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

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...
Continue reading
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...
Continue reading
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...
Continue reading
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, ...
Continue reading
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...
Continue reading
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...
Continue reading
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...
Continue reading
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...
Continue reading
May
10

Birthing People in the U.S. Pay Nearly $2,000 Out-of-Pocket to Have a Baby

The birth of a child is momentous for any person and family. New parents may face a range of challenges, including a lack of paid family leave, the rising costs of childcare, and potential health-related complications for the birthing person and new baby. In the midst of this major life transition, parents also face new financial burdens. A major cost – even among those with health insurance – is ...
Continue reading
May
10

As COVID-19 Hit, Birthing People Spent Less Time in the Hospital for Delivery

The COVID-19 pandemic has impacted Americans in a myriad of ways, including their use of the health care system for both COVID- and non-COVID related services. In this brief, we explore the ways in which the first year of the pandemic affected people for one of the most common hospital services – childbirth. In 2020, the first year of the pandemic, more than 3.6 million babies were born in the Uni...
Continue reading
Apr
28

COVID Tests Cost $0 for Most People in 2020

COVID-19 testing has become a regular part of life for many Americans over the last two years. In addition to facilitating individual returns to work, school, and other activities, testing is a crucial component of the public health strategy to monitor and address the spread of the virus. Even as testing becomes more available, there is widespread concern and frustration about the high and variabl...
Continue reading
Feb
14

Love is Expensive; So is a Trip to the Emergency Room

Valentine's Day – known for romantic candlelit dinners, lavish jewelry, and red roses – is pricey. Indeed, the National Retail Federation's Annual Valentine's Day Spending Survey suggests that an individual spends an average of $175 on these gifts each year. However, data from the Consumer Product Safety Commission shows that the cost of love may be even greater, as more than 300 emergency room vi...
Continue reading
Dec
17

Assessing the Long-Term Viability of Data Platforms for Research

Health care in the United States is notoriously fragmented. A patient may receive care from a variety of health systems, physicians, and other providers, and that care may or may not be recorded in a patchwork of administrative claims data systems and electronic health record (EHR) systems. At the same time, health data has become an increasingly valuable commodity. Billions of health data points ...
Continue reading
Nov
19

Ouch!: New Data reveals ER spending increased by 51% from 2012 – 2019, with patient out of pocket payments increasing by 85%

Introduction Excessive emergency room (ER) spending and utilization have long been major areas of focus for health care stakeholders. The ER is an important source of health care for many individuals, especially those who lack a usual source of care, or those with work schedules that limit the ability to access care during "normal business hours." But an ER visit can be extremely expensive, and pa...
Continue reading
Oct
15

Capping Out-of-Pocket Spending on Insulin would Lower Costs for a Substantial Proportion of Commercially Insured Individuals

Previous HCCI analysis documented rapid growth in insulin spending over the 2012-17 period. High out-of-pocket spending may deter adherence to insulin among individuals with diabetes, with potentially fatal effects. In this blog, we update our analysis of out-of-pocket insulin spending to 2019 using HCCI's unique commercial claims dataset, which includes prescription drug claims for 29 millio...
Continue reading
Jun
11

Real World Consequences of the Qualifying Payment Amount in the No Surprises Act

The United States Congress passed the No Surprises Act last year, offering several protections to consumers. Beginning in 2022, providers can no longer bill patients for more than their insurance's in-network cost sharing. The law also bans balance billing except in situations where a patient is notified in advance and their written consent is obtained. Independent dispute resolution between insur...
Continue reading
May
21

2019 Health Care Cost and Utilization Report

The 2019 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2015 through 2019 for individuals under the age of 65 who receive health insurance coverage through an employer. This report examines trends within four categories of service: inpatient admissions, outpatient visits and procedures, professional services, ...
Continue reading
Apr
16

The Impact of COVID-19 on the Use of Preventive Health Care

Updated 4/16/2021 to include data through 12/30/2020. Since the original post on 9/9/2020, the data have been adjusted to account for claims submission lags. For more information, see Methods Note below. COVID-19 has had an extraordinary impact on the US health care system since its emergence in early 2020. One of the largest and most immediate impacts has been the death toll, with ...
Continue reading
Tags:
Apr
01

The Insanity of U.S. Health Care Pricing: An Early Look at Hospital Price Transparency Data

The numbers in this report have been updated to reflect the most recent pricing data made available by Sutter Health. While nearly all of the prices remained unchanged (93%), some, generally higher cost services were revised downward by Sutter. For example, in the initial report we found that C-section prices ranged from $7,634 to $89,244 across the Sutter system, whereas in the more recently avai...
Continue reading
Mar
08

Daily Deaths During Coronavirus Pandemic by State

The staggering death toll of the novel coronavirus pandemic in the United States has been widely reported, surpassing 523,000 as of March 8, 2021. Over the course of the current pandemic a common method for measuring the probable number of deaths caused by COVID-19 has been comparing actual deaths in 2020 to the expected number of deaths in 2020 based on deaths in previous years. To add to the gro...
Continue reading
Feb
24

Using Medicare Data to Improve Vaccine Targeting: Providers Serving Highest Risk Patients

As the production and distribution of SARS-CoV-2 vaccines ramps up in the United States, there is a need to ensure that communities at highest risk for severe COVID-19 morbidity and mortality are targeted. As of February 2021, the Pfizer/BioNTech and Moderna mRNA vaccines, which were approved by the U.S. Food and Drug Administration (FDA) under Emergency Use Authorization (EUA) in late 2020, remai...
Continue reading
Tags:
Feb
18

COVID-19 Disparities Persist in Community Health Centers' Vulnerable Populations

Community Health Centers (CHCs) serve over 29 million vulnerable patients, making the lack of data on COVID-19-related racial disparities in patients served in CHCs a critical knowledge gap in assessments of the pandemic's national impact. In rural and poor urban areas, CHCs may be the only accessible healthcare option. Even when other options exist, CHCs reduce barriers such as cost, lack of insu...
Continue reading
Tags:
Jan
25

When the Medicare Rate Isn’t the Medicare Rate: Analyzing Differences Between the Medicare Physician Fee Schedule and Payments Received by Physicians.

Increasingly, policymakers are considering proposals that tie payments made by private health insurers, in some way, to rates paid by Medicare. These proposals are inspired by the rising cost of health care and widespread variation in health care prices. For example, we recently found that the cost of the same service can vary by 5-fold, 10-fold or more within the same market among the commerciall...
Continue reading
Dec
09

How Differences Between Commercial, Medicare Professional Service Prices Could Result in Different Policy Impacts

 Introduction As rising health care costs force difficult choices for families, employers, and federal, state, and local governments, a range of policy proposals are emerging to address health care spending in the U.S. In this presidential election year, there has been heightened attention on lowering health care costs and making care more affordable, which will likely accelerate with the ele...
Continue reading
Nov
12

Past the Healthy Marketplace Index, Volume II: Exploring Changes in Actual Prices Paid for Specific Services by Metro Area from 2013 to 2017

In the first brief of the Past the Healthy Marketplace Index series, we explored how prices compared across the country and found that, in 2017, health care prices for specific services varied by as much as 22-fold across metro areas and even up 40-fold within them. In this next brief, we looked at variation in price growth and examined if that variation was related to the substantial observed dif...
Continue reading