Each year, HCCI creates the Healthy Marketplace Index (HMI) to measure how health care spending varies across the United States. The HMI shows local health care spending, prices, and use compared to the national median. By describing how health care spending varies geographically, HMI is a starting point in understanding what is causing high and rising health care costs in a particular metropolitan area. Across the country, a range of factors drive health care spending. High spending on health care, in turn, forces families, businesses, and governments to make difficult tradeoffs between needed care and other priorities such as housing, education, and food. This case study begins to broaden HMI’s exploration of health care spending in specific areas by describing some of the factors contributing to spending, use, and prices in one area--Washington, D.C.--including social determinants of health, prevalence of disease, health care providers, and health care markets. The HMI shows that health care spending in Washington, D.C. was 14% lower than the national median in 2020 with slightly higher prices and higher use, but a lower cost mix of services provided. Spending in Washington, D.C. grew at a rate roughly similar to the national median--about 4%--from 2016 2020. Although Washington, D.C.’s HMI includes the broader Washington-Arlington-Alexandria metro area, this case study focuses only on Washington, D.C.
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