Publications

The Health Care Cost Institute (HCCI) in collaboration with West Health created this brief as part of an ongoing series examining how vertical integration is changing provider behavior. In this brief, we extend our previous analysis by using the same panel of physicians acquired by health systems between 2019 and 2021 to examine shifts in…

This brief highlights spending by age and service category in 2022 among people with employer-sponsored insurance (ESI). Key Findings: -Spending per person at $25,000 in the first year of life.-Although overall inpatient spending increases with age, we find different patterns of utilization by age across inpatient service categories.-Although overall outpatient spending increases with age, we…

Conventional wisdom and economic theory suggest that more competition means lower prices. In health care, there is longstanding evidence that geographic areas with less competition among hospitals are associated with higher negotiated commercial prices. Regulators and researchers use the Herfindahl-Hirschman Index (HHI) to measure market concentration at a geographic area. HHI can range from 0 (competitive market) to 10,000 (monopoly market). Hospital markets that are considered “highly concentrated,” (HHI greater than…

Skin substitutes have gained attention recently for the rapid growth in Medicare Part B spending. Used to replace or regenerate damaged skin, skin substitutes are bioengineered materials or tissue products that mimic the structure and function of healthy skin and can serve as a permanent or temporary solution to conditions like diabetic foot ulcers or burns.  …

In this report, we study changes in billing and practice patterns following providers’ acquisition by health systems, from 2018 to 2022, using HCCI’s unique dataset of people with employer-sponsored insurance. First, we looked at Evaluation and Management (E&M) visits to see if providers that had been acquired billed higher intensity visits following acquisition, which could…

In 2021, Keytruda (pembrolizumab) became the highest-spending clinician-administered drug among the commercially insured population (people under age 65 covered through employer-sponsored insurance). Keytruda is an immune checkpoint inhibitor (anti–PD-1 monoclonal antibody) administered by infusion and used across a growing number of cancers, often in combination with chemotherapy or other agents and in both metastatic and…

The Health Cost Landscape is an interactive tool created by the Health Care Cost Institute that uses data from employer-sponsored insurance plans to compare health care spending, prices, use, and service mix across 269 metro areas and 45 states. The Landscape tool shows that health care spending varies widely across the United States, ranging from…

Across several HCCI analyses, imaging services have emerged as commonly used services that account for a significant amount of spending, specifically in hospital outpatient department settings. This brief highlights the use and price of imaging services in hospital outpatient settings among people with employer-sponsored insurance (ESI).