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The latest news from HCCI

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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
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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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
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
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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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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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
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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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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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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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
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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Sep
01

Selected Health Care Trends for Young Adults: 2007-2012

This issue brief is one of the first to examine health care trends for young adults (ages 19-25) with employer-sponsored insurance before and after implementation of Section 1001 of the Affordable Care Act that allows parents to include their adult children in family health plans.    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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