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RESEARCH On the Rise

Out-of-Pocket Healthcare Spending in 2017

Leveraging financial transaction data, the JPMorgan Chase Institute provides a unique cash flow view of families’ healthcare out-of-pocket spending and financial burden. In 2017 we released the first estimates of out-of-pocket healthcare spending levels and burden at the state and county level from 2013 to 2016, from our JPMorgan Chase Institute Healthcare Out-of-pocket Spending Panel (JPMCI HOSP) data asset. In this new report, we describe enhancements to, and key findings from, the updated JPMCI HOSP data asset that includes the first available estimates of 2017 healthcare out-of-pocket spending trends, as well as a first-ever look at year-over-year trends at the state and county level and for different demographic groups.

Our key findings are:


Finding 1: Year-over-year growth in out-of-pocket healthcare spending levels accelerated since 2014 to 8.5 percent in 2017. The burden of healthcare spending as a percent of take-home income ticked up slightly.

Finding 2: In 2017 high-income families experienced the fastest growth in healthcare spending, while low-income families experienced the highest growth in healthcare spending burden.

Finding 3: In 2017, families in Utah spent the most on and were the most burdened by out-of-pocket healthcare spending, while families in California saw the highest growth in spending levels.

Finding 4: Out-of-pocket healthcare spending grew the most at hospitals and ‘other’ healthcare providers and decreased at drug stores for the third consecutive year.

Average annual out-of-pocket healthcare spending level grew the fastest in 2017, while healthcare spending burden ticked up slightly.

From 2016 to 2017, healthcare spending grew the most in California and healthcare spending burden grew the most in Utah.

In conclusion, for three consecutive years, out-of-pocket healthcare spending has accelerated. We observed positive growth across every state and demographic group. For the first time in three years, we observed an uptick in healthcare spending burden as a percent of take-home income. The increase in burden occurred across demographic groups, but was largest among families in the lowest income quintiles and families living in Utah. Families in California experienced the highest growth in healthcare spending levels. At the county-level, the coastal region of California showed especially high growth in spending. It is important that we continue to monitor levels and trends in out-of-pocket healthcare costs borne by families, as we seek to do with the JPMCI HOSP data asset, because they affect people’s choices regarding whether and when to consume care.


Diana Farrell

Founding and Former President & CEO

Fiona Greig

Former Co-President