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The latest news from HCCI

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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
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
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

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
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
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

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
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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Mar
14

Under Pressure - Adults with Hypertension are Spending Increasingly More on Health Care

This issue brief compares trends in health care spending from 2012 to 2016 for adults with employer-sponsored insurance who were diagnosed with hypertension to those not diagnosed with hypertension. It also considers how changes in prescription drug spending compare to changes in prescription drug use for adults with a hypertension diagnosis.   Excel Data Tables Machine-Readable Data   D...
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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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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
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
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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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
01

Health Affairs: Insurer Market Power Lowers Prices In Numerous Concentrated Provider Markets

 ABSTRACT: Using prices of hospital admissions and visits to five types of physicians, we analyzed how provider and insurer market concentration—as measured by the Herfindahl-Hirschman Index (HHI)—interact and are correlated with prices. We found evidence that in the range of the Department of Justice's and Federal Trade Commission's definition of a moderately concentrated market (HHI of...
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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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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
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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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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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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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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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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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
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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Sep
01

Spending on Prescriptions in 2011

Findings from HCCI's Health Care Cost and Utilization Report: 2011    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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