Health care lost 400 jobs in January 2014, and revised data for December 2013 showed a scant gain of 2,400 jobs. This two-month increase of 2,000 jobs is the lowest since our data series began in 1989, and the 3-month moving average gain of 10,500 jobs has not been lower in more than a decade. Benchmark revisions to the establishment survey shifted the historical series of health sector jobs down by about 70,000 while increasing total nonfarm jobs by 370,000, dropping the health sector share of total employment from 10.71 percent to 10.62 percent.

Our data show that national health expenditures grew at an annual rate of 4.1 percent in 2013. While above the 3.7 percent seen in 2012, this looks to be the fifth consecutive year of spending growth in the 4 percent vicinity, a rate not previously seen in the 50-plus years of national health expenditures accounting until 2009. The December 2013 year-over-year rate of 4.5 percent could be signaling a long-expected acceleration as the impact of the recession wanes, but these data are preliminary and will be revised in each of the next two months (and again in July). The health spending share of gross domestic product was 17.3 percent in December 2013, a rate that has been mostly stable since hitting its all-time high of 17.5 percent in July 2009.

As we reported on January 17, national health care prices in December 2013 were 1.1 percent higher than in December 2012, barely above the all-time low of 1.0 percent recorded in October 2013. These data come from the monthly Health Sector Economic IndicatorsSM briefs released by Altarum Institute’s Center for Sustainable Health Spending (

“We have noted since first publishing on the health care spending slowdown that health labor would eventually need to follow suit,” said Charles Roehrig, director of the Center. “We have apparently finally reached that point. Also, as we noted last month, the data suggest an upward drift in the health spending growth rate since the first quarter of 2013, but we will await revised data before issuing a clearer verdict. Of course, most of our attention will be on gauging spending effects of the Affordable Care Act insurance coverage expansion that begins this year.”

Sustainable U.S. Health Spending: Public Sector Imperative, Private Sector Urgency, the monograph for our July 30, 2013, symposium, is now available here. It features some of the nation’s leading scholars discussing the U.S. fiscal position and whether the health spending slowdown is cyclical (transitory) or structural (permanent).

Altarum Institute ( integrates objective research and client-centered consulting skills to deliver comprehensive, systems-based solutions that improve health and health care. Altarum employs almost 400 individuals and is headquartered in Ann Arbor, Mich., with additional offices in the Washington, D.C., area; Portland, Maine; and San Antonio, Texas.


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