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  • Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016

    Tags: Out-of-Network
    Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
    Zirui Song, William Johnson, Kevin Kennedy, Jean Fuglesten Biniek, and Jacob Wallace
    June 1, 2020

    In HCCI’s publication in Health Affairs, we examined out-of-network spending in the privately insured population.  Abstract:  “While out-of-network or potential “surprise” billing has garnered increasing attention, particularly in emergency department and inpatient settings, few national studies have examined out-of-network care overall or in other settings. We examined out-of-network spending and use among two large nationwide…

    Read more: Health Affairs: Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016
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  • How often do providers bill out of network?

    Tags: Commercially Insured, Out-of-Network
    How often do providers bill out of network?
    Jean Fuglesten Biniek, John Hargraves, Bill Johnson, and Kevin Kennedy
    May 28, 2020

    In recent analysis, we document extensive variation across states and metropolitan areas in the frequency of out-of-network visits among individuals with health insurance provided by an employer. These differences raise the question of whether individual providers bill out of network at dissimilar rates. To explore whether a small group of providers are responsible for most…

    Read more: How often do providers bill out of network?
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  • Use of Prenatal Care Varies among People with Employer-Sponsored Insurance

    Tags: Maternal Health
    Use of Prenatal Care Varies among People with Employer-Sponsored Insurance
    Aaron Bloschichak, John Hargraves, Katie Martin
    May 13, 2020

    Prenatal care leads to healthier pregnancy, healthier pregnant people, and healthier babies. In fact, birthing parents who receive prenatal care are three times less likely to deliver low birthweight babies, and the baby is five times more likely to survive delivery. To explore the kind of prenatal care pregnant people receive, we looked at utilization…

    Read more: Use of Prenatal Care Varies among People with Employer-Sponsored Insurance
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  • Understanding Variation in Spending on Childbirth Among the Commercially Insured

    Tags: Commercially Insured, Maternal Health, Prices, Spending
    Understanding Variation in Spending on Childbirth Among the Commercially Insured
    William Johnson, Anna Milewski, Katie Martin, Elianna Clayton
    May 13, 2020

    Childbirth is the most frequent reason for an inpatient admission in the United States, and Cesarean-section (C-section) is the most common operating room procedure in an inpatient hospital stay. Among people who get insurance through an employer, the combination of labor, delivery, and newborn care makes up nearly one in six dollars spent on inpatient…

    Read more: Understanding Variation in Spending on Childbirth Among the Commercially Insured
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  • Most Postpartum Spending Occurs Beyond 60 Days After Delivery

    Tags: Maternal Health, Spending
    Most Postpartum Spending Occurs Beyond 60 Days After Delivery
    Aaron Bloschichak, Katie Martin
    May 13, 2020

    The postpartum period is a vulnerable time for both birthing parent and newborn and is critically important to their health and well-being. The American College of Obstetricians and Gynecologists (ACOG) recommends ongoing, comprehensive care, including physical, social, and psychological services, during the postpartum period. In large part because of an increasing maternal mortality rate in the US –…

    Read more: Most Postpartum Spending Occurs Beyond 60 Days After Delivery
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  • Compared to What? Baseline Understanding of the Distribution of Hospital Care

    Tags: Commercially Insured, HCCUR, Inpatient Spending, Prices, Utilization
    Compared to What? Baseline Understanding of the Distribution of Hospital Care
    Jean Fuglesten Biniek, Katie Martin, and John Hargraves
    April 1, 2020

    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…

    Read more: Compared to What? Baseline Understanding of the Distribution of Hospital Care
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  • 2018 Health Care Cost and Utilization Report

    Tags: HCCUR, Out-of-Pocket, Prices, Spending, Utilization
    2018 Health Care Cost and Utilization Report
    HCCI
    February 13, 2020

    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…

    Read more: 2018 Health Care Cost and Utilization Report
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  • What if Price Transparency Reduced Commercial Price Variation?

    Tags: Commercially Insured, Prices, Spending, Transparency
    What if Price Transparency Reduced Commercial Price Variation?
    Kevin Kennedy, William Johnson, and John Hargraves
    January 29, 2020

    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…

    Read more: What if Price Transparency Reduced Commercial Price Variation?
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  • CMS-specified shoppable services accounted for 12% of 2017 health care spending among individuals with employer-sponsored insurance

    Tags: Commercially Insured, Inpatient Spending, Out-of-Pocket, Outpatient Spending, Shoppable Services, Utilization
    CMS-specified shoppable services accounted for 12% of 2017 health care spending among individuals with employer-sponsored insurance
    Aaron Bloschichak, Anna Milewski, Katie Martin
    January 16, 2020

    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 available information for shoppable services – generally, non-emergency services that a person could choose more deliberately. In 2021, hospitals will be required to display, in a consumer-friendly manner,…

    Read more: CMS-specified shoppable services accounted for 12% of 2017 health care spending among individuals with employer-sponsored insurance
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  • International comparisons of health care prices from the 2017 iFHP survey

    Tags: Administered Drugs, Commercially Insured, Drug Spending, Inpatient Spending, Outpatient Spending, Prices
    International comparisons of health care prices from the 2017 iFHP survey
    John Hargraves and Aaron Bloschichak
    December 17, 2019

    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…

    Read more: International comparisons of health care prices from the 2017 iFHP survey
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