All HCCI Reports
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Feb
12

HCCI Spotlights American Heart Month: Cardiac Rehabilitation Rates Have Room to Grow

Consistently Low Rates of Cardiac Rehabilitation Sessions

Cardiac rehabilitation is a program to help patients with heart events recover and return to normal activities. It is recommended following acute heart events and as a component of addressing chronic heart failure. Despite recommendations from federal agencies, advocacy groups, and national health associations and the documented benefits of cardiac rehabilitation, only 20-30% of people who could b...

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Jan
08

Can Employers Help Lower Health Care Prices through Self-Insured Plans?

10 FAQs about Employer-based Health Plans Recent data from the Health Care Cost Institute (HCCI) show that price growth accounted for more than half the change in per person health care spending from 2017 to 2021. Nearly half of people in the US get health insurance through work, either through their own employer or as a dependent. Accordingly, rising health care spending is a big problem for empl...

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Dec
17

Severe Maternal Morbidity Increased by 25% from 2017-2021 among those with Employer Sponsored Insurance

The CDC defines Severe Maternal Morbidity (SMM) as 'unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman's health.' These outcomes are largely preventable and are an important indicator of maternal health care quality. The CDC reports that SMM has steadily increased in recent years, and the consequences are wide-ranging, including detrime...

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Dec
14

On Average, ESI Pays Nearly 3 times Medicare for Hospital Outpatient Services

Health care spending continues to grow, and prices are the primary driver. Without addressing high and growing prices, efforts to make care more affordable will not be successful. One way to understand what is going on with prices in employer-sponsored insurance (ESI) is to compare negotiated rates paid in that market to Medicare payments for the same services. New analysis from the Heal...

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Nov
13

Antidepressant Medication Use Increased Post-Pandemic, but Large Disparities Exist across Nearly Every Demographic Measure

The World Health Organization reported that, following the COVID-19 pandemic, there was a 25% increase in the prevalence of anxiety and depression worldwide. Mental health crises following months and years of social isolation and other effects of the pandemic have renewed national interest in mental health care access. Understanding how mental health services, including medications used to treat m...

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Oct
26

Emergency Room Spending, Price, and Use Trends 2012-2021

The emergency room (ER) is a critical and life-saving source of care for many Americans, but the resulting medical bills that patients receive can be a source of confusion and extreme financial burden. From incredibly high, varying prices to surprise bills resulting from in/out of network confusion, many Americans have no idea what to expect when it comes to the cost of ER services. Poli...

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Oct
12

Ambulance Trends over 10 Years (2012-2021)

Ambulance services play an essential, life-saving role in the health care system but can also be a source of surprise bills to patients and unexpected high out-of-pocket costs. This HCCI data brief and downloadable data explores the 10-year trends in ambulance prices, utilization, spending, and the frequency of out-of-network billing for the commercially insured - people who get their health ...

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Sep
28

Long COVID Affects People with Higher Medical Needs and is Associated with Higher Per Person Health Spending

Important research is underway to understand the impacts of Long COVID. Studies about the clinical pathways, patient-specific needs, and treatment for Long COVID are highlighting necessary medical care and intervention. To inform public and private decisionmakers' efforts to support and treat patients, this study uses HCCI's unique health care claims dataset to identify the effects of Long CO...

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Sep
21

Rates of Gynecological Care Services Suggest Underdiagnosis of Uterine Fibroids and Endometriosis

Uterine fibroids can affect up to 80% of women by age 50. Endometriosis affects 1 in 10 women of reproductive age. Together, they are two of the leading conditions among reproductive-aged women causing infertility, chronic pelvic pain, fatigue, nausea, and heavy menstruation. Symptoms of uterine fibroids and endometriosis are also associated with abdominal pelvic pain, heavy and painful menst...

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ESI
Sep
12

HCCI Data Brief: Sexual and Reproductive Health Among People with Employer-Sponsored Insurance, 2021 Data Update

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 reproducti...

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Sep
05

More Children Visit the Emergency Room for Asthma during School Months Compared to Summer Months

Asthma is the most common chronic condition among children in the U.S. and one of the leading reasons for pediatric emergency room (ER) visits. Schools play an important role in managing asthma among children since kids spend most of their time in school and school buildings may have environmental factors such as poor air quality and mold which can trigger asthma flare-ups. When asthma is uncontro...

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Aug
04

Trends in Asynchronous Health Communication

The COVID-19 pandemic led to an increase in the use of telehealth services and online asynchronous health communication, commonly referred to as emails. These tools allow patients to ask their physicians and other clinicians questions regarding medication changes, symptoms, and to check in regarding management of chronic conditions. In March 2020, CMS expanded Medicare telehealth billing to includ...

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Jul
25

NICU Admissions and Spending Increased Slightly from 2017-2021

Neonatal Intensive Care Units (NICUs) provide critical, often life-saving, care to over 300,000 infants every year. The specialized care and technology available in NICUs have allowed preterm and otherwise vulnerable babies to survive and thrive even in the face of a host of potentially life-threatening complications and are recognized as contributing to the decline in infant mortality over the pa...

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Jul
07

ARM and ASHEcon 2023 Recap: HCCI Staff Research

In June, HCCI staff attended AcademyHealth's Annual Research Meeting (ARM) and ASHEcon. In addition to connecting with other health services researchers, staff presented original research using HCCI's commercial claims dataset. Here's a sampling of HCCI staff presentations:  ASHEcon: Effect of Critical Access Hospital Designation on Inpatient Prices in Employer-Sponsored Insurance Presen...

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Jun
14

The Share of Ozempic Users with Diabetes has Decreased Over Time, Indicating Increased Off-label Use

Ozempic, a relatively new anti-diabetes drug, has been in the headlines because of widespread shortages that are making it difficult for patients who use the drug to manage diabetes to access it. Some news articles suggest that off-label use for weight loss has been a factor associated with increased demand. The active ingredient in Ozempic is semaglutide, which helps regulate insulin product...

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Jun
12

HCCI Data Byte: Unintended effect of federal COVID vaccine policy on claims billing patterns

In HCCI's most recent Health Care Cost and Utilization Report, we observed substantial growth in spending on vaccines among individuals with employer-sponsored health insurance (ESI), which we attributed largely to uptake of COVID-19 vaccinations in 2021. Although they may be largely responsible for this trend, federal procurement complicates analyses of COVID-19 vaccines using claims data. Resear...

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Jun
06

Facility Fees and How They Affect Health Care Prices: Policy Explainer

In this brief, we explain the basics of "facility fees," which have been gaining attention at the state and federal levels. We discuss what a facility fee is, why patients might receive a bill for a facility fee for non-hospital services, why there is controversy around these bills, and what policymakers are doing to address them. Download and read the brief below. As described in the br...

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Jun
01

Out-of-Pocket Spending Grew Over 200% among ESI Enrollees Diagnosed with Cancer

Cancer diagnoses can have devastating psychological and financial tolls on patients and their families. Previous research shows that Medicare beneficiaries who are newly diagnosed with cancer experience health care costs that can reach close to a quarter of household income in the year following diagnosis. People with employer-sponsored insurance (ESI) may experience even greater financial burden ...

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May
25

Use of and Spending on Top Prescription Drugs in Employer Sponsored Insurance, 2021

Recent policy and other initiatives aim to reduce spending on prescription drugs. At the federal level, the Inflation Reduction Act targets reductions in drug spending in Medicare through price negotiation, capping out-of-pocket spending by patients, and requiring drug manufacturers to pay rebates when prices rise faster than inflation. At the state level, there are initiatives to increase drug pr...

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May
23

Over 80% of ESI Enrollees Used Evaluation and Management Services in 2021, with Primary Care and Telehealth the Most Commonly Used

Evaluation and Management (E&M) services provide an entry point for many people into the health care system. This category of services includes most office visits to a primary care physician or specialist, including behavioral health services, as well evaluation and management services provided in an emergency room or outpatient setting. These visits typically involve a physician or other heal...

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May
12

The Price of Childbirth Can be Twice as High Even in the Same Hospital

According to HCCI's data, the price of a hospital admission for childbirth among birthing people with employer-sponsored health insurance (ESI) varies by a factor of three across hospitals within a local area. Even within the same hospital and within the same type of delivery, some births cost twice as much as others. Different prices for the same service in the same hospital with the same type of...

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May
12

From Prenatal through Postpartum Care, it Cost More Than $24,000 to Have a Baby on Average

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...

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Apr
25

Focusing on Seven Services Could Eliminate More Than Two-Thirds of Low-Value Care in HCCI's ESI Data

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...

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Apr
04

Insulin Prices in ESI Nearly Doubled from 2012-2021, with Effects of Emerging Biosimilars Evident in Recent Years

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...

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Mar
30

Uptake of Biosimilars Remains Low Among People with Employer-Sponsored Insurance

Biologic drugs represent advances in medical research and treatment but are a major driver of drug spending in the United States. Spending on biologics increased by 50% between 2014 and 2018 in the U.S. even though just 2% of Americans used them. Biosimilars, clinically equivalent, lower-cost versions of original biologic drugs, analogous to generic versions of brand name "small molecule" drugs, c...

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