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HCCI Reports

  • Issue Brief: ESI Payments to 340B Hospitals are Multiples Higher than Their Estimated Acquisition Costs

    Issue Brief: ESI Payments to 340B Hospitals are Multiples Higher than Their Estimated Acquisition Costs
    Jessica Chang
    October 30, 2025

    The Health Care Cost Institute (HCCI) conducted an analysis on estimated acquisition costs and ESI reimbursement costs among 340B-participating hospitals in 2022. This issue brief analyzes the estimated ESI and Medicare fee-for-service price mark-up, relative to estimated acquisition costs, among 340B hospitals. Among the three physician-administered drugs of interests: daratumumab, pegfilgrastim, and infliximab, we found…

    Read more: Issue Brief: ESI Payments to 340B Hospitals are Multiples Higher than Their Estimated Acquisition Costs
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  • Drug administration shifted toward outpatient departments, especially to 340B hospitals

    Drug administration shifted toward outpatient departments, especially to 340B hospitals
    Jessica Chang and Tanya Natwick
    October 23, 2025

    The federal 340B Drug Discount Program was created in 1992 to lower the cost of drugs for non-profit hospitals that disproportionately care for people with lower incomes. Under the program, discounts from drug manufacturers to hospitals are estimated to range from 20 to 50% on most outpatient medications, although the actual discounts are not publicly disclosed. Because the program does not restrict the patients who can receive…

    Read more: Drug administration shifted toward outpatient departments, especially to 340B hospitals
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  • Preventive Health Services: What are they and how much do they cost?

    Preventive Health Services: What are they and how much do they cost?
    Bianca Silva Gordon
    October 2, 2025

    What are preventive health services? Preventive health services help people stay healthy and detect health problems early. Preventive care includes services like wellness visits, immunizations, contraceptive services, and cancer screenings. Specific services recommended by expert committees must be provided at no cost to the patient. This means that even if a patient has not met…

    Read more: Preventive Health Services: What are they and how much do they cost?
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  • 4% of Health Spending Goes to Primary Care

    4% of Health Spending Goes to Primary Care
    Jessica Chang, Bianca Silva Gordon, Catalina Desouza
    September 17, 2025

    Primary care offers patients a critical connection point to the health care system. With contact, continuity, comprehensiveness, and coordination as its base1, primary care has been shown to improve health outcomes and population health, reduce health disparities, and save health care dollars. Despite the virtues and benefits of primary care, it seems to be getting harder to access. In 2025, there…

    Read more: 4% of Health Spending Goes to Primary Care
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  • Prices in Hospital Outpatient Departments are Consistently Higher than Physician Offices among Site-Neutral Services

    Prices in Hospital Outpatient Departments are Consistently Higher than Physician Offices among Site-Neutral Services
    Jessica Chang and Linsay Sarfo
    August 13, 2025

    As federal and state policymakers pursue policies to lower health care costs, “site neutral payment” has emerged as a potential tool with bipartisan support to bring down spending. Adopting “site neutral payments” would mean that a given service would cost the same amount regardless of where the care was received (i.e., the site of service)….

    Read more: Prices in Hospital Outpatient Departments are Consistently Higher than Physician Offices among Site-Neutral Services
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  • Issue Brief: System-affiliated hospitals associated with higher prices

    Issue Brief: System-affiliated hospitals associated with higher prices
    Kelsey Burke, Jessica Chang
    July 8, 2025

    Forty-five percent of per-person health spending among people with employer-sponsored insurance was spent on inpatient or outpatient services. The Health Care Cost Institute (HCCI) conducted an analysis of hospital inpatient and outpatient prices by key hospital characteristics from 2012-2022. During our study period, we found system-affiliated hospitals were associated with higher prices; non-profit hospitals were…

    Read more: Issue Brief: System-affiliated hospitals associated with higher prices
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  • Rates of Blood Cancer Diagnosis Among Private and Public Insurers

    Rates of Blood Cancer Diagnosis Among Private and Public Insurers
    Kelsey Burke
    July 1, 2025

    Blood cancers represent a range of diseases that can affect blood cells, bone marrow, lymph nodes, and other parts of the lymphatic system. Health care claims data can provide insights into how many people are dealing with blood cancers. Using claims data from people enrolled in Medicaid, employer-sponsored insurance (ESI), and Traditional Medicare, this data…

    Read more: Rates of Blood Cancer Diagnosis Among Private and Public Insurers
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  • Outpatient Hospital Prices are Higher Among System-Affiliated, For-Profit, and Urban Hospitals

    Outpatient Hospital Prices are Higher Among System-Affiliated, For-Profit, and Urban Hospitals
    Kelsey Burke, Jessica Chang
    June 25, 2025

    Spending on hospital (inpatient and outpatient) services accounts for more than half of per-person health care spending in the employer-sponsored insured (ESI) population. In 2022, hospital outpatient facility spending per person accounted for nearly a third of total per person spending. Per-person outpatient spending increased 18% from 2018 to 2022, which was driven by a…

    Read more: Outpatient Hospital Prices are Higher Among System-Affiliated, For-Profit, and Urban Hospitals
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  • How do Pre-Medicare Adults Aged 55-64 Interact with the Health Care System?

    How do Pre-Medicare Adults Aged 55-64 Interact with the Health Care System?
    Bianca Silva Gordon, Jessica Chang, and West Health
    May 22, 2025

    The Health Care Cost Institute (HCCI), in collaboration with West Health, conducted an analysis on health care use and spend patterns among older adults with employer-sponsored insurance (ESI). This group is the key to anticipating future needs and demands on the health care system as they approach Medicare eligibility. We found that from 2018 to 2022, people aged 55-64…

    Read more: How do Pre-Medicare Adults Aged 55-64 Interact with the Health Care System?
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  • Shorter Stays, Lower C-Section Rates, and Fewer System-Affiliated Hospitals Contribute to Lower Childbirth Costs in Rural Areas

    Shorter Stays, Lower C-Section Rates, and Fewer System-Affiliated Hospitals Contribute to Lower Childbirth Costs in Rural Areas
    Jessica Chang, Catalina Desouza, and John Hargraves
    May 15, 2025

    Childbirth costs, outcomes, and access to care differ between rural and urban hospitals. Rural areas have fewer short-term general acute care (GAC) hospitals, with only about 35% of all GAC hospitals operating in rural locations in 2023. As rural hospitals continue to face financial distress, many unprofitable service lines, such as hospital-based obstetric service units…

    Read more: Shorter Stays, Lower C-Section Rates, and Fewer System-Affiliated Hospitals Contribute to Lower Childbirth Costs in Rural Areas
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