The institute compared spending data collected by Vermont with spending from nearly 6 million national medical claims from Aetna, Humana, Kaiser Permanente and UnitedHealthcare. Vermont's spending data included medical bills for roughly nine out of 10 residents with insurance from an employer. Vermont health policymakers commissioned the report to get a handle on state spending for future state policy discussions.
“This is important to our work in Vermont because we need solid comparative data to track the impacts of changes and to gain a deeper understanding of how factors such as health status, age, prices and availability of services influence trends in spending,” Dian Kahn, director of analysis and data management for the Vermont Green Mountain Care Board, said in a written statement. The board regulates Vermont insurance rates and hospital budgets. Kahn declined an interview request to discuss the findings in more detail.
Despite the positive news on per capita spending, Vermont's health spending accelerated faster than the national average during the five years, even during the recession. During the first full year of the Great Recession in 2008, Vermont's health spending per person increased 6.9% compared with 5.7% nationally.
If Vermont's spending growth continues to outpace national spending growth, “they're going to start to catch up with national spending,” said Carolina Herrera, director of research at HCCI. “The gap is starting to narrow.”
Nonetheless, spending per person remains below the U.S. average and that of the state's Northeast neighbors, Herrera said. Vermont spent $112 less per person on healthcare in 2011 than the U.S. average, in part because of shorter hospital stays. Patients in Vermont are more likely to visit the hospital, but they were quicker to leave. Hospital spending per person in Vermont was $282 less in 2011 than the U.S. average.
Vermont residents, too, spent less of their own money on deductibles and copayments than the average American patient. Spending by Vermont residents from their own pockets, which totaled $595 a person in 2011, accounted for 13% of their total medical bill compared with 16.3% nationally, which amounted to $733 a person, on average.
Notably, patients in Vermont were more likely to get laboratory, radiology and imaging tests done at the hospital than at less-costly physician offices. Prices for hospital laboratory, radiation and imaging services were $25 higher but more significantly, Vermont patients had 2.6 more hospital-outpatient bills per person than the national average.
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