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Nov
25

Comparing Post-Acute Care Use and First Site of Care Among Medicare Advantage Enrollees and Medicare Fee-for-Service Beneficiaries

Using data from the Health Care Cost Institute (HCCI) and Centers for Medicare & Medicaid Services (CMS), we examined trends in inpatient hospital admissions and post-acute care (PAC) utilization among Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries. Specifically, we compared how frequently individuals in each group were discharged from the hospital, whether they had evidence o...

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Nov
25

Health Services Research: Comparing Different Methods of Indexing Commercial Health Care Prices

​The methodology for HCCI's Healthy Marketplace Index was published in a Methods Brief for Health Services Research. Abstract Objective: To compare different methods of indexing health care service prices for the commercially insured population across geographic markets.Data Sources: Health Care Cost Institute commercial claims data from 2012 to 2016.Study Design: We compare price i...

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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...

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Nov
12

Health Affairs: Stop Blaming The Victim: The Case For Systemic Health System Transparency

In HCCI's publication in Health Affairs Blog, we examine the case for systemic health system transparency and directing changes towards key stakeholders.  From the article: "Health care costs strain the budgets of families, businesses, and governments, leaving less room for other spending and forcing painful tradeoffs. In 2017, the United States spent $3.5 trillion on health care - ...

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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, ...

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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 ...

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Oct
30

Antidepressant Use Increased for Individuals with a Mood Disorder with Employer-Sponsored Insurance

Depression is a common mood disorder that affects how people feel, think, and conduct daily activities. Approximately 17 million adults (1 in 14) had at least one major depressive episode in 2017. Surveys have found that antidepressant prescribing has increased over the past two decades. For example, a 2017 National Center for Health Statistics survey found that, among people age 12 and ...

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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...

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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...

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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...

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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...

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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...

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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...

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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 ...

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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...

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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 ...

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May
02

Lower Health Care Spending and Use for People with Chronic Conditions in Consumer-Directed Health Plans

To better understand differences in spending and use across types of health plans, we examine individuals enrolled in consumer-directed health plans (CDHPs) and individuals enrolled in non-CDHP health plans. CDHPs are a type of HDHP that typically include a health savings account (HSA) or a health reimbursement arrangement (HRA). We analyzed a sample of over 10 million individuals under the age of...

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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...

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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 ...

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Apr
01

American Economic Journal: Applied Economics: Health Care Spending and Utilization in Public and Private Medicare

Abstract: We compare health care spending in public and private Medicare using newly available claims data from Medicare Advantage (MA) insurers. MA insurer revenues are 30 percent higher than their health care spending. Adjusting for enrollee mix, health care spending per enrollee in MA is 9 to 30 percent lower than in Traditional Medicare (TM), depending on the way we define "comparable" enrolle...

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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...

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Feb
27

BMC Public Health: Area-Level Deprivation and Preterm Birth: Results from a National, Commercially-Insured Population

Abstract Background: Area-level deprivation is associated with multiple adverse birth outcomes. Few studies have examined the mediating pathways through which area-level deprivation affects these outcomes. The objective of this study was to investigate the association between area-level deprivation and preterm birth, and examine the mediating effects of maternal medical, behavioural, and psyc...

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Feb
04

Health Affairs: Variation In Health Spending Growth For The Privately Insured From 2007 to 2014

ABSTRACT We examined the growth in health spending on people with employer-sponsored private insurance in the period 2007–14. Our analysis relied on information from the Health Care Cost Institute data set, which includes insurance claims from Aetna, Humana, and UnitedHealthcare. In the study period private health spending per enrollee grew 16.9 percent, while growth in Medicare spending per fee-f...

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Feb
04

Health Affairs: Medicare Advantage And Commercial Prices For Mental Health Services

​Abstract: In 2014, insurers paid an average of 13–14 percent less for in-network mental health services in their commercial and Medicare Advantage plans than fee-for-service Medicare paid for identical services—despite paying up to 12 percent more than Medicare when the same services were provided by other physician specialties. However, patients went out of network more frequently for mental hea...

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Feb
04

Health Affairs: Hospital Prices Grew Substantially Faster Than Physician Prices For Hospital-Based Care In 2007–14

Abstract: Evidence suggests that growth in providers' prices drives growth in health care spending on the privately insured. However, existing work has not systematically differentiated between the growth rate of hospital prices and that of physician prices. We analyzed growth in both types of prices for inpatient and hospital-based outpatient services using actual negotiated prices paid by insure...

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