% Total Medical Spending % Out-of-Pocket Medical Spending % Medical Charges% Medical Utilization All Medical Care 11.8 15.6 12.317.2Inpatient Care7.95.68.04.8Outpatient Care13.116.513.717.2 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 ...
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Jan
16
Sep
12
We previously published two blogs discussing trends in out-of-pocket spending on insulin products. First, we presented data illustrating how average monthly out-of-pocket spending in 2017 varied considerably by month, particularly for individuals enrolled in consumer-directed health plans (CDHPs) that carry higher deductibles. Second, we examined the relationship between increasing point-of-sale p...
Sep
12
Earlier this week we presented data on out-of-pocket spending on insulin during each month in 2017. In that blog, we showed that enrollees in employer-sponsored health insurance paid more out-of-pocket for insulin products at the beginning of the calendar year. We examined the relationship between increasing point-of-sale prices for insulin and higher out-of-pocket spending in January for a subset...
Feb
11
The 2017 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.2 percent, the second year in a row of spending growth over four percent. Price increases were the primary driver. The report covers the period 2013 through 2017 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedH...
Dec
13
ABSTRACT BACKGROUND: The health care costs associated with treating autism spectrum disorder (ASD) in children can be substantial. State-level mandates that require insurers to cover ASD-specific services may lessen the financial burden families face by shifting health care spending to insurers.METHODS: We estimated the effects of ASD mandates on out-of-pocket spending, insurer spending...
Jun
19
The 2016 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.6 percent, faster than in previous years. Price increases were the primary driver. The report covers the period 2012 through 2016 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare. The data in the report can al...
May
23
ABSTRACTObjective: 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 instrumen...
Apr
01
ABSTRACTBackground: 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 implicatio...
Mar
07
By: Elizabeth FiteHypertension, 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 w...
Feb
01
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...
Dec
04
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 docto...
Dec
01
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...
Aug
31
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 amount ...
Aug
01
This data brief examines geographic variation in health care per capita spending, with a focus on consumer per capita out-of-pocket spending across geographies (2012-2015). It also explores whether the proportion of people enrolled in consumer-directed health plans (CDHPs) and the proportion not utilizing health care services had any influence on out-of-pocket spending. Download PDF File H...
Mar
01
ABSTRACT: Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the "choice architecture" by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are sele...
Jan
01
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...
Nov
22
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 Healt...
Sep
13
By: Dan ManganYour less expensive health insurance plan could cost you — even if you use less health care.People in so-called consumer-driven health plans tend to use fewer medical services than people with other types of coverage, a new study finds.But they also tend to spend substantially more out of their own pocket at the same time, both in dollar terms and as a share of their overall health c...
Sep
01
This data brief examines the health care use and spending from 2010-2014 for people who are enrolled in consumer-driven health plans (CDHPs), and compares these trends to non-CDHP enrollees. Findings indicate that although fewer total dollars were spent on health care for CDHP enrollees, they had higher per capita out-of-pocket spending on deductibles, copays, and coinsurance. Downloa...
Sep
01
ABSTRACTImportance: 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, re...
Mar
01
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%—nearly $...
Oct
29
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. Key FindingsHeal...
May
07
This issue brief examines health care spending for adults and children with diabetes relative to those without diabetes, both in terms of total per capita health care spending and out-of-pocket costs from 2009-2013. Key Findings: In 2013, $14,999 was spent per capita on health care for people with diabetes.Per capita health care spending for children with diabetes rose 7% from 201...
Feb
01
This data brief looks at per capita out-of-pocket spending rates nationally and statewide and examines average differences in consumer prices for a set of five common medical procedures: office visit for the evaluation of a new patient, colonoscopy, cataract removal, lower leg MRI; and ultrasound for pregnancy nationally and in nine states: Arizona, Colorado, Florida, Georgia, Maryland, New Jersey...
Oct
23
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). Key FindingsHealth care spending aver...
Oct
01
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
Feb
27
The Children's Health Care Spending: 2009-2012 report shows that spending on health care for privately insured children increased between 2009 and 2012, rising an average 5.5 percent a year, with more dollars spent on boys than girls, and higher spending on infants and toddlers (ages 0-3) than any other children's age group. Key FindingsPer capita spending on children reached $2,437 in 201...
Oct
01
ABSTRACTLittle 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 in...
May
01
Health Care Costs from Birth to Death examines health care spending from birth to age 90 for people covered by commercial health insurance and for those covered by Medicare fee-for-service. The research sponsored by the Society of Actuaries (SOA) using data from the Health Care Cost Institute (HCCI) estimates that the average 55-year-old retiree will spend about $226,000 more out of pocket on heal...
Sep
25
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. Key FindingsRegional...
Sep
05
A summary of HCCI's 2011 Health Care Cost and Utilization Report. Download PDF File Here
Jul
02
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
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