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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...

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, ...

Obesity is a serious and costly chronic disease that has been increasingly common among the U.S. population. Electronic health record (EHR) data have the potential to support research and patient care interventions. The timeliness and availability of aggregated clinical data can be used in near-real time to monitor obesity prevalence based on body mass index (BMI) at the population-level to guide ...

Telehealth facilitates medical care, allows for the sharing of health information, and offers patient health education through remote communication. In 2020, the onset of the public health emergency prompted many localities to restrict in-person gatherings to prevent transmission of the virus. Health care providers responded by expanding telehealth services in an effort to continue serving their p...

The onset of the COVID-19 pandemic fundamentally shifted health and health care in the US in 2020. Hospitals have been central to responding to the pandemic and treating COVID, which means that hospitalizations can provide an important lens to understanding the pandemic's impact. Earlier HCCI research looked at hospital use and spending among people with employer-sponsored insurance (ESI) before t...

Diabetes is a chronic health condition that affects over 10% of the U.S. population. It is possible for people  who are diagnosed with diabetes to live a healthy, long life if the condition is managed properly. However, management often involves significant health care use, which can be costly for patients. Over the past few months, we used HCCI's commercial claims dataset to e...

Inequities in health care access and outcomes among vulnerable populations are well-documented, as is the fact that where you live affects health outcomes to a similar or even greater extent than your health behaviors. Previous HCCI work shows that employer-sponsored health insurance (ESI) plays an important role in many vulnerable communities. Among the population in the United States with health...

Previously, HCCI analyzed prescription drug spending to understand how many insulin users with employer sponsored insurance (ESI) would be affected by a $35 monthly cap on patient out-of-pocket spending on insulin. Our estimates were based on average monthly out-of-pocket spending on insulin across all insulin products. The Inflation Reduction Act (IRA) recently passed by Congress includes a $35 p...

 The Affordable Care Act (ACA) requires insurers to cover certain services without charging patients out-of-pocket. These services include routine preventive care, such as wellness visits, immunizations, contraceptive services, and cancer and other disease screenings. In September 2022, a federal court ruled portions of the law's preventive services provision unconstitutional. If the court de...

In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association, declared a National State of Emergency in Children's Mental Health associated with the COVID-19 pandemic, including the loss of caregivers, school closures, social isolation, and gaps in health care (see citations below). Understanding the effect of the COV...

Pre-exposure prophylaxis (PrEP) for HIV are medications that reduce an individual's chances of contracting HIV. The CDC estimates that 1.2 million people are at risk of HIV infection and may benefit from a PrEP prescription. We analyzed health insurance claims for 55 million Americans with employer-sponsored insurance in order to examine utilization and spending on these drugs between 2016 and 202...

Mammography screenings are recommended every 1-2 years for women aged 40 and older, as well as for younger women who are at high risk for breast cancer. These screenings are an essential tool for early detection and treatment of breast cancer. Using HCCI's data on people with employer-sponsored insurance as well as Medicare and Medicaid data, we examined mammography utilization patterns from 2018 ...

The population with employer-sponsored health insurance (ESI) includes individuals who receive health insurance coverage from an employer, including employees and their dependents, such as spouses and eligible children. Half of the children in the U.S. are covered by ESI, making this form of coverage the largest source of insurance for American children. In this report, we present data on health c...

It is no secret that the COVID-19 pandemic upended the U.S. health care system in 2020, with effects still being felt in 2022. HCCI previously published a brief that showed precipitous drops in the utilization of several preventive health care services in early 2020. Several news outlets have also covered the effect of the pandemic on routine services, including childhood vaccination rat...

Half of American children have health insurance coverage through an employer (typically as a dependent on a parent's coverage). Therefore, a major asset of employer-sponsored insurance (ESI) claims data is the opportunity to understand more about how children use and experience the health care system. In this brief, we use HCCI's unique national dataset encompassing health care claims for over one...

The Centers for Disease Control and Prevention (CDC) reports that there were more than 45,000 firearm-related deaths in 2020; in addition, evidence suggests that there were an additional 2-3 nonfatal firearm injuries seen per death. Recent studies estimate that more than 200 people are injured by firearms each day, and the notable tragedies in 2022, along with the daily toll of firearm-related inj...