3,000 U.S. counties, counting differences in spending and the types of individuals who were accessible from coast to coast.
The study, which they claim is the most thorough analysis of U.S. health care spending, examined 1 billion facility records and over 40 billion insurance claims from Medicare, Medicaid, and commercial health plans to track payments for 148 medical conditions.
Consumers are currently struggling with rising medical expenses as a result of the UW study. According to a recent analysis by consulting firm PwC, consumers will experience the largest increase in health care expenditures in 13 years this year.
According to a survey from the University of Washington, Oregon spent $30.3 billion on healthcare in 2019, which is almost $7 billion more than it did in 2010.
Spending from government programs, insurance, and patients is included in the total.
Health care spending in Oregon increased by 22% annually, from $5,888 in 2010 to $7,205 in 2019. During the same time period, this growth exceeded the 16% national growth rate. But even with the quicker growth, Oregon’s per capita health care spending was remained below the national average in terms of dollars.
Health care spending varies across Oregon counties
At the county level, the study found notable differences in health care spending. People in some Oregon counties spend significantly more than others, even after controlling for variables like age and health.
According to academics, this implies that variations in health care costs may result from a variety of factors, including access to care, local price, and the frequency of health service use, in addition to demographics that are older or more ill.
More people taking charge of their health and seeking medical attention were probably found in the counties with the highest per capita health care spending.
In terms of ambulatory care visits—which include urgent care, outpatient specialty treatments, primary care, and rehabilitation programs—Clackamas and Deschutes counties, for example, lead the state. These counties had the highest per capita spending on physician and outpatient services in 2019, in addition to having the highest rates of medical visits.
The counties with the lowest health care spending per capita in 2019 were Wheeler and Umatilla, with $5,455 and $5,959, respectively.
Neither is one of the wealthiest areas of Oregon. Wheeler County has one of the oldest populations in Oregon, with a median age of 59, and the third-poorest county in the state with a typical household income of $40,926. In spite of this, Wheeler County inhabitants went to the doctor less frequently than people in any other county in 2019.
In contrast, the typical household income in Umatilla County is $56,700, which is less than the statewide norm of $62,818. Being one of the youngest counties in Oregon, with a median age of 36.5 years, Umatilla’s population may have utilized fewer health care services overall.
According to Dr. Joseph Dieleman, an associate professor at the University of Washington and the study’s principal author, there isn’t necessarily a fundamental issue in Oregon just because some counties spend more than others in the state. According to him, there are several explanations for why health care costs are higher in some counties than in others.
The cost of living is a significant factor. According to Dieleman, health care services are typically more costly in places with higher average living costs. He stated that expenditure trends are influenced by a county’s population’s age and general health.
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Dieleman and his associates also discovered that counties with older populations typically need more medical care, and that regions with higher chronic sickness rates also typically spend more on health care.
He went on to say, “We know we spend more on older populations and less on younger populations in some places with older populations.” Last but not least, certain locations are sicker than others. Therefore, the prevalence of the condition can account for some of the difference.
However, use was the main cause of the differences in health costs. Even when their populations are not appreciably older or sicker than others, some counties have greater rates of hospital stays and doctor visits, according to Dieleman. He pointed out that rather than variations in treatment prices, age, or disease prevalence, over 65% of the study’s spending variation was related to how frequently participants sought medical attention.
According to Dieleman, this indicates that people are visiting doctors for illnesses far more frequently than they would be otherwise. Alternatively, people are seeking more intensive treatments at the hospital or visiting the emergency room rather than visiting an outpatient clinic or primary care physician.
According to the survey, a large portion of the disparity in health spending can be ascribed to the frequency of visits to urgent care centers, doctor’s offices, and other outpatient clinical settings. Prescription medications and doctor visits or outpatient clinical services were also more expensive in the counties with the greatest overall spending, such as Clackamas, Deschutes, and Lane counties.
Health spending by payer
The study also looked at how expenditure disparities throughout Oregon are influenced by various forms of health insurance.
Clackamas County has the greatest out-of-pocket expenses per person and the highest private insurance spending per patient in the state. The highest Medicaid spending per beneficiary was $7,357 in Union County, while the highest Medicare spending per beneficiary was in Deschutes County.
Spending habits are significantly influenced by insurance coverage. According to the study, health care services were utilized more frequently in counties with higher incomes and higher rates of private insurance enrollment.
Are health care dollars going where they re needed?
Whether more investment results in better health outcomes is a crucial point that the study did not address.
Medical treatments and doctor visits were more common in some high-spending regions. However, the study did not look at whether people’ health outcomes are improved by more spending and more frequent medical visits.
The survey also looked at the health issues that cost the most money.
According to data, the state’s highest spending was driven by oral conditions like cavities and misaligned teeth. However, there were notable differences in the amount spent on dental care around the state.
For instance, Multnomah County spent $694 per person on dental treatment, the most in Oregon. This was almost four times more than the $175 per person spent in Gilliam and Sherman counties.
According to Dieleman, counties with higher dental insurance rates and easier access to dentists typically spend more on oral health care.
Because many people lack dental insurance, it’s really fascinating that over half of the money spent on dental offices’ oral care and treatments is paid for out of pocket, he said. The fact that people are effectively spending money to pay for that makes it a huge concern, because it directly affects people’s household budgets.
The study’s findings imply that the most urgent health issues might not necessarily coincide with budgetary priorities. Chronic obstructive pulmonary disease, low back pain, and ischemic heart disease were the top three causes of poor health in Oregon in 2019. However, data indicates that the majority of the state’s health care budget that year was allocated to treating type 2 diabetes, musculoskeletal conditions, and dental problems.
The results raise concerns about whether overall health care spending is well linked with the population’s largest medical requirements, even though this does not necessarily imply that excessive amounts are being spent on dental treatment.
He claimed that some of the expenditure variance is genuinely inexplicable and somewhat enigmatic. To learn why that exists, further research is necessary and new questions are raised. The wide range in utilization raises the possibility that some locations are receiving more treatment than they require, while others may not be receiving enough.
–Kristine de Leon uncovers tales about data enterprise, small company, and consumer health. [email protected] is her email address.
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