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The pandemic of a new coronavirus, COVID-19, is increasing demand on hospitals as unprecedented numbers of people with respiratory disease seek treatment. In addition to straining hospital resources directly related to care of COVID-19, the outbreak may also displace other types of care. In this analysis, we hope to inform the understanding of the distribution of care provided in hospitals and how...

The 2018 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2014 through 2018 for individuals under the age of 65 who receive health insurance coverage through an employer. The report draws on data from more than 2.5 billion medical and prescription drug claims for approximately 40 million individuals enrolled in employer-sponsored h...

As previous reports have indicated, there is widespread price variation in the U.S. commercial health care system. Many studies have shown that prices are dramatically different not only across geographies, but they vary substantially even within the same market for the same service. For example, we found that prices for the same blood tests could vary 39-fold within Tampa, Florida and the cost of...

% Total Medical Spending % Out-of-Pocket Medical Spending % Medical Charges% Medical  Utilization All Medical Care 11.8 15.6 12.317.2Inpatient Care7.95.68.04.8Outpatient Care13.116.513.717.2 In response to high and growing health care spending, policymakers have proposed improving price transparency as a solution. Several such proposals rely on consumers taking action on publicly av...

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

​Using HCCI's data, we assessed the share among individuals younger than 65 years covered by employer-sponsored insurance from 2013 to 2017.  We assessed primary care spending using 2 main definitions: a definition which included the total spending on services rendered by primary care clinicians (broad definition) and one where only CPT codes for specific services specified as prima...

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...

​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...

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...

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 - ...

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, ...

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 ...

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 ...

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...

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...

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...

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...

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...

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...

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 ...

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...

 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 ...

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...

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...

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 ...