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Asthma is the most common chronic condition among children in the U.S. and one of the leading reasons for pediatric emergency room (ER) visits. Schools play an important role in managing asthma among children since kids spend most of their time in school and school buildings may have environmental factors such as poor air quality and mold which can trigger asthma flare-ups. When asthma is uncontro...

The COVID-19 pandemic led to an increase in the use of telehealth services and online asynchronous health communication, commonly referred to as emails. These tools allow patients to ask their physicians and other clinicians questions regarding medication changes, symptoms, and to check in regarding management of chronic conditions. In March 2020, CMS expanded Medicare telehealth billing to includ...

Neonatal Intensive Care Units (NICUs) provide critical, often life-saving, care to over 300,000 infants every year. The specialized care and technology available in NICUs have allowed preterm and otherwise vulnerable babies to survive and thrive even in the face of a host of potentially life-threatening complications and are recognized as contributing to the decline in infant mortality over the pa...

Asthma is the most common chronic condition among children in the U.S. and one of the leading reasons for pediatric emergency room (ER) visits. Schools play an important role in managing asthma among children since kids spend most of their time in school and school buildings may have environmental factors such as poor air quality and mold which can trigger asthma flar...

In June, HCCI staff attended AcademyHealth's Annual Research Meeting (ARM) and ASHEcon. In addition to connecting with other health services researchers, staff presented original research using HCCI's commercial claims dataset. Here's a sampling of HCCI staff presentations:  ASHEcon: Effect of Critical Access Hospital Designation on Inpatient Prices in Employer-Sponsored Insurance Presen...

Ozempic, a relatively new anti-diabetes drug, has been in the headlines because of widespread shortages that are making it difficult for patients who use the drug to manage diabetes to access it. Some news articles suggest that off-label use for weight loss has been a factor associated with increased demand. The active ingredient in Ozempic is semaglutide, which helps regulate insulin product...

In HCCI's most recent Health Care Cost and Utilization Report, we observed substantial growth in spending on vaccines among individuals with employer-sponsored health insurance (ESI), which we attributed largely to uptake of COVID-19 vaccinations in 2021. Although they may be largely responsible for this trend, federal procurement complicates analyses of COVID-19 vaccines using claims data. Resear...

In this brief, we explain the basics of "facility fees," which have been gaining attention at the state and federal levels. We discuss what a facility fee is, why patients might receive a bill for a facility fee for non-hospital services, why there is controversy around these bills, and what policymakers are doing to address them. Download and read the brief below. As described in the br...

Cancer diagnoses can have devastating psychological and financial tolls on patients and their families. Previous research shows that Medicare beneficiaries who are newly diagnosed with cancer experience health care costs that can reach close to a quarter of household income in the year following diagnosis. People with employer-sponsored insurance (ESI) may experience even greater financial burden ...

Recent policy and other initiatives aim to reduce spending on prescription drugs. At the federal level, the Inflation Reduction Act targets reductions in drug spending in Medicare through price negotiation, capping out-of-pocket spending by patients, and requiring drug manufacturers to pay rebates when prices rise faster than inflation. At the state level, there are initiatives to increase drug pr...

Evaluation and Management (E&M) services provide an entry point for many people into the health care system. This category of services includes most office visits to a primary care physician or specialist, including behavioral health services, as well evaluation and management services provided in an emergency room or outpatient setting. These visits typically involve a physician or other heal...

According to HCCI's data, the price of a hospital admission for childbirth among birthing people with employer-sponsored health insurance (ESI) varies by a factor of three across hospitals within a local area. Even within the same hospital and within the same type of delivery, some births cost twice as much as others. Different prices for the same service in the same hospital with the same type of...

Total Spending Averaged $24,336 across the Prenatal, Childbirth, and Postpartum Periods among ESI Enrollees HCCI has highlighted the high cost of childbirth in the United States, but delivery is only one component of the full financial cost of having a baby. The cost of prenatal and postpartum care may cause people to forgo appropriate services, even as this care could help improve maternal health...

There is substantial evidence that people in the U.S. receive health care services judged to be of low-value. These services are identified as low value based on recommendations from the U.S. Preventive Services Task Force (USPSTF) and professional medical societies that there is little to no clinical value associated with their provision and potential for harm in specific clinical scenarios. Thes...

Insulin is a life-saving medication for millions of Americans who live with diabetes. As the price of insulin has risen, people who depend on insulin have had to make difficult decisions about whether to pay for their medication or other necessities. Some have been forced to ration their supply, with devastating results. Recent legislation has limited insulin out-of-pocket...

Biologic drugs represent advances in medical research and treatment but are a major driver of drug spending in the United States. Spending on biologics increased by 50% between 2014 and 2018 in the U.S. even though just 2% of Americans used them. Biosimilars, clinically equivalent, lower-cost versions of original biologic drugs, analogous to generic versions of brand name "small molecule" drugs, c...

Every year, 1 million people in the U.S. receive chemotherapy for cancer treatment. Most chemotherapy treatment requires patients to be present in a physician's office or hospital outpatient department to receive the treatment (typically an infusion or injection). Chemotherapy plays a critical role in treatment for many patients with cancer, but it also often leads to high financial costs for pati...

Colorectal cancer screenings are essential for early disease detection, prevention, and treatment. Since 2014, Cologuard, a DNA-based screening test that can detect colorectal cancer and precancerous cells, has been available to individuals 45 and older at average risk for colorectal cancer. In contrast to colonoscopies, which must be done at a health care facility, Cologuard is non-invasive ...

Colorectal cancer is the third most common cancer diagnosed in the U.S., and the second most common cause of cancer deaths among men and women combined. Screening via colonoscopy is highly effective in terms of improving prognosis of colorectal cancer via early detection; over 90% of patients who are diagnosed early (i.e., when the cancer is small and has not spread) live five years or l...

November and December of 2022 saw growth in rates of flu, RSV, and COVID, that renewed attention to a seasonal trend of increased respiratory illnesses in the winter months. Data from Medicare, Medicaid, and private insurance illustrate the seasonal ups and downs of respiratory infections. Earlier HCCI research showed that hospitalizations from respiratory illness increased in the winter months (N...

Reproductive and sexual health services play an important role in daily life and wellbeing for many people. These services include preventive services (such as screenings for sexually transmitted infections and reproductive cancers), contraceptive services, and services relating to pregnancy and childbirth. The objective of this report is to provide national and state data on the use of repro...

Each year, HCCI creates the Healthy Marketplace Index (HMI) to examine how health care spending varies across the United States. The HMI shows health care spending, prices, and use compared to the national median for close to 200 local metro areas. By describing how health care spending varies geographically and how use and price contribute to spending in each area, HMI is a starting point in unde...

HCCI's commercial claims dataset includes claims for over one-third of the population with health insurance through their job (employer-sponsored insurance, or ESI). There are a number of unique features of these data that make them valuable for answering important health care and health policy questions. One such feature is the 5-digit zip codes of ESI enrollees (i.e., where people live) and thei...

Sexually transmitted infections (STIs) are infections caused by pathogens spread through sexual contact. STIs can progress from an infection into a sexually transmitted disease (STD). Chlamydia, gonorrhea, syphilis and HIV are the most commonly screened for STIs in the US. The CDC STD Surveillance Data estimates that there were more than 2.5 million cases of chlamydia, gonorrhea, and syphilis...

High out-of-pocket costs for health care services can put necessary care and medications out of reach for many people. In one survey, nearly half of adults reported difficulty paying for health care services. In this brief, we used HCCI's commercial claims dataset, which includes health care spending information for over one-third of the population who receives health insurance through their job, ...