CDC Cost Calculator

The CDC Cost Calculator provides state-level estimates by gender for five age bands or strata: age 0-17, (2) age 18-44, (3) age 45-64, (4) age 65-79, and (5) age 80 or older. The cost estimates from the CDC Cost Calculator include all additional or attributable medical expenditures for the entire state population (all payers and the uninsured) and includes estimates of absenteeism. The estimates were derived from the 2004 through 2008 Medical Expenditure Panel Survey (MEPS) Consolidated Data Files, a nationally representative survey of the civilian non-institutionalized population that provides data on annual medical expenditures, sources of payment, insurance coverage, and days missed from work due to illness or injury for each participant. Diseases were defined using ICD-9 codes based on self-reported diseases that were transcribed by professional coders and reported in the MEPS Medical Conditions files for years 2004 through 2008 (see Table 1). The combined five-year MEPS sample included 153,012 persons of all ages living in the U.S.

To account for multiple chronic diseases and avoid double-counting (i.e., overlap of disease costs) of the associated medical costs, the CDC Cost Calculator employs estimates from a two-stage statistical analysis that generates estimates of cost of multiple diseases. The resulting estimates of the costs of arthritis, asthma, cancer, CHF, CHD, stroke, other heart diseases and depression are thus independent of the other condition, although the cost estimates for hypertension and diabetes do include the costs of complications such as CHD, CHF and stroke. The costs of hypertension and diabetes are therefore not mutually exclusive of the costs of other reported diseases. We report the estimated cost of CHF, CHD, stroke, and hypertension separately, but report only the combined cost of cardiovascular disease that includes these four diseases (we do not estimate costs for other heart diseases).

To account for differences between counties in the cost per case due to variations in the price of healthcare services across the state, prices were adjusted using the Geographic Adjustment Factor (GAF) reported by the Institute of Medicine (IOM) and based on the Center for Medicare and Medicaid Studies (CMS) Medicare geographic practice cost index (GPCI) for California. The GAF takes account of geographic differences due to three factors: cost of physician services, practice expenses due to location (e.g., rent and cost of operating a facility), and geographic differences in malpractice or professional indemnity. The GAF, which divides California into 9 distinct regions for which GPCIs are calculated, was applied to the cost estimate for each condition, age, and gender for each region of California. The cost adjusters, ranging from 1.0323 to 1.1817, were applied to the cost estimates from the CDC Cost Calculator.  To account for the increase in the cost of care, the estimates from the CDC cost calculator were adjusted using to 2023 dollars using a medical cost calculator. The rates for the years from 2009 to 2023 are shown below.