National Health Care Spending Research Articles

National Health Care Spending In 2022: Growth Similar To Prepandemic Rates.

Health care spending in the US grew 4.1percent to reach $4.5trillion in 2022, which was still a faster rate of growth than the increase of 3.2percent in 2021 but was much slower than the rate of 10.6percent seen in 2020. In 2022, strong Medicaid and private health insurance spending growth, including a turnaround in the net cost of insurance, was somewhat offset by continued declines in federal spending associated with the COVID-19 pandemic. The insured share of the population reached a historic high of 92.0percent in 2022 as enrollment in private health insurance increased at a faster rate relative to 2021 and Medicaid enrollment continued to experience strong growth. The share of the economy accounted for by the health sector was 17.3percent in 2022, which was down from a peak of 19.5percent in 2020 but was more consistent with the average share of 17.5percent during 2016-19.

EPID-32. A COST ANALYSIS OF BRAIN AND NERVOUS SYSTEM CANCER CARE: AN EXAMINATION OF HEALTHCARE EXPENDITURE TRENDS IN THE UNITED STATES FROM 1996 TO 2016

Abstract INTRODUCTION Management of brain and central nervous system malignancies is associated with substantial healthcare spending, yet estimates of per-patient cost and longitudinal temporal trends remain elusive. In this study, we investigate trends in United States (US) healthcare spending on these diseases between 1996-2016. METHODS We utilize inflation-adjusted national healthcare spending data and age-adjusted prevalence estimates from the Institute for Health Metrics and Evaluation to estimate per-patient US healthcare spending stratified by age and care setting. We employ joinpoint regression to identify temporal trends in healthcare spending, expressed as annual percent change (APC). Drivers of change data from 1996-2013 were evaluated to investigate shifts associated with increased spending. RESULTS In 2016, total healthcare spending attributable to brain and nervous system cancers was $6.85 billion (95% CI, $5.98-7.57 billion), corresponding to $2,245 (95% CI $1,962-$2,480) per patient, with the largest share coming from inpatient care settings ($4.60 billion [95% CI 3.87-5.24 billion]). Private payers shouldered the majority of costs (65.6%) compared to public payers (28.1%) and out-of-pocket expenses (6.4%). The average APC in spending between 1996-2016 was 3.69% [95% CI 3.00%-4.39%], driven primarily by an increase in the price and intensity of inpatient care (11.8% [95% CI 7.7%-16.1%). Further, three statistically significant periods of spending change were identified: 1996-2005 (2.42% [95% CI 2.04-2.80%], p < 0.001 ), 2005-2008 (4.43% [95% CI 1.08%-7.89%], p < 0.0001), 2008-2014 (6.32% [95% CI 5.41%-7.25%], p < 0.001), with spending being relatively stable from 2014-2016. DISCUSSION US expenditures for brain and nervous system malignancies are substantial and have significantly increased between 1996-2016, largely driven by increased inpatient spending. These findings may inform policy efforts to reduce the disease burden while balancing healthcare spending.

Local Social Vulnerability as a Predictor for Cancer-Related Mortality Among US Counties.

Substantial gaps in national healthcare spending and disparities in cancer mortality rates are noted across counties in the US. In this cross-sectional analysis, we investigated whether differences in local county-level social vulnerability impacts cancer-related mortality. We linked county-level age-adjusted mortality rates (AAMR) from the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research database, to county-level Social Vulnerability Index (SVI) from the CDC Agency for Toxic Substances and Disease Registry. SVI is a metric comprising 15 social factors including socioeconomic status, household composition and disability, minority status and language, and housing type and transportation. AAMRs were compared between least and most vulnerable counties using robust linear regression models. There were 4 107 273 deaths with an overall AAMR of 173 per 100 000 individuals. Highest AAMRs were noted in older adults, men, non-Hispanic Black individuals, and rural and Southern counties. Highest mortality risk increases between least and most vulnerable counties were noted in Southern and rural counties, individuals aged 45-65, and lung and colorectal cancers, suggesting that these groups may face highest risk for health inequity. These findings inform ongoing deliberations in public health policy at the state and federal level and encourage increased investment into socially disadvantaged counties.

Age-related disparities and trends in national healthcare spending formanagement of appendicitis in the United States: A retrospective cost-analysis.

Changes in clinical care for appendicitis have impacted healthcare use associated with treatment. We evaluated national trends and assessed factors associated with healthcare costs for appendicitis in the United States. The Disease Expenditure Project, the Global Burden of Disease study, and the National Inpatient Sample were used to estimate total national expenditures, per-capita costs for incident cases, and factors associated with inpatient costs for appendicitis management, respectively. The national estimates of appendicitis costs were obtained from 1996 to 2016. Appendicitis incidence was estimated to calculate per-capita costs. After application of survey weights for the stratified sample design, 191,180 weighted discharges for appendicitis from the 2016 National Inpatient Sample study were evaluated. The Disease Expenditure Project and the Global Burden of Disease study were used to estimate total and per-capita spending. Temporal trends were evaluated using joinpoint regression, expressed as annual percent change. Multivariable linear regression was used to evaluate patient factors associated with total hospital charges. In 2016, total spending on appendicitis was $9.3 billion (95% confidence interval: $8.0-$10.8], a 2-fold increase from $4.7 billion ($4.0-$5.3) in 1996. Per-capita spending decreased significantly after 2011 (annual percent change -3.7% [-4.4% to -2.9%]). Patients ≥65 years accounted for 64.1% (61.1%-67.3%) of total spending for appendicitis. The hospital charges for older patients were significantly higher among those undergoing appendectomy. Overall healthcare spending for appendicitis has doubled from 1996 to 2016, but per capita spending has decreased since 2011, driven by improved efficiency of inpatient care. Nearly two-thirds of spending is on patients ≥65 years, with significantly higher costs associated with surgical management in this population.

National Health Care Spending In 2021: Decline In Federal Spending Outweighs Greater Use Of Health Care.

Health care spending in the US grew 2.7percent to reach $4.3trillion in 2021, a much slower rate than the increase of 10.3percent seen in 2020. The slower rate of growth in 2021 was driven by a 3.5percent decline in federal government expenditures for health care after a spike in 2020 that occurred largely in response to the COVID-19 pandemic. Alongside this decline, the use of medical goods and services increased in 2021. The share of the economy accounted for by the health sector fell from 19.7percent in 2020 to 18.3percent in 2021, but it was still higher than the 17.6percent share in 2019. In 2021 the number of uninsured people declined for the second consecutive year as Medicaid enrollment increased.

Reduction of Cardiovascular Events and Related Healthcare Expenditures through Achieving Population-Level Targets of Dietary Salt Intake in Japan: A Simulation Model Based on the National Health and Nutrition Survey.

Reducing population dietary salt intake is expected to help prevent cardiovascular disease and thus constrain increasing national healthcare expenditures in Japan’s super-aged society. We aimed to estimate the impact of achieving global and national salt-reduction targets (8, <6, and <5 grams/day) on cardiovascular events and national healthcare spending in Japan. Using published data including mean salt intake and systolic blood pressure from the 2019 National Health and Nutrition Survey, we developed a Markov model of a closed cohort of adults aged 40–79 years in 2019 (n = 66,955,000) transitioning among six health states based on the disease course of ischemic heart disease (IHD) and stroke. If mean salt intake were to remain at 2019 levels over 10 years, cumulative incident cases in the cohort would be approximately 2.0 million for IHD and 2.6 million for stroke, costing USD 61.6 billion for IHD and USD 104.6 billion for stroke. Compared with the status quo, reducing mean salt intake towards the targets over 10 years would avert 1–3% of IHD and stroke events and save up to 2% of related national healthcare costs. Attaining dietary salt-reduction goals among adults would yield moderate health economic benefits in Japan.

Understanding Health Economics in Joint Replacement Surgery.

The number of arthroplasty procedures has been rising at a significant rate, contributing to a notable portion of the nation's health care spending. This growth has contributed to an increase in the number of health care economic studies in the field of adult reconstruction surgery. Although these articles are filled with important information, they can be difficult to understand without a background in business or economics. The goal of this review is to define the common terminology used in health care economic studies, assess their value and benefit in the context of total joint arthroplasty, and highlight shortcomings in the current literature. [Orthopedics. 2022;45(4):e174-e182.].

National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic.

US health care spending increased 9.7percent to reach $4.1trillion in 2020, a much faster rate than the 4.3percent increase seen in 2019. The acceleration in 2020 was due to a 36.0percent increase in federal expenditures for health care that occurred largely in response to the COVID-19 pandemic. At the same time, gross domestic product declined 2.2percent, and the share of the economy devoted to health care spending spiked, reaching 19.7percent. In 2020 the number of uninsured people fell, while at the same time there were significant shifts in types of coverage.

Population-based Trends in Healthcare Utilization and National Healthcare Spending on Pancreatitis in North America

It is estimated that the global incidence of pancreatitis has increased from ∼1.0 million new cases per year in 1990 to ∼1.6 million new cases annually in 2017.1 In the United States, pancreatitis is the third most common gastrointestinal diagnosis requiring hospitalization.2 With rising rates of alcohol consumption and obesity, the incidence of pancreatitis is anticipated to continue to increase. Furthermore, the management of pancreatitis is highly resource intensive and often requires hospitalization, close monitoring, and therapeutic interventions or surgery to manage either the underlying etiology or pancreatitis-related complications.

US Health Care Spending by Race and Ethnicity, 2002-2016

Measuring health care spending by race and ethnicity is important for understanding patterns in utilization and treatment. To estimate, identify, and account for differences in health care spending by race and ethnicity from 2002 through 2016 in the US. This exploratory study included data from 7.3 million health system visits, admissions, or prescriptions captured in the Medical Expenditure Panel Survey (2002-2016) and the Medicare Current Beneficiary Survey (2002-2012), which were combined with the insured population and notified case estimates from the National Health Interview Survey (2002; 2016) and health care spending estimates from the Disease Expenditure project (1996-2016). Six mutually exclusive self-reported race and ethnicity groups. Total and age-standardized health care spending per person by race and ethnicity for each year from 2002 through 2016 by type of care. Health care spending per notified case by race and ethnicity for key diseases in 2016. Differences in health care spending across race and ethnicity groups were decomposed into differences in utilization rate vs differences in price and intensity of care. In 2016, an estimated $2.4 trillion (95% uncertainty interval [UI], $2.4 trillion-$2.4 trillion) was spent on health care across the 6 types of care included in this study. The estimated age-standardized total health care spending per person in 2016 was $7649 (95% UI, $6129-$8814) for American Indian and Alaska Native (non-Hispanic) individuals; $4692 (95% UI, $4068-$5202) for Asian, Native Hawaiian, and Pacific Islander (non-Hispanic) individuals; $7361 (95% UI, $6917-$7797) for Black (non-Hispanic) individuals; $6025 (95% UI, $5703-$6373) for Hispanic individuals; $9276 (95% UI, $8066-$10 601) for individuals categorized as multiple races (non-Hispanic); and $8141 (95% UI, $8038-$8258) for White (non-Hispanic) individuals, who accounted for an estimated 72% (95% UI, 71%-73%) of health care spending. After adjusting for population size and age, White individuals received an estimated 15% (95% UI, 13%-17%; P < .001) more spending on ambulatory care than the all-population mean. Black (non-Hispanic) individuals received an estimated 26% (95% UI, 19%-32%; P < .001) less spending than the all-population mean on ambulatory care but received 19% (95% UI, 3%-32%; P = .02) more on inpatient and 12% (95% UI, 4%-24%; P = .04) more on emergency department care. Hispanic individuals received an estimated 33% (95% UI, 26%-37%; P < .001) less spending per person on ambulatory care than the all-population mean. Asian, Native Hawaiian, and Pacific Islander (non-Hispanic) individuals received less spending than the all-population mean on all types of care except dental (all P < .001), while American Indian and Alaska Native (non-Hispanic) individuals had more spending on emergency department care than the all-population mean (estimated 90% more; 95% UI, 11%-165%; P = .04), and multiple-race (non-Hispanic) individuals had more spending on emergency department care than the all-population mean (estimated 40% more; 95% UI, 19%-63%; P = .006). All 18 of the statistically significant race and ethnicity spending differences by type of care corresponded with differences in utilization. These differences persisted when controlling for underlying disease burden. In the US from 2002 through 2016, health care spending varied by race and ethnicity across different types of care even after adjusting for age and health conditions. Further research is needed to determine current health care spending by race and ethnicity, including spending related to the COVID-19 pandemic.

Prevalence-adjusted trends in U.S. healthcare spending on colorectal cancer, 1996-2016.

e18819 Background: Colorectal cancer is rising in prevalence and associated with high healthcare costs. We estimated trends in the US healthcare spending in patients with colorectal cancer between 1996 and 2016. Methods: We used data on national healthcare spending developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project. Corresponding US age-specific prevalence of colon cancer was estimated from the Global Burden of Diseases Study. Prevalence-adjusted, temporal trends in the US healthcare spending in patients with colorectal cancer, stratified by age groups ( &lt; 20, 20-44, 45-64, &gt;65) and by type of care (ambulatory, inpatient, emergency department, pharmaceutical prescriptions, nursing care and government administration) were estimated using joinpoint regression, expressed as annual percent change (APC) with 95% confidence intervals. Results: Overall, annual US healthcare spending on colorectal cancer increased from $8.85 billion (95% CI $8.17 billion, $9.53 billion) in 1996 to $10.5 billion (95% CI $9.35 billion, $11.7 billion) in 2016, with total costs increasing by 0.9%/year (95% CI 0.1%, 1.6%). After adjusting for colorectal cancer prevalence, the absolute per capita spending decreased from $8848 to $8427 and there has been no significant change over time (APC 0.3%, 95% CI, -0.2%, 0.8%). However, spending in patients &gt; 65 decreased significantly by 1.3%/year (95% CI -2.2%, -0.5%). Inpatient care was the largest contributor to total colorectal cancer-related expenditures: in 2016, 65.9% (95% CI 59.5%, 71.0%) and 19.7% (95% CI 14.8%, 25.8%) of the total cost were spent on inpatient care and ambulatory care, respectively. Between 1996-2016, increases in the price and intensity of care (defined by the cost per encounter) was the largest positive driver of changing healthcare spending, accounting for $5.02 billion ($2.60, $7.33 billion). Conclusions: After adjusting for rising prevalence, US healthcare spending on colorectal cancer has not changed significantly since 1996, while the per capita cost continues to decrease, primarily in patients &gt; 65 years old. Inpatient care accounts for the majority of colorectal cancer-related expenditures.

Prevalence-adjusted trends in U.S. healthcare spending on upper gastrointestinal cancers, 1996 to 2016.

e16064 Background: Upper gastrointestinal cancers are rising in prevalence and associated with high healthcare costs. We estimated trends in the US healthcare spending in patients with esophageal and stomach cancer between 1996 and 2016. Methods: We used data on national healthcare spending developed by the Institute for Health Metrics and Evaluations Disease Expenditure Project. Corresponding prevalence of esophageal and stomach cancer was estimated from the Global Burden of Diseases Study. Prevalence-adjusted, temporal trends in the US healthcare spending in patients with upper gastrointestinal cancer, stratified by age and setting of care (ambulatory, inpatient, emergency department, pharmaceutical prescriptions, nursing care and government administration) were calculated using joinpoint regression, expressed as annual percent change (APC) with 95% confidence intervals. Results: Overall, annual US healthcare spending on esophageal cancer increased from $0.76 billion (95% CI 0.68-0.86) in 1996 to $1.06 billion (95% CI 0.88-1.29) in 2016, although after adjusting for increasing prevalence, there was a significant decrease in per capita spending of -0.4%/year (95% CI -0.7%, -0.1%). Annual US healthcare spending on stomach cancer increased from $1.23 billion (95% CI $1.14 billion - $1.34 billion) in 1996 to $1.49 billion (95% CI $1.20 billion - $2.03 billion) in 2016. Per capita spending increased by 1.8%/year (95% CI 1.4%, 2.1%) between 1996 and 2011, followed by a decrease in gastric cancer-related per capita spending after 2011 (APC -4.4%/year [95% CI -5.8%, -2.9%]). Inpatient care was the largest contributor to total cost of both cancers between 1996-2016: 61.9% for esophageal cancer and 73.1% in gastric cancer in 2016. The rising price and intensity of care (defined as the cost per encounter) was the largest driver of change from 1996-2016 for both cancers, accounting for $0.28 billion (95% CI 0.12-0.41) for esophageal cancer and $0.95 billion (95% CI 0.41-1.39) for stomach cancer. Conclusions: After adjusting for rising prevalence, US per capita healthcare spending on esophageal cancer has decreased significantly since 1996, while per capita spending on gastric cancer has remained stable. Inpatient care was the most significant contributor to costs for both cancers over the time period studied.

Trends in U.S. Health Care Spending on Inflammatory Bowel Diseases, 1996-2016.

Inflammatory bowel diseases (IBD) are rising in prevalence and are associated with high health care costs. We estimated trends in U.S. health care spending in patients with IBD between 1996 and 2016. We used data on national health care spending developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project. We estimated corresponding U.S. age-specific prevalence of IBD from the Global Burden of Diseases Study. From these 2 sources, we estimated prevalence-adjusted, temporal trends in U.S. health care spending in patients with IBD, stratified by age groups (<20 years, 20-44 years, 45-64 years, ≥65 years) and by type of care (ambulatory, inpatient, emergency department [ED], pharmaceutical prescriptions, and nursing care), using joinpoint regression, expressed as an annual percentage change (APC) with 95% confidence intervals. Overall, annual U.S. health care spending on IBD increased from $6.4 billion (95% confidence interval, 5.7-7.4) in 1996 to $25.4 billion (95% confidence interval, 22.4-28.7) in 2016, corresponding to a per patient increase in annual spending from $5714 to $14,033. Substantial increases in per patient spending on IBD were observed in patients aged ≥45 years. Between 2011 and 2016, inpatient and ED care accounted for 55.8% of total spending and pharmaceuticals accounted for 19.9%, with variation across age groups (inpatient/ED vs pharmaceuticals: ages ≥65 years, 57.6% vs 11.2%; ages 45-64 years, 49.5% vs 26.9%; ages 20-44 years, 59.2% vs 23.6%). Even after adjusting for rising prevalence, U.S. health care spending on IBD continues to progressively increase, primarily in middle-aged and older adults, with unplanned health care utilization accounting for the majority of costs.

Trends in the Economic Burden of Chronic Liver Diseases and Cirrhosis in the United States: 1996-2016.

The management of chronic liver diseases (CLDs) and cirrhosis is associated with substantial healthcare costs. We aimed to estimate trends in national healthcare spending for patients with CLDs or cirrhosis between 1996 and 2016 in the United States. National-level healthcare expenditure data developed by the Institute for Health Metrics and Evaluations for the Disease Expenditure Project and prevalence of CLDs and cirrhosis derived from the Global Burden of Diseases Study were used to estimate temporal trends in inflation-adjusted US healthcare spending, stratified by setting of care (ambulatory, inpatient, emergency department, and nursing care). Joinpoint regression was used to evaluate temporal trends, expressed as annual percent change (APC) with 95% confidence intervals (CIs). Drivers of change in spending for ambulatory and inpatient services were also evaluated. Total expenditures in 2016 were $32.5 billion (95% CI, $27.0-$40.4 billion). Over 65% of spending was for inpatient or emergency department care. From 1996 to 2016, there was a 4.3%/year (95% CI, 2.8%-5.8%) increase in overall healthcare spending for patients with CLDs or cirrhosis, driven by a 17.8%/year (95% CI, 14.5%-21.6%) increase in price and intensity of hospital-based services. Total healthcare spending per patient with CLDs or cirrhosis began decreasing after 2008 (APC -1.7% [95% CI, -2.1% to -1.2%]), primarily because of reductions in ambulatory care spending (APC -9.1% [95% CI, -10.7% to -7.5%] after 2011). Healthcare expenditures for CLDs or cirrhosis are substantial in the United States, driven disproportionately by acute care in-hospital spending.

National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Year.

US health care spending increased 4.6percent to reach $3.8trillion in 2019, similar to the rate of growth of 4.7percent in 2018. The share of the economy devoted to health care spending was 17.7percent in 2019 compared with 17.6percent in 2018. In 2019 faster growth in spending for hospital care, physician and clinical services, and retail purchases of prescription drugs-which together accounted for 61percent of total national health spending-was offset mainly by expenditures for the net cost of health insurance, which were lower because of the suspension of the health insurance tax in 2019.

National Health Care Expenditures Associated With Disability.

In 2003, national disability-associated health care expenditures (DAHE) were $398 billion. Updated estimates will improve our understanding of current DAHE. The objective of this study was to estimate national DAHE for the US adult population and analyze spending by insurance and service categories and to assess changes in spending over the past decade. Data from the 2013-2015 Medical Expenditure Panel Survey were used to estimate DAHE for noninstitutionalized adults. These estimates were reconciled with National Health Expenditure Accounts (NHEA) data and adjusted to 2017 medical prices. Expenditures for institutionalized adults were added from NHEA data. National DAHE in total, by insurance and service categories, and percentage of total expenditures associated with disability. DAHE in 2015 were $868 billion (at 2017 prices), representing 36% of total national health care spending (up from 27% in 2003). DAHE per person with disability increased from $13,395 in 2003 to $17,431 in 2015, whereas nondisability per-person spending remained constant (about $6700). Public insurers paid 69% of DAHE. Medicare paid the largest portion ($324.7 billion), and Medicaid DAHE were $277.2 billion. More than half (54%) of all Medicare expenditures and 72% of all Medicaid expenditures were associated with disability. The share of health care expenditures associated with disability has increased substantially over the past decade. The high proportion of DAHE paid by public insurers reinforces the importance of public programs designed to improve health care for people with disabilities and emphasizes the need for evaluating programs and health services available to this vulnerable population.

National Health Care Spending In 2018: Growth Driven By Accelerations In Medicare And Private Insurance Spending.

US health care spending increased 4.6percent to reach $3.6trillion in 2018, a faster growth rate than the rate of 4.2percent in 2017 but the same rate as in 2016. The share of the economy devoted to health care spending declined to 17.7percent in 2018, compared to 17.9percent in 2017. The 0.4-percentage-point acceleration in overall growth in 2018 was driven by faster growth in both private health insurance and Medicare, which were influenced by the reinstatement of the health insurance tax. For personal health care spending (which accounted for 84percent of national health care spending), growth in 2018 remained unchanged from 2017 at 4.1percent. The total number of uninsured people increased by 1.0million for the second year in a row, to reach 30.7million in 2018.

Medical Professional Liability in Gastroenterology: Understanding the Claims Landscape and Proposed Mechanisms for Reform

Physicians enter the medical field to improve patients’ quality of life by optimizing health outcomes, and often build long-term relationships with their patients as a result. But even the most conscientious physician may become the subject of a medical professional liability (MPL) claim at some point during his or her career. Fear of medical liability is often cited as a prominent driver of medical overuse and a contributor to ballooning health care costs. Although challenging to precisely quantify, the annual cost of the medical liability system is estimated at >$55 billion, equivalent to ∼2.4% of total national health care spending.

Regional Anesthesia and Readmission Rates After Total Knee Arthroplasty.

Total knee arthroplasty is a commonly performed procedure and an important contributor to national health care spending. Reducing the incidence of readmission could have important consequences for patient well-being and relevant financial implications. Whether regional anesthesia techniques are associated with decreased readmission rates and costs among privately insured patients remains unknown. Using administrative claims data, we identified 138,362 privately insured patients 18-64 years of age who underwent total knee arthroplasty between 2002 and 2013. We then examined whether the use of a nerve block was associated with decreases in readmission rates and related costs during the 90 days after discharge. Our analyses were adjusted for potential confounding variables including medical comorbidities and previous use of opioids and other medications. After adjusting for patient demographics, comorbidities, and preoperative medication use, the adjusted 90-day readmission rate was 1.8% (95% confidence interval [CI], 1.1-2.4) among patients who did not receive a block compared to 1.7% (95% CI, 1.1-2.4) among patients who did (odds ratio, 0.99; 95% CI, 0.91-1.09; P = .85). The adjusted readmission-related postoperative cost for patients who did not receive a block was $561 (95% CI, 502-619) and $574 (95% CI, 508-639) for patients who did (difference, $13; 95% CI, -75 to 102; P = .74). This lack of statistically significant differences held for subgroup and sensitivity analyses. Nerve blocks were not associated with improved measures of long-term postoperative resource use in this younger, privately insured study population.

Cost impact of sobering centers on national health care spending in the United States.

Acute alcohol intoxication is responsible for a sizable share of emergency department visits. Intoxicated individuals without other medical needs may not require the high level of care provided by an emergency department. We estimate the impact on U.S. health care spending if individuals with uncomplicated, acute alcohol intoxication were treated in sobering centers instead of the emergency department. We performed a budget impact analysis from the perspective of the U.S. health care system based on published and gray literature reports. Ninety-five percent confidence intervals (CI) were estimated using Monte Carlo modeling with random variation for three variables (cost of an emergency department visit, cost of a sobering center visit, and start-up costs per sobering center visit) and the percentage of cases diverted from emergency departments to sobering centers. Outcomes were expressed in terms of national savings in 2017 U.S. dollars. Assuming a diversion rate of 50% based on previous studies, national savings range from $230 million to $1.0 billion annually. In the Monte Carlo modeling, we found annual national savings of $99.02 million (95% CI: $95.89-$102.19 million), $792.34 million (95% CI: $767.09-$817.58 million), and $1,185.51 million (95% CI: $1,150.64-$1,226.37 million) with diversion rates of 5%, 40%, and 60%, respectively. Implementing sobering centers as a treatment alternative for individuals with uncomplicated acute alcohol intoxication could yield substantial cost savings for the U.S. health care system.