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

Nov
16

Telehealth Use Increased more than 50-fold for Primary Care Visits and Behavioral Health Services in Early Months of the COVID-19 Pandemic

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...

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Nov
15

COVID-19 Hospitalizations in 2020 were Highest for People Living in the Most Socially Vulnerable Areas and American Indian and Alaska Native People

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...

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Nov
12

HCCI Spotlights National Diabetes Month: ESI Enrollees with Diabetes Face High Out-of-Pocket Costs. A Cap on Insulin Costs Would Help Many.

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...

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Nov
10

Prevention and Screening Rates among ESI Enrollees are Lower in Rural and Socially Vulnerable Areas, with Smaller Differences in Medication Adherence

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...

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Nov
09

Over 50% of Insulin Users with ESI Spend over $35 Out-of-pocket on 30-day Supply of Insulin

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...

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Oct
12

Spending on Preventive Services Represents a Small Fraction of Total Health Care Spending, but Costs to Individuals Could Be High without ACA Protection

 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...

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Oct
11

Greater Share of Children’s Emergency Room Visits were for Mental Health Needs in 2020

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...

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Oct
06

Trends in HIV PrEP utilization, spending, and price

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...

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Oct
04

HCCI Spotlights Breast Cancer Awareness Month: Use of Mammograms Peaks in October

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 ...

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Sep
20

Biosimilar Savings among People with Employer-Sponsored Insurance Not Keeping Pace with Savings in Medicare

Biologic drugs include a range of life-saving medications to treat cancer, diabetes, rheumatoid arthritis, retinal diseases, and many other conditions. Unlike "small molecule" drugs (e.g., statins), which can generally be taken at home, biologics are typically infusions or injections which require administration by a physician or other clinician in a hospital or physician's office. While just...

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Sep
07

Children's Health Services 2020 Report

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...

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Sep
07

COVID-19 Disrupted On-Time Vaccination Rates In ESI and Medicaid in 2020

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...

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Sep
07

Mental Health and Respiratory Admissions Account for the Majority of Non-Newborn Children’s Hospitalizations from 2016-2020

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...

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Aug
31

Use of and Spending on Firearm-Related Injuries Increased among People with Employer-Sponsored Health Insurance from 2016-2020

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...

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Aug
25

HCCUR Data Point: Trends in Total (Administered and Prescription) Drug Spending in ESI

Total spending on drugs includes spending on prescription drugs (typically oral medications prescribed by a physician, picked up by a patient at a local pharmacy, and taken at home) and administered drugs (typically injected or infused under the supervision of a health care professional either in an outpatient facility or physician office). In HCCI's Health Care Cost and Utilization Repo...

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Aug
24

Employer-Sponsored Health Insurance Plays a Significant Role in Vulnerable and Rural Communities

Health care insurance claims data capture what health care services people use and how much they pay. These data are crucial for understanding the state of the U.S. health care system, including aspects that function well, those that need improvement, and how to achieve better health and access to care across populations. In this report, we look at the characteristics of individuals who have emplo...

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Aug
23

HCCUR Data Point: Use and Spending on Clinician Services in Hospital and Non-Hospital Settings

In HCCI's Health Care Cost and Utilization Report (HCCUR), we report per person spending on health care services of $5,607 in 2020. Of this spending, $1,514 (27%) was on services that occurred in a hospital outpatient setting and $1,071 (19%) was on services that occurred in a hospital inpatient setting. These spending amounts do not include spending on professional services that a patient receive...

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Aug
02

Price Markups for Clinical Labs: Employer‑based Insurance Pays Hospital Outpatient Departments 3X More Than Physician Offices and Independent Labs for Identical Tests

The Health Care Cost Institute (HCCI) in collaboration with West Health conducted an analysis of the high prices that employer-based insurance pays hospital outpatient departments for clinical lab tests. We found that insurers are paying 3 times more for identical tests (such as simple blood and urine tests) when billed by hospital outpatient departments compared to physician offices and inde...

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Jul
20

International comparisons of health care prices from the 2019 iFHP study

The International Federation of Health Plans (iFHP), an executive 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 multiple countries, today published the latest International Health Cost Comparison Report. The report compares the median prices paid by a sample of private he...

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Jul
13

Privately Insured Individuals with Diabetes Spend Twice as Much Out-of-Pocket on Health Care as those without Diabetes

Over 10% of the U.S. population— more than 34 million individuals— lives with diabetes, with 1.5 million new cases diagnosed each year. As people with diabetes manage this chronic condition, they often pay substantial amounts out of their own pockets on medical care and prescription medications. Using HCCI's unique health care claims dataset, this brief illustrates the impact of diabetes on the us...

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Jul
07

The First Year of the COVID-19 Pandemic Had a Disproportionate Impact on Inpatient Service Use in Socially Vulnerable Metro Areas

Each year, HCCI publishes an annual update to the Healthy Marketplace Index (HMI), an interactive tool that describes how health care prices, use, and spending vary across metropolitan areas. HMI helps us to understand how these aspects of the health care system compare and contrast to the median metropolitan area. We recently released the latest version of the HMI, which provides data from 2020, ...

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Jun
09

One-Third of Births Occurred by C-Section in ESI and Medicaid in 2020

Caesarean sections (c-sections) are often life-saving procedures that can prevent injury and death among birthing people and newborns. At the same time, when they are not medically necessary, c-sections may have higher risks to babies and birthing people than vaginal births. Monitoring rates of c-sections among birthing people is an important component of efforts to improve the quality of mat...

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Jun
09

Average Payments for Childbirth Among the Commercially Insured and Fee-for-Service Medicaid

It is well-established that the rates hospitals and physicians are paid to provide health care services are significantly lower in Medicaid than in private health insurance. In this brief, we provide new data on this payment gap in the context of childbirth, an especially relevant area of care since Medicaid and ESI together cover the vast majority of births in the United States. We used HCCI's un...

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Jun
08

Effects of COVID-19 on Health Care Spending Were Concentrated in April-May 2020

The COVID-19 pandemic shaped health care spending and use over the past two years in numerous ways. We recently released our Health Care Cost and Utilization Report which provides data from the first year of the pandemic on health care use, spending, and prices across different types of services for approximately 55 million individuals enrolled in employer-sponsored health insurance. In the report...

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May
10

The Price of Childbirth in the U.S. Tops $13,000 in 2020

As HCCI has previously documented, the price of childbirth in the U.S. is higher than in many other countries. When prices are high, patients with health insurance pay directly through coinsurance (i.e., cost-sharing calculated as a percent of what their insurer pays for the service) and over time, as higher prices charged to insurers are passed along to individuals through higher premiums. We exa...

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