A Look at Healthcare Spending, Employment, Pay, benefits, and Prices

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June 2016

A look at healthcare spending, employment, pay, benefits, and prices

While Benjamin Franklin once said, "Nothing is more fatal to health than an over care of it," people are now living longer and have growing expectations for the quality and availability of healthcare. As one of the largest industries in the United States, healthcare is steadily growing to meet the needs of an increasing population with an increasing life expectancy. From 2014 to 2024, the demand for healthcare workers is projected to grow faster than the rate for all occupations.

In this Spotlight, we look at the healthcare industry, including how much people spend on healthcare, current and projected employment in the industry, employer-provided healthcare benefits, healthcare prices, and pay for workers in healthcare occupations.

Average annual expenditures on healthcare per household, 2014
Item	Expenditure
Health insurance	$2,868.04
Blue Cross, Blue Shield	933.46
Fee for service health plan (BCBS)	526.59
Health maintenance organization (BCBS)	344.50
Commercial medicare supplement (BCBS)	45.27
Other health insurance (BCBS)	17.10
Commercial health insurance	594.31
Fee for service health plan (not BCBS)	594.31
Health maintenance organization (not BCBS)	561.21
Medicare payments	430.74
Commercial medicare supplements and other health insurance	194.33
Commercial medicare supplement (not BCBS)	108.93
Other health insurance (not BCBS)	85.40
Medicare prescription drug premium	80.45
Long term care insurance	73.54
Medical services	790.20
Dental services	281.31
Physician's services	189.10
Hospital room and services	115.79
Service by professionals other than physician	59.12
Eyecare services	47.16
Lab tests, x-rays	44.60
Care in convalescent or nursing home	33.54
Other medical care services	19.37
Repair of medical equipment	0.14
Medical care in retirement community	0.08
Drugs	485.51
Prescription drugs	329.67
Nonprescription drugs	99.66
Nonprescription vitamins	56.18
Medical supplies	146.31
Eyeglasses and contact lenses	74.32
Topicals and dressings	41.23
Hearing aids	17.73
Supportive and convalescent medical equipment	5.46
Medical equipment for general use	3.08
Adult diapers	3.02
Rental of supportive, convalescent medical equipment	0.86
Rental of medical equipment	0.61

Average U.S. household spent nearly $4,300 on healthcare in 2014

Healthcare expenditures include spending on health insurance, medical services, drugs, and medical supplies. In 2014, the average U.S. household spent $4,290 on healthcare, or 8 percent of total spending. Among healthcare expenditures, households spent the most on health insurance ($2,868). Medical services represented 18 percent of total healthcare expenditures. Among medical services, households spent the most on dental services ($281).

Average annual household spending on healthcare by income group, 2014
Income group	Expenditure
Lowest 20 percent	$1,868
Second 20 percent	3,252
Third 20 percent	4,026
Fourth 20 percent	5,082
Highest 20 percent	7,219

Households in top 20 percent of income spend more on healthcare than those in lowest 40 percent

In 2014, households ranked in the top 20 percent in annual income spent an average of $7,219 on healthcare. That was almost 4 times the amount spent by households in the lowest 20 percent ($1,868). The top 20 percent also spent more than the combined amount spent by households in the lowest 40 percent.

Average annual household spending on healthcare as a percentage of total spending, by income group, 2014
Income group	Share of total annual household spending
Lowest 20 percent	7.9%
Second 20 percent	9.7
Third 20 percent	8.9
Fourth 20 percent	8.4
Highest 20 percent	6.9

Households in top 20 percent of income spend lowest share of total expenditures on healthcare

In 2014, households in the top 20 percent in annual income spent a smaller proportion (7 percent) of their annual spending on healthcare than any other income group. Households in the second lowest 20 percent spent 10 percent of their annual spending on healthcare, the largest share among the five (quintile) income groups.

County employment in hospitals industry, per 10,000 population, 2014 annual averages

262 and higher

177 to 261

135 to 176

97 to 134

96 and lower

Hover over a county to see data.
Hover over legend items to see counties in a category.
Source: U.S. Bureau of Labor Statistics.

County employment in hospitals industry, per 10,000 population, 2014 annual averages
County	Employed per 10,000 population
Suffolk, Massachusetts	1,097
St. Louis City, Missouri	868
Monongalia, West Virginia	757
Baltimore City, Maryland	710
Grafton, New Hampshire	707
Ohio, West Virginia	685
Peoria, Illinois	672
Minnehaha, South Dakota	662
Petersburg City, Virginia	584
Cabell, West Virginia	542
Wyandotte, Kansas	497
Greene, Missouri	484
New York, New York	480
St. Louis, Minnesota	479
Davidson, Tennessee	463
Cuyahoga, Ohio	455
Dauphin, Pennsylvania	452
Forsyth, North Carolina	438
Kanawha, West Virginia	431
Richmond, Georgia	431
Hamilton, Ohio	430
Vanderburgh, Indiana	418
Caddo Parish, Louisiana	415
Lehigh, Pennsylvania	413
District of Columbia	410
Bibb, Georgia	400
Philadelphia, Pennsylvania	387
Stearns, Minnesota	385
Allen, Ohio	381
Jefferson, Illinois	376
Cumberland, Maine	370
Sangamon, Illinois	368
Lauderdale, Mississippi	367
Kent, Michigan	361
Norfolk City, Virginia	357
Eau Claire, Wisconsin	352
Potter, Texas	349
Windham, Vermont	348
Allegheny, Pennsylvania	348
Penobscot, Maine	342
Marion, Indiana	341
Bradford, Pennsylvania	339
Silver Bow, Montana	336
Smith, Texas	335
Rapides Parish, Louisiana	323
Chelan, Washington	322
Pulaski, Arkansas	321
Albany, New York	320
Craighead, Arkansas	314
Fulton, Georgia	311
Houghton, Michigan	306
Montgomery, Ohio	299
Hinds, Mississippi	298
Lucas, Ohio	296
Ada, Idaho	296
Providence, Rhode Island	294
Monroe, New York	294
Pontotoc, Oklahoma	291
Harvey, Kansas	289
Douglas, Nebraska	288
Sebastian, Arkansas	287
Jefferson, Ohio	287
Bowie, Texas	284
Wayne, Michigan	284
Tulsa, Oklahoma	284
Summit, Ohio	282
Oklahoma, Oklahoma	279
Hennepin, Minnesota	278
Brown, Wisconsin	275
Milwaukee, Wisconsin	275
New Castle, Delaware	275
St. Louis, Missouri	274
Muscogee, Georgia	273
Cambria, Pennsylvania	273
Blair, Pennsylvania	273
Huron, Michigan	272
Jefferson, Kentucky	271
Nassau, New York	270
Kankakee, Illinois	264
Winnebago, Illinois	264
Lafayette Parish, Louisiana	263
Ontario, New York	262
Vigo, Indiana	261
Jackson, Missouri	261
Polk, Wisconsin	259
Oakland, Michigan	257
Gregg, Texas	254
East Baton Rouge Parish, Louisiana	254
Flathead, Montana	251
Ramsey, Minnesota	251
Shelby, Tennessee	250
Evangeline Parish, Louisiana	248
Ouachita Parish, Louisiana	247
Richland, South Carolina	247
Cass, North Dakota	247
Berkshire, Massachusetts	244
Knox, Tennessee	244
Hampden, Massachusetts	243
Barron, Wisconsin	242
Taylor, Texas	240
Warren, Kentucky	239
Carson City, Nevada	239
Montcalm, Michigan	238
Butte, California	237
Barton, Kansas	234
Jefferson, Alabama	234
Merrimack, New Hampshire	230
Lake, Indiana	230
Chatham, Georgia	228
Mercer, New Jersey	228
Goodhue, Minnesota	228
Orleans Parish, Louisiana	224
Duval, Florida	224
Camden, New Jersey	224
Aroostook, Maine	223
Worcester, Massachusetts	221
Franklin, Ohio	220
Henrico, Virginia	215
Hillsborough, New Hampshire	213
Tom Green, Texas	213
Cook, Illinois	212
Etowah, Alabama	210
Hancock, Maine	209
Anchorage Borough, Alaska	208
Atlantic, New Jersey	204
Mesa, Colorado	203
Stark, Ohio	203
St. Joseph, Indiana	202
Fayette, Kentucky	201
New Haven, Connecticut	201
Sauk, Wisconsin	201
Leon, Florida	199
Natrona, Wyoming	198
Calcasieu Parish, Louisiana	198
Mercer, Pennsylvania	198
Garland, Arkansas	198
Terrebonne Parish, Louisiana	198
Montgomery, Pennsylvania	197
Oneida, New York	195
Nueces, Texas	195
Hartford, Connecticut	195
Orange, Florida	193
Grayson, Texas	193
Coos, New Hampshire	193
Tippecanoe, Indiana	193
Erie, Pennsylvania	193
Bergen, New Jersey	190
Scott, Iowa	187
Escambia, Florida	187
Jefferson, Texas	186
Bronx, New York	185
Jefferson Parish, Louisiana	185
Madison, Indiana	184
Dodge, Wisconsin	183
Multnomah, Oregon	181
DeKalb, Georgia	181
Wapello, Iowa	179
St. Lawrence, New York	179
Polk, Iowa	179
Washington, Maryland	178
Middlesex, Massachusetts	177
Racine, Wisconsin	177
Lancaster, Nebraska	177
Sanilac, Michigan	176
Boulder, Colorado	176
Hillsborough, Florida	175
Floyd, Kentucky	174
Sarasota, Florida	174
Spokane, Washington	174
Charleston, South Carolina	173
Berks, Pennsylvania	173
Houston, Alabama	171
DuPage, Illinois	170
Pottawattamie, Iowa	170
Indian River, Florida	170
Lackawanna, Pennsylvania	170
LaSalle, Illinois	170
Ashtabula, Ohio	170
Champaign, Illinois	170
Luzerne, Pennsylvania	170
Essex, New Jersey	170
Barnstable, Massachusetts	169
Miami-Dade, Florida	167
Middlesex, New Jersey	167
Somerset, Pennsylvania	164
Travis, Texas	164
Sedgwick, Kansas	164
Pinellas, Florida	163
Centre, Pennsylvania	163
Essex, Massachusetts	163
Elkhart, Indiana	163
Apache, Arizona	162
Pima, Arizona	161
Bay, Florida	161
Trumbull, Ohio	161
Mohave, Arizona	161
Waukesha, Wisconsin	161
Westchester, New York	160
Somerset, Maine	159
Brazos, Texas	158
Lincoln Parish, Louisiana	158
St. Clair, Michigan	157
York, Pennsylvania	157
Monmouth, New Jersey	157
Genesee, Michigan	156
Bristol, Massachusetts	156
Lubbock, Texas	155
Harris, Texas	155
Jefferson, New York	155
Washington, Pennsylvania	155
Denver, Colorado	154
Belmont, Ohio	153
Mobile, Alabama	153
Washington, Arkansas	153
Florence, South Carolina	153
Burlington, New Jersey	152
Johnson, Kansas	149
Wake, North Carolina	148
Victoria, Texas	148
Salt Lake, Utah	148
Volusia, Florida	148
Dallas, Texas	147
Eddy, New Mexico	146
Coffee, Tennessee	145
Fairfield, Connecticut	145
Adams, Colorado	144
Lincoln, South Dakota	144
Bucks, Pennsylvania	143
Chippewa, Wisconsin	142
Tarrant, Texas	141
Norfolk, Massachusetts	141
Baltimore, Maryland	141
Marion, Oregon	141
Honolulu, Hawaii	141
Osceola, Florida	140
Warrick, Indiana	139
Lancaster, Pennsylvania	139
Union, New Jersey	137
Beauregard Parish, Louisiana	137
Pierce, Washington	136
Niagara, New York	136
Richmond, North Carolina	136
Polk, Florida	135
Madison, Illinois	135
Erie, New York	133
Cumberland, Pennsylvania	133
Delaware, Pennsylvania	132
Chautauqua, New York	132
Yakima, Washington	132
Hernando, Florida	131
Maricopa, Arizona	131
Dutchess, New York	131
Vermilion, Illinois	130
Lake, Illinois	130
Washoe, Nevada	130
DeKalb, Illinois	130
Kane, Illinois	128
King, Washington	128
Santa Clara, California	127
Lawrence, Indiana	127
Mahoning, Ohio	126
DeSoto, Mississippi	126
Humboldt, California	126
St. Croix, Wisconsin	125
Suffolk, New York	125
Charlotte, Florida	125
St. Tammany Parish, Louisiana	124
Palm Beach, Florida	124
Steuben, New York	124
Dona Ana, New Mexico	123
Brevard, Florida	122
Butler, Ohio	121
Arapahoe, Colorado	121
Schuylkill, Pennsylvania	121
Columbia, Florida	121
Cobb, Georgia	121
Rockingham, New Hampshire	121
Passaic, New Jersey	120
Winnebago, Wisconsin	120
Fresno, California	119
Bexar, Texas	118
Coweta, Georgia	118
Chester, Pennsylvania	118
McPherson, Kansas	117
Delaware, New York	115
Stanislaus, California	115
Hudson, New Jersey	115
Yamhill, Oregon	114
Collier, Florida	113
Plymouth, Massachusetts	113
Lake, Florida	112
Boone, Missouri	112
Macomb, Michigan	112
Acadia Parish, Louisiana	111
Ocean, New Jersey	111
Hidalgo, Texas	111
Grant, Wisconsin	111
Lorain, Ohio	110
Los Angeles, California	109
San Francisco, California	109
Santa Barbara, California	108
Comal, Texas	108
Orange, New York	107
Monroe, Florida	106
Kings, New York	105
Wood, Texas	105
Sacramento, California	105
Alameda, California	104
Dane, Wisconsin	104
York, Maine	103
Montgomery, Maryland	103
Queens, New York	102
Tolland, Connecticut	101
Frederick, Maryland	101
Bossier Parish, Louisiana	99
Rankin, Mississippi	99
Clackamas, Oregon	99
Pasco, Florida	99
San Bernardino, California	98
Utah, Utah	98
Cameron, Texas	98
Marion, Florida	97
St. Charles, Missouri	97
Washington, Oregon	97
Greenville, South Carolina	97
Somerset, New Jersey	96
Okaloosa, Florida	96
Orange, California	96
Hampshire, Massachusetts	95
Wharton, Texas	94
Santa Cruz, California	91
Manatee, Florida	90
Westmoreland, Pennsylvania	89
McHenry, Illinois	89
Collin, Texas	89
Cochise, Arizona	88
Wright, Minnesota	88
Solano, California	88
Clay, Florida	87
Seminole, Florida	87
Ascension Parish, Louisiana	86
El Paso, Texas	83
Clark, Nevada	83
Horry, South Carolina	83
Ulster, New York	83
Kern, California	81
Sonoma, California	80
Litchfield, Connecticut	80
Chesterfield, Virginia	79
Benton, Arkansas	78
Will, Illinois	78
Douglas, Colorado	78
York, South Carolina	78
San Mateo, California	78
Fairfax, Virginia	77
San Diego, California	76
St. Lucie, Florida	76
Contra Costa, California	76
Hamilton, Indiana	75
Webb, Texas	74
San Joaquin, California	73
Ventura, California	73
Howard, Maryland	73
Clayton, Georgia	72
San Luis Obispo, California	69
Medina, Ohio	67
Prince George's, Maryland	67
Gwinnett, Georgia	65
Montgomery, Texas	65
Riverside, California	65
Harrison, Mississippi	64
Santa Rosa, Florida	61
Northampton, Pennsylvania	60
El Paso, Colorado	59
Ector, Texas	58
Mecklenburg, North Carolina	58
Northumberland, Pennsylvania	58
Hays, Texas	58
Denton, Texas	57
Broward, Florida	56
Williamson, Texas	54
Clark, Indiana	53
Marin, California	51
Calhoun, Alabama	49
Fort Bend, Texas	48
Rusk, Texas	46
Galveston, Texas	44
Davis, Utah	44
Williamson, Tennessee	43
Loudoun, Virginia	43
Spartanburg, South Carolina	41
Ellis, Texas	41
Madison, Alabama	40
Beaufort, South Carolina	35
Hardin, Kentucky	34
Tangipahoa Parish, Louisiana	30
Liberty, Texas	24
Pinal, Arizona	23
Cleveland, Oklahoma	22
Midland, Texas	22
St. Landry Parish, Louisiana	21
Kootenai, Idaho	19
Clay, Missouri	18
Lee, Florida	6
Chesapeake City, Virginia	⁽¹⁾
Dorchester, South Carolina	⁽¹⁾
Footnotes: ⁽¹⁾ Less than 1 employed per 10,000 population

County employment in the hospitals industry

The hospitals industry provides medical, diagnostic, and treatment services that include care from doctors, nurses, and other healthcare practitioners on both an inpatient and outpatient basis. In 2014, in Suffolk County, Massachusetts, there were 1,000 jobs in the hospitals industry for every 10,000 people in the general population. Other counties with over 700 jobs in the hospitals industry per 10,000 population were St. Louis City, Missouri; Monongalia, West Virginia; Baltimore City, Maryland; and Grafton, New Hampshire. Counties with fewer than 20 jobs in the hospitals industry per 10,000 population were Dorchester, South Carolina; Chesapeake City, Virginia; Lee, Florida; Clay, Missouri; and Kootenai, Idaho.

Employment in private healthcare industries as a percentage of total private employment, 1990–2015 annual averages
Industry	Ambulatory healthcare services	Hospitals	Nursing and residential care facilities
1990	3.1%	3.9%	2.0%
1991	3.4	4.0	2.2
1992	3.6	4.1	2.3
1993	3.7	4.1	2.3
1994	3.8	3.9	2.3
1995	3.8	3.8	2.4
1996	3.9	3.8	2.4
1997	4.0	3.7	2.4
1998	3.9	3.7	2.3
1999	3.9	3.6	2.3
2000	3.9	3.6	2.3
2001	4.0	3.7	2.4
2002	4.2	3.8	2.5
2003	4.4	3.9	2.6
2004	4.5	3.9	2.6
2005	4.6	3.9	2.5
2006	4.6	3.9	2.5
2007	4.7	3.9	2.6
2008	4.9	4.0	2.6
2009	5.3	4.3	2.8
2010	5.5	4.3	2.9
2011	5.6	4.3	2.9
2012	5.6	4.3	2.8
2013	5.7	4.2	2.8
2014	5.7	4.1	2.8
2015^(p)	5.7	4.1	2.7
Footnotes: ^(p) = preliminary.

Ambulatory healthcare services has highest share of private employment among healthcare industries

The ambulatory healthcare services industry includes offices of physicians, dentists, and other healthcare practitioners such as chiropractors and optometrists; outpatient care centers; medical and diagnostic laboratories; and home healthcare services. In 2015, the share of total private industry employment in ambulatory healthcare services was 5.7 percent, highest among major healthcare industries. Since 1990, employment in ambulatory healthcare services has more than doubled, from 2.8 million in 1990 to 6.9 million in 2015.

Private healthcare employment as a percentage of total private employment by state, 2014 annual average

14.7% and higher

13.2% to 14.6%

12.6% to 13.1%

11.2% to 12.5%

11.1% and lower

Hover over a state to see data.
Hover over legend items to see states in a category.
Source: U.S. Bureau of Labor Statistics.

Private healthcare employment as a percentage of total employment by state, 2014 annual average
State	Percent of employment	Total private health care employment	Total private employment
West Virginia	17.4	98,179	563,304
Maine	16.8	82,958	494,882
Rhode Island	16.7	67,579	404,329
Massachusetts	15.7	460,831	2,933,247
Pennsylvania	15.7	776,713	4,961,421
South Dakota	15.3	51,819	339,116
Ohio	14.9	669,102	4,478,047
Montana	14.9	53,398	357,881
Connecticut	14.7	209,015	1,417,753
Minnesota	14.7	347,275	2,358,269
Vermont	14.7	36,851	251,464
Maryland	14.5	299,561	2,066,547
Delaware	14.3	51,782	362,289
New York	14.3	1,066,932	7,484,182
Michigan	14.0	495,668	3,538,241
New Jersey	13.7	448,598	3,263,453
Missouri	13.6	305,322	2,250,862
New Hampshire	13.5	72,893	541,440
Alaska	13.3	33,741	253,462
New Mexico	13.2	81,670	618,494
Florida	13.2	887,031	6,731,170
Louisiana	13.1	211,045	1,611,244
Kentucky	13.0	195,929	1,508,025
Idaho	13.0	69,295	533,878
Arizona	12.9	277,908	2,153,171
Tennessee	12.9	301,160	2,342,369
Kansas	12.8	142,319	1,113,793
Indiana	12.8	318,971	2,499,895
North Dakota	12.8	47,950	376,049
Arkansas	12.7	121,405	957,335
Wisconsin	12.6	300,367	2,379,110
Nebraska	12.5	98,638	786,807
Oklahoma	12.4	156,595	1,262,371
Illinois	12.3	612,793	4,974,896
Oregon	12.3	178,991	1,453,801
North Carolina	12.0	406,071	3,375,660
Texas	11.9	1,138,927	9,597,288
Iowa	11.9	151,890	1,280,166
Alabama	11.7	175,359	1,504,320
Mississippi	11.5	99,925	865,964
Virginia	11.2	333,381	2,969,283
Washington	11.0	277,814	2,519,468
Georgia	10.9	371,097	3,396,684
Utah	10.6	113,896	1,076,055
Colorado	10.4	211,908	2,029,168
District of Columbia	10.4	51,551	495,073
California	10.1	1,362,408	13,501,711
South Carolina	10.1	157,124	1,557,179
Hawaii	9.8	49,192	504,390
Nevada	8.0	84,716	1,055,556
Wyoming	7.9	17,172	218,127

West Virginia has highest share of private industry employment in healthcare among U.S. states

In 2014, among U.S. states, West Virginia had the highest share of private industry employment in healthcare (17.4 percent). Five other states had proportions over 15 percent, three of which are in New England: Maine (16.8 percent), Rhode Island (16.7 percent), Massachusetts (15.7 percent), Pennsylvania (15.7 percent), and South Dakota (15.3 percent). Wyoming had the lowest share of private industry employment in healthcare (7.9 percent).

Counties with the highest relative concentration of employment (location quotient)
in the offices of physicians industry, 2014 annual average

1.7 and higher

1.5 to 1.6

1.3 to 1.4

1.1 to 1.2

1.0 and lower or data not disclosable