A Reconciliation of Health Care Expenditures in the National Health Expenditures Accounts and in Gross Domestic Product

This paper provides a detailed reconciliation of the National Health Expenditure Accounts (NHEA), the official estimates of health care spending in the United States from the Centers for Medicare and Medicaid Services, and the estimates of health expenditures that are part of gross domestic product (GDP) produced by the Bureau of Economic Analysis as part of the National Income and Product Accounts. It is an update of the previous reconciliation that was released in 2010. For the period from 2007 to 2018, the estimates of total national health spending in the NHEA and in the GDP data continue to be relatively similar, usually differing by less than 2 percent annually. Well over 90 percent of the total estimated expenditures in the two accounts consist of the same expenditures. However, some specific categories of health care expendi- tures—physician services, hospitals, drugs, health insurance, investment in equipment, and government programs—show proportionately larger differences. These differences reflect the classification and composition of health care spending in the two accounts as well as the use of varied estimation methods and data sources.