Decomposing Medical-Care Expenditure Growth


Abe Dunn

Eli Liebman

2012-26 | November 1, 2012

Medical-care expenditures have been rising rapidly, accounting for almost one-fifth of GDP in 2009. In this study, we assess the sources of the rising medical-care expenditures in the commercial sector. We employ a novel framework for decomposing expenditure growth into four components at the disease level: service price growth, service utilization growth, treated disease prevalence growth, and demographic shift. The decomposition shows that growth in prices and treated prevalence are the primary drivers of medical-care expenditure growth over the 2003 to 2007 period. There was no growth in service utilization at the aggregate level over this period. Price and utilization growth were especially large for the treatment of malignant neoplasms. For many conditions, treated prevalence has shifted towards preventive treatment and away from treatment for late-stage illnesses.

Article Citation

Dunn, Abe, Adam Hale Shapiro, and Eli Liebman. 2012. “Decomposing Medical-Care Expenditure Growth,” Federal Reserve Bank of San Francisco Working Paper 2012-26. Available at

About the Author
Adam Shapiro
Adam Shapiro is a vice president in the Economic Research Department of the Federal Reserve Bank of San Francisco. Learn more about Adam Shapiro