Publications

This Thursday the House Energy and Commerce and Ways and Means committees will convene a hearing with testimony from the nation’s health insurance CEOs to understand the core drivers working against health care affordability. What must not get lost in the discussions is the real driver of why health care is unaffordable for millions of…

A new discussion in Health Affairs written by Katie Martin and Shawn Gremminger explores the challenges employers face in accessing their data.Until information exists in a user-friendly format and employers can get their own detailed claims data, actionable plan design changes to lower health care costs will remain out of reach for many employers. To…

The Health Care Cost Institute (HCCI) conducted an analysis on estimated acquisition costs and ESI reimbursement costs among 340B-participating hospitals in 2022. This issue brief analyzes the estimated ESI and Medicare fee-for-service price mark-up, relative to estimated acquisition costs, among 340B hospitals. Among the three physician-administered drugs of interests: daratumumab, pegfilgrastim, and infliximab, we found…

The federal 340B Drug Discount Program was created in 1992 to lower the cost of drugs for non-profit hospitals that disproportionately care for people with lower incomes. Under the program, discounts from drug manufacturers to hospitals are estimated to range from 20 to 50% on most outpatient medications, although the actual discounts are not publicly disclosed. Because the program does not restrict the patients who can receive…

Primary care offers patients a critical connection point to the health care system. With contact, continuity, comprehensiveness, and coordination as its base1, primary care has been shown to improve health outcomes and population health, reduce health disparities, and save health care dollars. Despite the virtues and benefits of primary care, it seems to be getting harder to access. In 2025, there…

As federal and state policymakers pursue policies to lower health care costs, “site neutral payment” has emerged as a potential tool with bipartisan support to bring down spending. Adopting “site neutral payments” would mean that a given service would cost the same amount regardless of where the care was received (i.e., the site of service)….

Blood cancers represent a range of diseases that can affect blood cells, bone marrow, lymph nodes, and other parts of the lymphatic system. Health care claims data can provide insights into how many people are dealing with blood cancers. Using claims data from people enrolled in Medicaid, employer-sponsored insurance (ESI), and Traditional Medicare, this data…

The high and rising costs of childbirth pose a financial challenge to many families. One study found that 60% of pregnant and postpartum women reported having difficulty affording care, with women enrolled in commercial insurance more likely to report affordability challenges than those with public insurance. To understand the average total spending on childbirth related…