Catalyst for Payment Reform

Revolutionary: An interactive data tool on health care spending

Revolutionary: An interactive data tool on health care spending

Data is beautiful, even when you’re looking at a monstrous thing like the $2.10 trillion dollars spent in U.S. health care in 2013. If you don’t believe me, check out the Peterson-IHME Tracking personal health care spending in the US interactive data tool. As the product of a grant that the Peterson Center on Healthcare awarded to the University of Washington to analyze drivers of health care spending, the data tool seeks to inform future efforts to improve health care value. Let me take you on a journey exploring the visualization tool and the insights I found.

The treemap view shows the relative spending size of the 155 health conditions analyzed by the researchers, spread out over your screen like a cubic rainforest. The data tool lets you isolate what’s on your screen to any time frame from 1996 to 2013 and zero in on certain categories of care, including ambulatory, inpatient, prescribed pharmaceutical, etc. The darker the shade of color of each box, the greater the rate of growth in spending. Play around with timeframes and apertures, and you’ll discover a diversity of pale lavender boxes versus midnight purples. For instance, the box for prescribed pharmaceuticals for diabetes stands out in a dark, dark, navy blue – the $58 billion in 2013 spending for these drugs represented an 8.15% increase, annually, compared to 2008 spending levels. What shade of color are the conditions that most affect your population?

Next up, there’s a flow chart where the total cost of each category waterfalls into different health conditions. Here you can control the age groups on the left side, the type of care category in the middle column, and look at the relative spending of each health condition on the right. As you move your mouse along the display, the connections between these three columns dance like rays of light on water. Do a deep dive into Well Pregnancy Care by selecting it on the left column, and you’ll see how ambulatory spending and inpatient spending each accounted for $26 billion dollars in 2013. Insights like these can make strong cases for involving outpatient providers in any maternity care payment reform program. What condition makes the biggest splash for the age group and care category you’re interested in?

Did you know that mental and substance use disorders made up almost 30% of per capita health spending among under-30-year-old men in 2013? In the pyramid tab, you can compare the spend for each condition relative to per capita spending, total spending for each age group, or as a percent of spending. Between these three pyramid views, you can’t help but ask yourself: what kind of benefit design is helping shoulder the burden of the costliest conditions for your population?

And, finally, we reach the Drivers view- CPR’s favorite. Remember how spending for prescribed pharmaceuticals for diabetes increased annually by 8.15% from 2008 to 2013? This means that what was $36 billion in spending increased to $58 billion in just five years. Most people might assume that the cause of this increase is the growing prevalence of diabetes in the U.S. Think again. The Drivers view breaks down the changes in health care spending attributed to each type of cost driver and shows that only 0.6% of the increase in diabetes pharmaceutical spending can be attributed to disease prevalence. The main cost driver was price increase– changes in drug pricing resulted in more than half of those extra $21.8 billion dollars. IHME researchers focused on this type of analysis in the recent JAMA article introducing this revolutionary data tool.

What does this mean for the employers and other purchasers who are interested in managing their health care costs? A lot. Understanding the data behind the cost drivers might be the knowledge progressive purchasers need to really drive change. At CPR, we are excited to make full use of this powerful resource and hope that others are, too. No special technology is needed to adventure into the data tool, but we do recommend watching the tutorial recording published by the Altarum Institute. Let us know about the insights you find by emailing

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