News
The latest news from HCCI

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Nov
15

Trends In Primary Care Visits

Office visits to primary care physicians (PCPs) declined 18 percent from 2012 to 2016 for adults under 65 years old with employer-sponsored health insurance, while office visits to nurse practitioners (NPs) and physician assistants (PAs) increased 129 percent. Comparing 2012 to 2016, there were 273 fewer office visits per 1,000 insured individuals to primary care physicians over that span, while v...
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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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Oct
01

Health Affairs: Assessing The Impact Of State Policies For Prescription Drug Monitoring Programs On High-Risk Opioid Prescriptions

 ABSTRACT: Policies and practices have proliferated to optimize prescribers' use of their states' prescription drug monitoring programs, which are statewide databases of controlled substances dispensed at retail pharmacies. Our study assessed the effectiveness of three such policies: comprehensive legislative mandates to use the program, laws that allow prescribers to delegate its use to offi...
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Sep
19

Health Affairs: Health Care Spending Under Employer-Sponsored Insurance: A 10-Year Retrospective

ABSTRACT Using a national sample of health care claims data from the Health Care Cost Institute, we found that total spending per capita (not including premiums) on health services for enrollees in employer-sponsored insurance plans increased by 44 percent from 2007 through 2016 (average annual growth of 4.1 percent). Spending increased across all major categories of health services, although the ...
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Sep
11

ER facility prices grew in tandem with faster-growing charges from 2009-2016

HCCI often reports the prices of health care services, defined as the average amount a provider is paid for a given service based on negotiations with health care insurers. These prices typically represent a portion of charges , which are the amounts health care providers bill for the procedures they perform. The charge amount is often the starting point for negotiations between insurers and provi...
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Jun
25

Medical Care Research and Review: Prices for Physicians’ Services in Medicare Advantage and Commercial Plans

ABSTRACT: The prices that insurers pay physicians ultimately affect beneficiaries' health insurance premiums. Using 2014 claims data from three major insurers, we analyzed the prices insurers paid in their Medicare Advantage (MA) and commercial plans for 20 physician services, in and out of network, and compared those prices with estimated amounts that Medicare's fee-for-service (FFS) program...
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Jun
11

INQUIRY The Journal of Health Care Organization, Provision, and Financing: How do the Hospital Prices Paid by Medicare Advantage Plans and Commercial Plans Compare with Medicare Fee-for-Service Prices?

ABSTRACT The prices that private insurers pay hospitals have received considerable attention in recent years, but most of that literature has focused on the commercially insured population. Although nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, little is known about the prices paid to hospitals by the private insurers that administer such plans. More in...
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May
30

ER spending among the commercially insured continued to rise in 2016, driven by the price and use of high severity cases (2009-2016)

HCCI recently expanded its reporting on emergency room (ER) spending trends to include the most recent data available (2016). We characterize trends in spending, price, and utilization for the five Current Procedural Terminology (CPT) codes designed to capture the level of severity and complexity of every ER visit. While average prices for all five ER CPT codes were higher in 2016 than in 2009, th...
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May
23

Health Services Research: Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs

 ABSTRACT Objective: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. Data Sources: Commercial health insurance claims data, 2009–2013. Study Design: Retrospective analyses using two‐stage residual inclusion instru...
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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
01

NBER: The Price Ain't Right? Hospital Prices and Health Spending on the Privately Insured

ABSTRACT: We use insurance claims data covering 28 percent of individuals with employer-sponsored health insurance in the US to study the variation in health spending on the privately insured, examine the structure of insurer-hospital contracts, and analyze the variation in hospital prices across the nation. Health spending per privately insured beneficiary differs by a factor of three across...
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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
01

American Journal of Obstetrics & Gynecology: Nationwide trends in the utilization of and payments for hysterectomy in the United States among commercially insured women

ABSTRACT Background: Laparotomy followed by inpatient hospitalization has traditionally been the most common surgical care for hysterectomy. The financial implications of the increased use of laparoscopy and outpatient hysterectomy are unknown. Objectives: The objective of the study was to quantify the increasing use of laparoscopy and outpatient hysterectomy and to describe the financial implicat...
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Mar
01

Medical Care: The Differential Effects of Insurance Mandates on Health Care Spending for Children’s Autism Spectrum Disorder

ABSTRACT Objectives: There is substantial variation in treatment intensity among children with autism spectrum disorder (ASD). This study asks whether policies that target health care utilization for ASD affect children differentially based on this variation. Specifically, we examine the impact of state-level insurance mandates that require commercial insurers to cover certain treatments for ASD f...
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Feb
09

Health Affairs: Health Spending Growth Is Accelerating; Prices Are In The Driver’s Seat

 HEALTH AFFAIRS BLOG: "Perhaps nothing illustrates the intractability of America's struggle with health spending more than the recent announcement by Amazon, JP Morgan, and Berkshire Hathaway that they were founding a new entity to address health care costs for their employees. Despite lacking any concrete details this announcement managed to wipe billions of dollars in market capitalization ...
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Feb
01

New England Journal of Medicine: Consistently High Turnover in the Group of Top Health Care Spenders

 NEJM CATALYST: "The concentration of most U.S. health care spending in a small proportion of individuals is well documented. The notion that high health care spending only affects a small portion of people in a given year is particularly relevant to the ongoing policy debate about how to make health insurance affordable for all, while accommodating people with complex health care needs and a...
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Feb
01

Top Spenders Among the Commercially Insured Increased Spending Concentration and Consistent Turnover from 2013 to 2015

 This issue brief explores the distribution of health care spending among commercially insured individuals, with a focus on the top 5 percent of spenders and turnover within that group from year to year. It considers the share of spending incurred by this group of top spenders, how those dollars are distributed among the health care service categories, turnover within the group of top spender...
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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

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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Dec
04

ER spending increased 85%, driven by price increases for the most severe cases (2009-2015)

Medical bills from the Emergency Room (ER) are a mystery to many patients in the US health system. From incredibly high, varying charges 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 this necessary service. Recently, Vox reporter, Sarah Kliff , has begun collecting ER bills in an attempt to "bring transparency...
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Dec
01

Health Affairs: Rising Use Of Observation Care Among The Commercially Insured May Lead to Total And Out-Of-Pocket Cost Savings

ABSTRACT:  Proponents of hospital-based observation care argue that it has the potential to reduce health care spending and lengths-of-stay, compared to short-stay inpatient hospitalizations. However, critics have raised concerns about the out-of-pocket spending associated with observation care. Recent reports of high out-of-pocket spending among Medicare beneficiaries have received cons...
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Nov
20

New England Journal of Medicine: The Value of Health Insurance through Price Discounts

 NEJM CATALYST: " As context for the ongoing health care reform debate, we analyzed Health Care Cost Institute (HCCI) data. HCCI is a nonpartisan, nonprofit organization aimed at providing complete and accurate information about health care utilization and costs in the United States. Our goal was to demonstrate the value of insurance through these discounted rates. We did so by calculating me...
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Oct
01

Health Affairs: Effects Of State Insurance Mandates On Health Care Use And Spending For Autism Spectrum Disorder

ABSTRACT: Forty-six states and the District of Columbia have enacted insurance mandates that require commercial insurers to cover treatment for children with autism spectrum disorder (ASD). This study examined whether implementing autism mandates altered service use or spending among commercially insured children with ASD. We compared children age twenty-one or younger who were eligible for m...
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Oct
01

JAMA Oncology: Association Between Quality of Care for Breast Cancer and Health Insurance Exchange Coverage An Analysis of Use of Radiation Therapy After Breast-Conserving Surgery

ABSTRACT Research comparing quality of cancer care by insurance categories concluded that cancer patients without insurance or with Medicaid experienced inferior quality of care compared with those with private insurance. A new insurance category created from the Affordable Care Act (ACA) is insurance purchased from the Health Insurance Marketplace (also known as the exchange). The present st...
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Sep
01

Women's Health Issues: Maternal Medical Complexity Impact on Prenatal Health Care Spending among Women at Low Risk for Cesarean Section

ABSTRACT Background: Obstetric procedures are among the most expensive health care services, yet relatively little is known about health care spending among pregnant women, particularly the commercially-insured. Objective: The objective of this study was to examine the association between maternal medical complexity, as a result of having one or more comorbid conditions, and health care spending d...
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Sep
01

Psychiatric Services: Telehealth Delivery of Mental Health Services: An Analysis of Private Insurance Claims Data in the United States

ABSTRACT:  Objective:  This study characterizes telehealth claims for mental health and substance abuse (MH/SA) services by using national private claims data. Methods:  Telehealth-related mental health service claims were identified with private claims data from 2009 to 2013. These data—provided by the Health Care Cost Institute—included claims from Aetna, Humana, and UnitedHealth ...
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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
01

Health Affairs: Medicare Competitive Bidding Program Realized Price Savings For Durable Medical Equipment Purchases

ABSTRACT: From the inception of the Medicare program there have been questions regarding whether and how to pay for durable medical equipment, prosthetics, orthotics, and supplies. In 2011 the Centers for Medicare and Medicaid Services (CMS) implemented a competitive bidding program to reduce spending on durable medical equipment and similar items. Previously, CMS had used prices in an administrat...
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May
04

Academic Emergency Medicine: Association Between Maternal Comorbidities and Emergency Department Use Among a National Sample of Commercially Insured Pregnant Women

ABSTRACT Objectives: Evidence suggests that, despite routine engagement with the health system, pregnant women commonly seek emergency care. The objectives of this study were to examine the association between maternal comorbidities and emergency department (ED) use among a national sample of commercially insured pregnant women. Methods: We conducted a retrospective cohort study using multipayer m...
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Apr
04

Congressional Budget Office Working Paper Series: An Analysis of Private-Sector Prices for Hospital Admissions

ABSTRACT: Prices for hospital admissions have received considerable attention in recent years, both because they are an important component of health care spending and because they can vary widely. In this paper, we use 2013 claims data from three large insurers to examine the hospital payment rates of those insurers in their commercial plans and their Medicare Advantage plans and compare them wit...
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Feb
28

Non-Shoppable Health Care Services: Inpatient Hospitalizations

This data brief reports on spending and utilization in populations likely unable to shop for a hospital prior to seeking care, comparing spending and length-of-stay for individuals who were admitted through the emergency department (ED) to that of individuals who needed ambulance services the day of their admission through the ED.    Download PDF File Here
Feb
19

Health Services Research: Payer Type and Low‐Value Care: Comparing Choosing Wisely Services across Commercial and Medicare Populations

ABSTRACT Objective: To compare low‐value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low‐value care.​ Data Sources: 2009–2011 national Medicare and commercial insurance administrative data. Design: We created claims‐based algorithms to measure seven Choosing Wisely‐identified low‐value services and examined the ...
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Jan
01

JAMA Internal Medicine: A Perspective on Out-of-Pocket Spending

To the Editor Understanding out-of-pocket spending is critical to understanding health care costs in the United States. We applaud the efforts of Adrion et al as an important contribution to understanding the out-of-pocket spending of the commercially insured population younger than 65 years. The commercially insured comprise over 50% of the nonelderly US population and, as demonstrated by Ad...
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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

2015 Health Care Cost and Utilization Report

The 2015 Health Care Cost and Utilization Report shows that spending per privately insured averaged $5,141 in 2015, up $226 from the year before. Key Findings  ​Health care spending averaged $5,141 per individual in 2015, up $226 from the year before. Out-of-pocket spending rose 3.0 percent in 2015, to an average of $813 per capita. Spending on prescription drugs grew faster than spending on ...
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Oct
01

NBER: Why Don't Commercial Health Plans Use Prospective Payment?

ABSTRACT One of the key terms in contracts between hospitals and insurers is how the parties apportion the financial risk of treating unexpectedly costly patients. "Prospective" payment contracts give hospitals a lump-sum amount, depending on the medical condition of the patient, with limited adjustment for the level of services provided. We use data from the Medicare Prospective Payment System an...
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Sep
14

Washington Post: How companies are quietly changing your health plan to make you pay more

 By: Carolyn Johnson While politicians have been embroiled in a fiery debate over President Obama's signature health-care law, a quiet but profound shift is fundamentally reshaping how health insurance works for the roughly 155 million Americans who receive coverage through their employers. A national survey of employer health benefits released Wednesday shows how much deductibles — the healt...
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Sep
01

JAMA Pediatrics: Effects of Autism Spectrum Disorder Insurance Mandates on the Treated Prevalence of Autism Spectrum Disorder

ABSTRACT Importance: Most states have passed insurance mandates requiring commercial health plans to cover services for children with autism spectrum disorder (ASD). Insurers have expressed concerns that these mandates will increase the number of children diagnosed with ASD (treated prevalence) and therefore increase costs associated with their care. To our knowledge, no published studies have add...
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Sep
01

JAMA Internal Medicine: Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults

ABSTRACT Importance: Patients' out-of-pocket spending for major health care expenses, such as inpatient care, may result in substantial financial distress. Limited contemporary data exist on out-of-pocket spending among nonelderly adults. Objectives: To evaluate out-of-pocket spending associated with hospitalizations and to assess how this spending varied over time and by patient characteristics, ...
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Aug
01

Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays

ABSTRACT There is ongoing debate about how prices paid to providers by Medicare Advantage plans compare to prices paid by fee-for-service Medicare. We used data from Medicare and the Health Care Cost Institute to identify the prices paid for hospital services by fee-for-service (FFS) Medicare, Medicare Advantage plans, and commercial insurers in 2009 and 2012. We calculated the average price per a...
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Jul
01

Necessary versus Sufficient Claims Data

This data brief compares membership characteristics and health care service prices in non-ERISA and ERISA populations. The results suggest that non-ERISA data may be sufficient for policy relevant analyses, even when ERISA data is not available.    Download PDF File Here
Jun
20

Star Tribune: The dollars pile up with diabetes

By: Christopher Snowbeck  Per capita spending on patients with diabetes hit $16,021 in 2014, which was an increase of about 6 percent or $897 from the previous year, according to a report released Monday. The average person in an employer plan during 2014, meanwhile, wracked up $4,396 in medical spending, which was up 3 percent compared with the previous year. The numbers come from the Health...
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Jun
20

2014 Diabetes Health Care Cost and Utilization Report

The 2014 Diabetes Health Care Cost and Utilization Report examines how much is spent on health care for adults and children with diabetes, where those dollars are spent, and how that compares to people without diabetes. It is based on the health care claims of more than 40 million Americans younger than 65 covered by employer-sponsored insurance from 2012 to 2014.   Download Report Appendix K...
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Jun
03

Journal of Telemedicine and Telecare: Reimbursements for telehealth services are likely to be lower than non-telehealth services in the United States

ABSTRACT: Telehealth technologies promise to increase access to care, particularly in underserved communities. However, little is known about how private payer reimbursements vary between telehealth and non-telehealth services. We use the largest private claims database in the United States provided by the Health Care Cost Institute to identify telehealth claims and compare average reimbursem...
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May
05

Healthzette: The Health Savings We’re Missing - Cost transparency tools exist ... yet we're not using them

 By: Kristen Fischer  We have the tools to shop around and save on health care costs — but we aren't using them. A new Harvard Medical School study reveals that consumer access to price transparency tools doesn't make them any more popular or likely to decrease health care spending. Do we not want to save money, especially in a health care climate in which out-of-pocket costs are soaring...
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Apr
21

National Chartbook of Health Care Prices 2015

The National Chartbook of Health Care Prices – 2015 and accompanying Health Affairs article "Prices For Common Medical Services Vary Substantially Among the Commercially Insured" illuminates differences in price for over 240 common medical services in 41 states and the District of Columbia. Download Report   Download PDF File Here Among the commercially insured, wide variation in prices have ...
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Mar
01

Spending on Shoppable Services in Health Care

This issue brief examines health care spending on shoppable services in 2011. Contrary to expectations, giving consumers prices so they can shop for health care services may only have a modest effect on reducing health spending.   Key Findings: ​ In 2011, about 43% of the $524.2 billion spent on health care services for commercially insured people was considered shoppable. About 15%—near...
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Oct
29

2014 Health Care Cost and Utilization Report

The 2014 Health Care Cost and Utilization Report tracks changes in health care prices, utilization, and spending for people younger than 65 covered by employer-sponsored health insurance (ESI). The 2014 Health Care Cost and Utilization Report shows that spending per privately insured person grew 3.4% in 2014, with more dollars going to brand-name drugs than in prior years.   Download Report A...
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Jul
08

Children's Health Spending: 2010-2013

Children's Health Spending: 2010–2013 shows that spending on healthcare for children (ages 0-18) covered by employer-sponsored insurance grew an average of 5.7% per year. The increase in spending in 2013 occurred despite a drop in the use of prescription drugs and visits to the emergency room, demonstrating that rising health care prices were an evident driver behind the spending increase in that ...
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Oct
23

2013 Health Care Cost and Utilization Report

The 2013 Health Care Cost and Utilization Report shows that spending per privately insured grew 3.9% in 2013, as falling utilization offset rising prices. The 2013 Health Care Cost and Utilization Report tracks changes in health care prices, utilization, and spending for people younger than 65 covered by employer-sponsored health insurance (ESI).   Download Report Appendix Tables   Key F...
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Oct
01

Out-of-Pocket Spending Trends 2013

This issue brief accompanies the 2013 Spending Cost & Utilization Report and examines trends in out-of-pocket expenditures per capita for the national, younger than age 65 population covered by employer-sponsored insurance for the period of 2011 through 2013.    Download PDF File Here
Aug
25

2007-2011 Vermont Health Care Cost and Utilization Report

The 2007-2011 Vermont Health Care Cost and Utilization Report  compares national and Vermont health care trends for the privately insured.  The report finds that Vermonters with employer sponsored health insurance spent less on health care, but their spending grew faster than the national average.  The report was prepared in cooperation with the Green Mountain Care Board. Download R...
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Aug
01

Health Affairs: Health Spending Slowdown Is Mostly Due To Economic Factors, Not Structural Change In The Health Care Sector

ABSTRACT: The source of the recent slowdown in health spending growth remains unclear. We used new and unique data on privately insured people to estimate the effect of the economic slowdown that began in December 2007 on the rate of growth in health spending. By exploiting regional variations in the severity of the slowdown, we determined that the economic slowdown explained approximately 70...
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Feb
01

Key Findings from Children's Health Spending 2009-2012 Report

This issue brief summarizes the main findings of the Health Care Cost Institute's (HCCI's) Children's Health Spending: 2009-2012.    Download PDF File Here
Dec
01

The Prevalence of Diagnosed Diabetes, Pre-Diabetes, and Gestational Diabetes among the ESI Population, 2008-2012

  Download PDF File Here
Oct
01

Health Affairs: Trends Underlying Employer-Sponsored Health Insurance Growth For Americans Younger Than Age Sixty-Five

ABSTRACT Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this population between 2007 and 2011. During this period per capita spending on employer-sponsored i...
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Sep
13

2012 Health Care Cost and Utilization Report

The 2012 Health Care Cost and Utilization Report shows that the growth rate of health care spending among privately insured people under age 65 remained low in 2012, growing 4.0 percent, slightly lower than in 2011 (4.1%).   Download Report Appendix Tables Key Findings ​ Spending grew fastest for young adults, women, and people living in the Northeast. Out-of-pocket spending rose more quickly...
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Sep
25

2011 Health Care Cost and Utilization Report

 The Health Care Cost and Utilization Report: 2011 provides the first broad look at 2011 health care spending among those with employer-sponsored insurance (ESI). HCCI found that average dollars spent on health care services for that population climbed 4.6 percent in 2011, reaching $4,547 per person. This was well above the 3.8 percent growth rate observed in 2010. Download Report Appendix Ta...
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Jul
02

Differences in Health Care Spending of Children and Adults 2007-2010

This research brief highlights findings from the Health Care Cost Institute's (HCCI) Children's Health Care Spending Report: 2007—2010.    Download PDF File Here
Jul
01

2007-2011 Children’s Health Care Spending Report

In the Health Care Cost and Utilization Report: 2010, HCCI found that the health expenditures for children with ESI grew faster than any other age group. This report begins to explore why health care spending for commercially insured children rose so quickly, and whether growing expenditure on children's health care represents a potential long-term trend. HCCI assessed the levels and changes in pr...
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Jul
01

Trends in Children's Health Care Costs and Utilization

This research brief highlights findings from the Health Care Cost Institute's (HCCI) Children's Health Care Spending Report: 2007—2010. 1 The report tracks changes in expenditure and utilization of health care services for children age 18 and younger, who were covered by employer-sponsored private health insurance (ESI).   Download PDF File Here
May
21

2010 Health Care Cost and Utilization Report

The 2010 HCCI Health Care Cost and Utilization Report is the first report of its kind to track changes in expenditures and utilization of health care services by those younger than 65 covered by employer sponsored, private health insurance (ESI). This report assesses the levels and changes in prices and utilization (including changes in the mix of services) focusing on 2009 and 2010. This report i...
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