5% of patients account for half of health care spending

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 a person, the Agency for Healthcare Research and Quality says.

U.S. residents spent $1.26 tril- lion on care in 2009. 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 it showed how a tiny segment of the population can drive health care spending, the report 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 consumers stayed in the top 1% of spenders at least two straight 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: -60% were women. -40% were 65 or older. Only 3% were ages 18 to 29.

-80% were white. The study found that Hispanics, 16% of the 2009 population, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, 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.

For example, the government has told hospitals with Medicare patients that, starting in October, it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released.

Cohen said he will look at whether that will change the spending averages for people in the top health care cost brackets.