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The latest news from HCCI

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Dec
27

The Wall Street Journal: The Hidden System That Explains How Your Doctor Makes Referrals

By: Anna Wilde Mathews and Melanie Evans  More primary-care doctors work directly for hospitals, and they are being pushed to keep lucrative referrals in-house.  Phoebe Putney Health System doesn't want its doctors to send business to competitors. If they do, Phoebe makes sure their bosses know about it. Doctors working for the Albany, Ga.-based hospital system's affiliated physician gro...
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Dec
14

Vox: The Medicare-for-all paradox

Passing single-payer means disrupting health insurance for 160 million people who get coverage through their jobs  ​HCCI Data was featured in Vox showing the annual growth in per capita health care spending.  By: Dylan Scott Jessica Salfia knew the pay wasn't going to be great when she became a teacher in Martinsburg, West Virginia, but she did have really good health coverage. She felt ...
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Dec
11

Health Care Cost Institute Welcomes Two New Board Members

Appointees add leading-edge expertise in health economics and health care strategy entrepreneurship The Health Care Cost Institute is pleased to announce the appointment of two new board members, Amy Finkelstein and Marshall Votta, to further accelerate HCCI's vision and priorities as it enters 2019. "We are thrilled to welcome Amy and Marshall, who are true pioneers in their respective fields. Th...
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Nov
06

Announcing RWJF’s Health Data for Action Call for Proposals and Informational Webinar

  HCCI is participating in the Robert Wood Johnson Foundation's signature research program, Health Data for Action, which makes highly valued health datasets available for innovative research projects. Recently, RWJF announced its Call for Proposals and a Nov. 9th webinar to hear from staff at the Foundation, AcademyHealth, and the data experts to learn more about this Call for Proposals. Hea...
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Oct
12

HCCI Wins National Infographic Contest at 33rd Annual NAHDO Conference

 On Thursday October 11th, at the National Association of Health Data Organizations Annual Conference in Park City Utah, HCCI was announced the winner of NAHDO's nationwide yearly infographic competition. The infographic below is a sneak peak at what is to come when the full HMI report is released later this month.    Download PDF File Here
Oct
03

Wall Street Journal: Employer-Provided Health Insurance Approaches $20,000 a Year

HCCI's 2016 Annual Report was cited in the WSJ: The HCCI findings are "pretty compelling," said Paul Ginsburg, a professor at the University of Southern California. "Higher prices from providers is the most important element in rising premiums in the past few years."   Employer-Provided Health Insurance Approaches $20,000 a Year - WSJ The average cost of health coverage offered by employers r...
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Sep
18

Wall Street Journal: Behind Your Rising Health-Care Bills: Secret Hospital Deals that Squelch Competition

​HCCI data was featured in The Wall Street Journal showing that insurers pay higher prices for some services performed on an outpatient basis that could also be performed in doctors offices. Read the Article
Sep
18

The Wall Street Journal: Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition

Behind Your Rising Health-Care Bills: Secret Hospital Deals That Squelch Competition - WSJ Hidden provisions in contracts between health-care providers and insurers allow hospitals to hide prices from consumers, add fees and discourage use of less-expensive rivals. https://www.wsj.com/articles/behind-your-rising-health-care-bills-secret-hospital-deals-that-squelch-competition-1537281963?mod=hp_lea...
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Jun
20

Vox: The absurdity of American health care pricing, in one chart

​Research using HCCI data shows the different prices patients face for the same procedures performed in the same hospitals. " a new paper from economists Zack Cooper, Stuart Craig, Martin Gaynor, and John Van Reenen sheds light on another fascinating type of variation: price differences within a single hospital.  Their research is the first I've seen that shows insurers pay different prices f...
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Jun
20

POLITICO: Insurers spark blowback by reducing emergency room coverage

HCCI's emergency room analysis has been highlighted by Politico! "Emergency room spending essentially doubled between 2009 and 2016, even though the number of patients treated remained flat, according to an analysis of insurer claims data recently published by the Health Care Cost Institute. The growth is being driven entirely by the most expensive claims. Costs stemming from the two most expensiv...
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Jun
19

The Opacity of Transparency: The Search for a Cure to Our Health Care Woes

By: Niall Brennan Health care spending is exceedingly difficult to control for our nation, the states, and private payers, but also for individual patients and providers. While there has been some moderation in spending in recent years in programs like Medicare, the health share of gross domestic product (GDP) is projected to continue to rise from 17.9 percent in 2016 to 19.7 percent in 2026 (see ...
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May
31

Health Leaders: ER Spending Rise Driven by high-severity cases

By: John Commins  A review of emergency department claims for employer-sponsored plans from 2009 through 2016 found that the average prices for higher severity billing codes rose faster than lower severity codes. Emergency department spending per employer-sponsored plan enrollee increased 99% from 2009 to 2016, even as overall ED use for that cohort flat-lined, the Health Care Cost Institute ...
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May
30

Becker's Hospital Review: Rising ER prices, more high severity cases spurred greater healthcare spending - 7 takeaways

By: Kelly Gooch Among the commercially insured, national emergency room use remained unchanged from 2009 to 2016, but ER price hikes and greater use of high-severity codes resulted in more ER spending, according to updated data from the Health Care Cost Institute. The data on ER spending, price and utilization reflects five facility fee current procedural terminology codes, which indicate the...
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May
30

Modern Healthcare: ER spending rises with increasing prices, severity of visits

 By: Shelby Livingston Even though emergency department use has stayed the same, ED spending per member nearly doubled from 2009 to 2016 as the severity of ED visits and the prices associated with those visits increased, new data from the Health Care Cost Institute shows. The not-for-profit HCCI analyzed employer-sponsored insurance claims for the five procedure codes used to bill for ED...
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May
23

Health Payer Intelligence: Pros and Cons of High Cost Sharing for Employer Health Plans

  By Thomas Beaton Employer-sponsored health plans that include high cost sharing expectations can help control spending for plan sponsors, but could create longer-term health risks for employee beneficiaries. Striking the right balance between lowering costs and enabling healthy decision-making can be a challenge for employers and payers looking to design cost-effective plans. How can plan s...
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May
09

Becker's Hospital Review: Hospital pricing for privately insured varies by market structure - 6 study findings

By: Kelly Gooch   A newly revised study reveals insights into monopoly pricing, finding hospital market structure is strongly linked with pricing and insurer contract structure. For the study, researchers primarily examined private insurance claims data from Aetna, Humana and UnitedHealth. The data, provided by the Health Care Cost Institute, covers healthcare received by 28 percent of Americ...
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May
01

Vox: She didn’t get treated at the ER. But she got a $5,751 bill anyway.

 By: Sarah Kliff On October 19, 2016, Jessica Pell fainted and hit her head on a nearby table, cutting her ear. She went to the emergency room at Hoboken University Medical Center, where she was given an ice pack. She received no other treatment. She never received any diagnosis. But a bill arrived in the mail for $5,751. "It's for the ice pack and the bandage," Pell said of the fee. "That is...
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Apr
30

Business Wire: Vitals Reduced Medical Spending for Employers by $56M. Three people every hour shop and save on their health care

 Vitals today released its 2018 Book of Business report . The annual summary reports the metrics associated with shopping activity and savings achieved by employers and employees using Vitals SmartShopper. SmartShopper is a high-tech, high-touch health care program that allows consumers to shop for and choose better-value medical care. Over the past four years, SmartShopper has generated over...
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Apr
12

Health Exec: Drug competition didn’t stop sharp increase in MS spending

By: John Gregory  Between 2009 and 2015, spending on patients with multiple sclerosis (MS) greatly increased, with disease modifying therapies (DMTs) accounting for 82 percent of that increase as prices jumped every year and use slightly declined. The report from the Health Care Cost Institute (HCCI) examined claims for people with MS from 2009 to 2015 covered by individual market, employer-s...
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Mar
23

HCCI's Response to Senate Request for Feedback on Price Transparency

On February 28, 2018, HCCI, among other key stakeholders, was asked to provide feedback to several questions posed by six U.S. Senators on the issue of health care price transparency. The Senators are launching a bipartisan effort to increase health care price and information transparency to empower patients, improve the quality of health care, and lower health care costs. Feedback was due March 2...
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Mar
19

CNN Money: $12,000 for a bee sting? Emergency room visits get even pricier

 By:  Tami Luhby Sylvia Rosas decided to go to the emergency room after getting stung by a bee in her yard in Valrico, Florida. She had experienced allergic reactions in the past, but didn't have an EpiPen on hand. However, what really hurt was the $12,000 bill she received for the visit to the ER. The 53-year-old said she was seen by several doctors, who ordered thousands of dollars in ...
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Mar
14

Health Affairs: Disinvesting In Primary Care?

By: Christopher Koller and Margaret O'Kane The Health Care Cost Institute (HCCI) released its analysis of 2016 health spending for a group of commercial insurers last month. The report is a trove of information that, like all good analyses, suggests more questions than it answers. Buried in the report—in figure 15—is an alarming trend that should rise to the top of analysts' areas for further inve...
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Mar
07

Times Free Press: Cost of care growing for adults with hypertension

 By: Elizabeth Fite Hypertension, or high blood pressure, affects the health and wallets of more than 75 million U.S. adults, and the cost of managing this condition is growing, according to a new study from the Health Care Cost Institute. The study released Tuesday analyzed data from employer-sponsored health insurance claims of adults between the ages of 18 and 65 and found that adults...
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Mar
05

KHN: Need A Medical Procedure? Pick The Right Provider And Get Cash Back

Laurie Cook went shopping recently for a mammogram near her home in New Hampshire. Using an online tool provided through her insurer, she plugged in her ZIP code. Up popped facilities in her network, each with an incentive amount she would be paid if she chose it. Paid? To get a test? It's part of a strategy to rein in health care spending by steering patients to the most cost-effective providers ...
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Mar
02

Crain's Chicago Business: This fast-growing doctors group is betting it all on hips and knees

Baby boomers are living longer, getting their aching hips and knees replaced as they age. That puts Illinois Bone & Joint Institute in the sweet spot of medicine. Hip and knee replacements are among the most common surgeries in the U.S.—and they're pricey. Everything involved in replacing one, from surgery to the weeks of rehab that follow, costs an average $36,000, according to Guroo, a site ...
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Feb
23

Health Payer Intelligence: Medicare Advantage Evaluation Requires Transparent Claims Data

  By Thomas Beaton February 23, 2018 - The growth of the Medicare Advantage (MA) market requires the release of more claims data to evaluate the commercial and government impact of the program, according to a recent JAMA commentary from the Health Care Cost Institute, ProPublica, and the VA. "Despite the important and increasing role of Medicare Advantage plans, there is fairly little insight...
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Feb
15

RevCycle Intelligence: Hospital Cost-Shifting Increases Private Payer Payments by 1.6%

By: Jacqueline LaPointe Healthcare organizations that faced Medicare reimbursement reductions under the Affordable Care Act engaged in hospital cost-shifting that resulted in 1.6 percent higher average payments from private payers, a new working paper from the National Bureau of Economic Research uncovered. Researchers reported that hospitals penalized under the Hospital Readmission Reduction...
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Jan
30

CNN Money: Jeff Bezos, Warren Buffett, and Jamie Dimon want to fix health care

By: Chris Isidore  Amazon is partnering with Buffett's Berkshire Hathaway and JPMorgan Chase, the nation's largest bank, to try to address one of the nation's thorniest and priciest problems -- soaring health care costs. The three companies unveiled an as yet unnamed company to give their U.S. workers and families a better option on health insurance. The statement said the new company will be...
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Jan
24

The Hill: Americans using less health care, but paying more for it

 By: Jessie Hellman Health-care spending has increased because prices are rising, not because Americans are using more health care, according to a new study released Tuesday. The report from the Health Care Cost Institute (HCCI) showed that total health-care spending grew by 4.6 percent per person from 2015 to 2016 even as utilization of services remained steady, or declined in some cases. As...
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Jan
24

Wall Street Journal: Health-Care Costs Rose for Americans With Employer-Sponsored Insurance

By: Jeanne Whalen Spending on health care accelerated in 2016 for Americans who get insurance through work, even as use of most health-care services declined or remained flat. The reason, according to a new report: price increases. Rising prices for prescription drugs, surgery, emergency-room visits and other services drove a 4.6% increase in total spending per person, versus 4.1% in 2015 and less...
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Jan
23

News Wise: Plotting the Downward Trend in Traditional Hysterectomy

​ Fewer women are getting hysterectomies in every state across the country.  Instead, more patients may be choosing minimally invasive procedures or other alternatives to handle issues like pelvic pain and fibroids over a traditional abdominal hysterectomy, new Michigan Medicine research suggests. The rate of hysterectomies in the U.S. decreased 12 percent between 2010 and 2013, from nearly 4...
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Jan
23

Axios: We're using less health care, but paying more

By: Sam Baker Health care spending is up. Way up. That's because prices are up — not because we're using more health care, according to newly published data from the Health Care Cost Institute. The numbers that matter: Health care spending grew by 4.5% from 2015 to 2016, yet utilization was steady — or, in some cases, actually declined — during the same period. According to HCCI's analysis, which ...
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Jan
23

Miami Herald: Working Americans are using less healthcare but paying more for it

By: Daniel Chang Most Americans have health coverage through their jobs, but that doesn't mean they are better off when it comes to spending for their care, according to a five-year analysis of billions of insurance claims by the nonprofit Health Care Cost Institute. In a study published Tuesday, HCCI found that working Americans used less healthcare but paid more for it every year from 2012 to 20...
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Jan
23

POLITICO Pulse: Spending growth outpaces need for care

By: Dan Diamond Indiana is abuzz with news that the Trump administration this week will approve the state's pending Medicaid waiver, which would add a work requirement for able-bodied adults, multiple sources tell POLITICO's Rachana Pradhan. Indiana's pioneering conservative Medicaid model — which CMS Administrator Seema Verma helped develop as a consultant and then-Gov. Mike Pence used to expand ...
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Jan
23

WebMD: Spending More on Health Care? Here's Why

  By Robert Preidt Americans spent more on health care in 2016, even though their use of health care did not increase, and rising costs are the reason why, a new report shows. "It is time to have a national conversation on the role of price increases in the growth of health care spending," said Niall Brennan, president of the Health Care Cost Institute . The institute is a non-partisan, nonpr...
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Jan
23

Washington Post: Working Americans are using less health care, but spending more

By: Carolyn Johnson Americans who get health insurance through their jobs are not using more medical care than they were five years ago, but they are spending more due to soaring medical prices, according to a new report. Health spending for the more than 150 million people who receive insurance through their employers was $5,407 per person in 2016. That is a 4.6 percent increase over 2015, even t...
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Jan
05

Doctors Lounge: Socioeconomic Factors Associated With Opioid Prescriptions

​ Among disabled Medicare beneficiaries, county-level socioeconomic factors are associated with opioid prescriptions, with more prescriptions seen with lower socioeconomic indicators, according to a study published in the January issue of Medical Care . Chao Zhou, Ph.D., from the Health Care Cost Institute in Washington, D.C., and colleagues examined opioid prescriptions of disabled Medicare benef...
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Dec
08

Advisory Board: ED visits down - but ED facility fee spending is up, Vox analysis suggests

Spending on emergency department (ED) facility fees rose steadily between 2009 and 2015, even as the overall number of ED fees billed declined, according to an analysis of Health Care Cost Institute (HCCI) data, Sarah Kliff writes for Vox . However, the American College of Emergency Physicians (ACEP) is pushing back against the findings, noting that the analysis examined only spending by employer-...
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Dec
05

Healthcare Dive: ER facility fees skyrocket faster than outpatient or overall healthcare spending

 By: Les Masterson Dive Brief: Hospital emergency room (ER) facility fees increased 89% between 2009 and 2015, which is twice as fast as outpatient care and four times as fast as overall healthcare spending, reported Vox and Health Care Cost Institute (HCCI) in a new report. Vox and HCCI analyzed 70 million insurance bills for ER visits. The analysis focused on facility fees and not the hospi...
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Dec
04

Vox: Emergency rooms are monopolies. Patients pay the price.

By: Sarah Kliff  Around 1 am on August 20, Ismael Saifan woke up with a terrible pain in his lower back, likely the result of moving furniture earlier that day. "It was a very sharp muscle pain," Saifan, a 39-year-old engineer, remembers. "I couldn't move or sleep in any position. I was trying laying down, sitting down, nothing worked." Saifan went online to figure out where he could see a do...
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Nov
28

ProPublica: A Hospital Charged $1,877 to Pierce a 5-Year-Old's Ears. This Is Why Health Care Costs So Much.

By: Marshall Allen This story was co-published with NPR's Shots blog . Two years ago, Margaret O'Neill brought her 5-year-old daughter to Children's Hospital Colorado because the band of tissue that connected her tongue to the floor of her mouth was too tight. The condition, literally called being "tongue-tied," made it hard for the girl to make "th" sounds. It's a common problem with a simple fix...
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Sep
02

Modern Healthcare: Q&A with Brennan - "You are going to have more of an interest in what services actually cost"

Three months ago, Niall Brennan was appointed president and executive director of the Health Care Cost Institute, a not-for-profit organization based in Washington, D.C., that focuses on improving price transparency through the use of insurance data. He succeeds David Newman, a health policy expert who had led the organization since its founding in 2011. Brennan was the CMS first chief data office...
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Aug
31

Wall Street Journal: The Math Behind Higher Health-Care Deductibles

 By. Melanie Evans, Yaryna Serkez, and Merrill Sherman  More U.S. workers are taking a bigger out-of-pocket hit from their employer-provided health plans. Blame high deductibles. High-deductible plans required patients to spend $2,200 to $4,300, on average, in 2016 before insurance kicked in, and amounts can be significantly more. Employers have embraced high deductibles to cut the amoun...
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Aug
07

New York Times: Medicare Advantage Spends Less on Care, So Why Is It Costing So Much?

By: Austin Frakt   The Medicare Advantage program was supposed to save taxpayers money by allowing insurers to offer older Americans private alternatives to Medicare. The plans now cover 19 million people, a third of all those who qualify for Medicare. Enrollee satisfaction is generally high, and studies show that plans offer higher quality than traditional Medicare. But the government p...
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May
17

Becker's Hospital Review: 20 key takeaways on medical service prices - inpatient, outpatient, and physician services

By: Laura Dyrda The Health Care Cost Institute issued the " Healthy Marketplace Index: Medical Service Category Price Index " report for 2017 in April. The report calculates metrics comparing aspects of price, competition and productivity of healthcare markets over time, which shows trends for potential future research. The report includes data for inpatient, outpatient and physician medical servi...
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Apr
27

Modern Healthcare: Healthcare costs vary widely by region

By: Maria Castellucci  The best solutions to decrease the high costs of healthcare services may not be solved at the federal level but in states and their communities, a new study suggests. The report, published by researchers this week at the Health Care Cost Institute, found costs of services vary dramatically depending on a patient's zip code. For example, patients in El Paso, Texas, paid ...
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Apr
27

NBC News: U.S. Health Care Prices Are All Over the Map, New Study Finds

By: Maggie Fox  Why does a knee replacement cost $29,000 in Kansas but $40,000 in next-door Colorado? Health care prices are all over the map in the U.S., a new study finds. It digs deeply into the crazy pattern of health costs across the U.S. and shows there is very little consistency.   The report from the Health Care Cost Institute (HCCI) finds prices for the same procedures vary by s...
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Jan
09

Slate: A Failed Cure for Health Care Costs

By: Helaine Olen  It's a new year, and you know what that means: Your health insurance deductible just reset. Which for many of us means looking forward to paying a significant amount out of pocket for health care until we've spent enough for our insurance payments to kick in. According to the Henry J. Kaiser Family Foundation, in 2016, the average deductible for an American with employer-bas...
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Nov
23

CNBC: Health-care spending increased at a faster pace in 2015 as prices rose

By: Dan Mangan Spending on health care for people who have private insurance accelerated last year, ending a two-year period of more modest spending growth, a new study finds. In 2015, overall spending for people with private health insurance increased by 4.6 percent, according to the Health Care Cost Institute report. Most of that increase, again, was due to higher prices for prescription drugs a...
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Nov
22

Health Payer Intelligence: Deductibles, Out-of-Pocket Healthcare Spending Rose 3% in 2015

By: Vera Gruessner  Healthcare spending within the private health insurance market has grown 4.6 percent in 2015, according to a press release from the Health Care Cost Institute (HCCI). This type of growth in spending is higher than in recent years. For instance, healthcare spending in 2014 saw a 2.6 percent rise while 2013 spending increased by 3 percent. The HCCI study, called the 2015 Hea...
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