Minnesota's approach to the development and use of State health expenditure accounts (SHEAs) was developed to assist State policymakers with decisions regarding health care reform. The accounts are based on an annual survey of third-party payers and summary Medicaid and Medicare data. Summary data are presented along with a discussion of data collection methodology, estimation, and dissemination. Minnesota's experience demonstrates that the ability of States to conduct detailed analysis of health care spending and to use these estimates to change State policy, inform national policy debate, conduct impact analysis, educate policymakers, and monitor market trends.