Publications

Nearly half of adults in the US have high blood pressure or high cholesterol, which are key risk factors of heart disease – the leading cause of death in the US.  HHS estimates about 30 million adults in the US have blood pressure at levels where medication use is recommended but are untreated. The American…

HCCI analysis has shown that spending on urgent care services among people with employer-sponsored insurance (ESI) increased by over 50% from 2018-2022, primarily due to a 34% increase in the use of urgent care over that period. For example, from 2019 to 2020, the use of urgent care increased 21%, from 99 visits per 1,000…

Since CMS codified through regulation a single price Medicare will pay for select services, regardless of whether they occur in a hospital outpatient department (HOPD) or an independent office, site neutral payments policies have been seen as an opportunity to bring down health care spending. Subsequent policies exempted most existing HOPDs from the policy, limiting…

Per person spending among people with employer-sponsored insurance grew nearly 19% from 2018 to 2022, a combination of 14% price growth and 4% utilization growth. This trend reflects that prices primarily have been responsible for health spending increases over this period. Spending on urgent care grew at a substantially faster rate (more than 50%) from…

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…