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 understanding health care costs and cost growth in a particular area and across the country. 

In the case studies below, we add dimension to the data presented in HMI by looking more closely at some of the factors contributing to spending, use, and prices in four areas: Baltimore, Maryland; Springfield, Illinois; St. Louis, Missouri; and Washington, D.C.

In each study, we take a deeper dive into the context surrounding and contributing to health care spending in the area, including social determinants of health, prevalence of disease, health care providers, and health care markets. Understanding the range of factors that result in an area's health care spending, and the mix of use, price, and composition of health care services that drives spending, is important for any efforts to lower prices or improve the value of that spending.