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The latest news from HCCI

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Dec
13

American Academy of Pediatrics: Insurance Mandates and Out-of-Pocket Spending for Children With Autism Spectrum Disorder

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 spend...
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Jun
19

2016 Health Care Cost and Utilization Report

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 a...
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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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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
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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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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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
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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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

Trends in Total and Out-of-Pocket Spending in Metro Areas: 2012-2015

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 ...
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Mar
01

Health Affairs: Reference Pricing Changes the 'Choice Architecture' of Health Care for Consumers

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...
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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
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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Sep
13

CNBC: High-deductible plans tied to lower health use, higher out-of-pocket spending

By: Dan Mangan Your 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 healt...
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Sep
01

Consumer-Driven Health Plans: A Cost and Utilization Analysis

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...
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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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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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May
07

Per Capita Health Care Spending on Diabetes: 2009-2013

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% fro...
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Feb
01

Shopping for Health Care Makes “Cents” for Consumers

This data brief looks at p er capita out-of-pocket spending rates nationally and statewide and examines a verage 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 Jers...
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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
Feb
27

Children’s Health Spending: 2009-2012

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.   Download Report Appendix Tables Issue Brief Key Findings ​ Per cap...
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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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May
01

Health Care Costs from Birth to Death

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...
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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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Sep
05

Changes in Health Care Spending in 2011

A summary of HCCI's 2011 Health Care Cost and Utilization Report.    Download PDF File Here
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