Hover over a spending category and year to decompose the reasons for the change in this category from the prior year. Spending increases are due in part to inflation (the user can select an assumption of standard or medical inflation), in part to enrollment increases, and in part to higher utilization. What is meant by “high utilization” can include many things, such as:
- Enrollees are sicker/older and need more services
- Services are billed more intensively
- as a provider response to low reimbursement rates
- due to lack of code options for less intensive services
- Unnecessary services are provided, through duplication, incomplete recordkeeping, etc.
Sometimes costs can decrease from year to year as well, if enrollment or utilization in a particular category declines.