All HCCI Reports
HCCI’s original reports powered by #HCCIdata

Apr
01

Compared to What? Baseline Understanding of the Distribution of Hospital Care

The pandemic of a new coronavirus, COVID-19, is increasing demand on hospitals as unprecedented numbers of people with respiratory disease seek treatment. In addition to straining hospital resources directly related to care of COVID-19, the outbreak may also displace other types of care. In this analysis, we hope to inform the understanding of the distribution of care provided in hospitals and how...
Continue reading
Feb
13

2018 Health Care Cost and Utilization Report

The 2018 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2014 through 2018 for individuals under the age of 65 who receive health insurance coverage through an employer. The report draws on data from more than 2.5 billion medical and prescription drug claims for approximately 40 million individuals enrolled in employer-sponsored h...
Continue reading
Jan
29

What if Price Transparency Reduced Commercial Price Variation?

As previous reports have indicated, there is widespread price variation in the U.S. commercial health care system. Many studies have shown that prices are dramatically different not only across geographies, but they vary substantially even within the same market for the same service. For example, we found that prices for the same blood tests could vary 39-fold within Tampa, Florida and the cost of...
Continue reading
Dec
17

International comparisons of health care prices from the 2017 iFHP survey

The International Federation of Health Plans (iFHP), a CEO network of the global health insurance industry based in London, in partnership with the Health Care Cost Institute (HCCI) in the United States, and iFHP member companies in eight countries, today published the latest International Comparison of Health Prices Report. The report compares the median prices paid by a sample of private he...
Continue reading
Nov
21

How common is out-of-network billing?

Congress is considering legislation to address "surprise bills", which occur when a person visits an in-network facility, but receives services from a provider that is outside of their insurer's network. Bills in both the House and Senate include provisions to determine a benchmark rate for out-of-network payments based on what in-network providers of the same specialty are paid for delivering sim...
Continue reading
Nov
07

Air Ambulances – 10 Year Trends in Costs and Use

Air ambulances are either fixed wing (airplane) or rotary wing (helicopter) aircraft used to transport people in often time-sensitive medical situations. Air ambulances have become a frequent topic in the news due to their high cost and propensity to lead to surprise bills. Our analysis shows that although air ambulances are not frequently used and their use declined over the 2008 to 2017 period, ...
Continue reading
Nov
05

Comparing Average Rates for Select Anesthesiology, Emergency Medicine, and Radiology Services by Local Areas

When a person unknowingly receives health care services from a provider that is outside of their insurer's network, it gives rise to the potential for a "surprise bill". Congress continues to consider legislation aimed at reducing the financial burden of "surprise bills" for patients. The approach approved by committees in both the House and Senate is to set a benchmark for the amount that can be ...
Continue reading
Sep
12

Insulin Use Explains Variation in Level, but not Growth, of Out-of-Pocket Spending on Insulin Products

We previously published two blogs discussing trends in out-of-pocket spending on insulin products. First, we presented data illustrating how average monthly out-of-pocket spending in 2017 varied considerably by month, particularly for individuals enrolled in consumer-directed health plans (CDHPs) that carry higher deductibles. Second, we examined the relationship between increasing point-of-sale p...
Continue reading
Sep
12

Rising Point-of-Sale Prices for Insulin Correspond with Higher Out-of-Pocket Spending on Insulin in January

Earlier this week we presented data on out-of-pocket spending on insulin during each month in 2017. In that blog, we showed that enrollees in employer-sponsored health insurance paid more out-of-pocket for insulin products at the beginning of the calendar year. We examined the relationship between increasing point-of-sale prices for insulin and higher out-of-pocket spending in January for a subset...
Continue reading
Sep
10

Out-of-Pocket Spending on Insulin is Highest at the Beginning of the Year

People who get health insurance through their jobs pay more than twice as much for insulin at the beginning of the year than they do at the end of the year, on average. New analysis of HCCI data shows that, nationally, in January 2017, average out-of-pocket spending on insulin was $105. This spending declined every month throughout the calendar year, likely as enrollees met their annual deductible...
Continue reading
Jul
31

State Variation in Opioid Prescribing over 10 Years

Changes in opioid utilization correlated with state-level policy changes aimed at decreasing opioid prescription rates. Previous research by HCCI illustrated that national opioid utilization in pills per person fell 27% between the years of 2008 and 2017, driven by declines in the use of hydrocodone (Vicodin). In addition to giving insight into prescription opioid utilization by the commercially i...
Continue reading
Jul
29

Health Care Spending in New York Growing Faster Than Rest of U.S.

Spending per person in employer-sponsored plans reaches all-time high of $6,335 Health care spending for the average New Yorker with employer-sponsored health insurance is increasing faster in New York State than the rest of the country, according to a new analysis released today by the New York State Health Foundation (NYSHealth) and the Health Care Cost Institute (HCCI). Per-person spending grew...
Continue reading
Jul
23

Comparing Commercial and Medicare Rates for Select Anesthesia, Emergency Room, and Radiology Services by State

Committees in both the House and Senate have advanced legislation that includes measures to address "surprise bills." A surprise bill results when a person unknowingly receives medical care from a provider that is not part of their insurer's network. Both pieces of legislation set a benchmark for out-of-network payments. Those benchmarks are determined based on the median in-network amount paid by...
Continue reading
Jul
15

Opioid Prescriptions Declined 32% for the Commercially Insured over 10 Years (2008 to 2017)

Among people who get health insurance from their employers (56% of the population in 2017), prescription opioid use peaked in 2010/2011 and declined every year from 2012 to 2017. In a new study using the Health Care Cost Institute's commercial claims data from 2008 to 2017, we observed a decline regardless of how utilization was measured. We also found that utilization trends were driven by three ...
Continue reading
May
31

HCCI will be presenting at AcademyHealth's 2019 Annual Research Meeting

The Health Care Cost Institute (HCCI) is proud to present five posters at the AcademyHealth 2019 Annual Research Meeting in Washington, D.C. These posters, which cover HCCI research on a wide variety of topics, focus on health care spending and utilization trends among the commercially insured population. If you are attending the conference, please check out the schedule below to meet our staff an...
Continue reading
May
15

Examining the adoption of a new Medicare billing code for cognitive assessments: a slow but steady uptake

 On January 1, 2017, the Medicare program started reimbursing providers for a new procedure code for clinical visits for cognitive assessments and care planning services (CPT code G0505). This newly-billable service is intended to improve the care of patients with Alzheimer's disease and related dementias and hopefully increase early detection and diagnosis. A G0505 visit includes a complete ...
Continue reading
Apr
30

Past the Price Index: Exploring Actual Prices Paid for Specific Services by Metro Area

As policymakers, employers, and patients increasingly struggle with rising health care costs, there is a lack of clarity around the actual price of health care services and why those prices are so different. Recent efforts have focused on greater price transparency as a way to impact growing prices. A range of proposals from both Congress and the White House seek to shed more light on the confusin...
Continue reading
Apr
02

Shifting Care from Office to Outpatient Settings: Services are Increasingly Performed in Outpatient Settings with Higher Prices

Where people receive health care matters, especially in terms of costs. The same services may have a much higher price tag when performed in one setting rather than another, but this price difference is rarely publicized to patients. To understand what settings people used and how prices differed, we looked at the utilization and average price paid from 2009 to 2017 for a set of services commonly ...
Continue reading
Mar
28

Surprise out-of-network medical bills during in-network hospital admissions varied by state and medical specialty, 2016

 Out-of-network billing practices have increasingly garnered attention as individuals with commercial health insurance continue to experience "surprise billing." A surprise medical bill commonly describes a charge to a patient for care delivered by an out-of-network (OON) professional who works within an in-network facility. We used the Health Care Cost Institute's (HCCI) vast commercial...
Continue reading
Jan
21

Spending on Individuals with Type 1 Diabetes and the Role of Rapidly Increasing Insulin Prices

We used health care claims data to investigate trends in total health care spending on individuals with type 1 diabetes between 2012 and 2016. We found a rapid increase in total health care spending, driven primarily by gross spending on insulin that doubled over the period. During that time insulin use rose only modestly. While the composition of insulins used shifted, the price of all types of i...
Continue reading
Nov
15

Trends In Primary Care Visits

Office visits to primary care physicians (PCPs) declined 18 percent from 2012 to 2016 for adults under 65 years old with employer-sponsored health insurance, while office visits to nurse practitioners (NPs) and physician assistants (PAs) increased 129 percent. Comparing 2012 to 2016, there were 273 fewer office visits per 1,000 insured individuals to primary care physicians over that span, while v...
Continue reading
Sep
19

Health Affairs: Health Care Spending Under Employer-Sponsored Insurance: A 10-Year Retrospective

ABSTRACT Using a national sample of health care claims data from the Health Care Cost Institute, we found that total spending per capita (not including premiums) on health services for enrollees in employer-sponsored insurance plans increased by 44 percent from 2007 through 2016 (average annual growth of 4.1 percent). Spending increased across all major categories of health services, although the ...
Continue reading
Sep
11

ER facility prices grew in tandem with faster-growing charges from 2009-2016

HCCI often reports the prices of health care services, defined as the average amount a provider is paid for a given service based on negotiations with health care insurers. These prices typically represent a portion of charges, which are the amounts health care providers bill for the procedures they perform. The charge amount is often the starting point for negotiations between insurers and provid...
Continue reading
May
30

ER spending among the commercially insured continued to rise in 2016, driven by the price and use of high severity cases (2009-2016)

HCCI recently expanded its reporting on emergency room (ER) spending trends to include the most recent data available (2016). We characterize trends in spending, price, and utilization for the five Current Procedural Terminology (CPT) codes designed to capture the level of severity and complexity of every ER visit. While average prices for all five ER CPT codes were higher in 2016 than in 2009, th...
Continue reading
Apr
24

Interactive Tool: Disease Modifying Therapies Drove 82% of Total Increase in Health Care Spending for People with Multiple Sclerosis

In a recent issue brief, HCCI found that the already high cost of care for people with multiple sclerosis (MS) rose dramatically over the past several years. The primary driver was the increasing cost of a small group of prescription drugs called Disease Modifying Therapies (DMTs). To illustrate the role prescription drug prices play in driving overall health care spending for people with MS, we d...
Continue reading