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Abstract: 

Our editors summarize and analyze a new report from the Pew Charitable Trusts and the Vera Institute, “Prison Health Care: Costs and Quality How and Why States Strive For High-Performing Systems.” The full 140-page report includes summary level data on health care delivery systems, costs and cost-drivers, utilization, quality assurance, and the advantages and disadvantages of public and privatized prison health. The report found that large disparities exist among state prison health systems, with some states (like California, which spends nearly $20,000 on health care per inmate annually) outspending others (like Louisiana, which spent about $2,000 per inmate) by orders of magnitude up to 8x. Pew also found that these spending differences have persisted for decades, with the same states spending more on a consistent basis. But Pew also found that very few states systematically record or analyze what they spend, or measure patient outcomes. In the absence of even basic cost and outcome analysis, it is impossible to say whether high spending states are enjoying better health outcomes, or spending wastefully, or some combination of the two. Our summary also includes additional charts and tables on spending levels and rates, using US Census data not included in the original Pew report.

Keywords: Pew Charitable Trusts; prison inmate health spending; capitated contracts; quality monitoring

Affiliations:  1: Correctional Health Care Report .