Healthy Marketplace Index Volume I: Price Index

Health care prices have grown rapidly across the United States. But focusing on the national picture doesn’t capture how these rising prices have affected local areas differently. Over the last five years, price levels and growth rates varied widely for different types of health care services both across and within metro areas. In short, each locality had a different experience.

This report explores these differences.

Analyzing over 1.78 billion commercial claims, we compared the average prices paid for the same set of health care services in 112 metro areas across the country. This report presents the price level benchmarks for the U.S. health care system from 2012 to 2016 using a variety of interactive maps and charts to help consumers and stakeholders understand how the prices in their local area compare to others around the country.

How does your area stack up?

Find Out!

Health Care Cost Institute

 

 

 

 

 

Overall Health Care Prices in U.S. Metros Relative to National Average, 2016

Find a Metro:

PERCENT OF NATIONAL AVERAGE

-50%
 
50%

 

the national average in 2016

Similar prices to ___ and ___

Metros Ranked by Price

 

___

___

2

Health Care Prices Varied Widely by Metro

Health care prices across the country were heavily skewed. Several major outliers were well above the national average, inflating the average dramatically: Anchorage, AK (65% above the national average), San Jose, CA (65%), and San Francisco, CA (49%). As a result, 86 of the 112 metros we analyzed fell below the national average.

Baltimore, MD had the lowest overall health care price level in 2016, at 33% below the national average. To put this in context, prices in the most expensive metro (Anchorage) were nearly 2.5 times higher than in Baltimore.

Distribution of Overall Price Levels in Select U.S. Metros, 2016

Find a Metro:

 

the national average in 2016

3

Within Metros, Price Levels Were Not Consistent Across Service Categories

To see whether prices were driven by a particular subset of services, we decomposed overall price levels in to three distinct service categories: inpatient, outpatient, and professional (clinician) services.

Some metros had consistently high or low prices across all service categories, such as Baltimore (below-average prices) and San Francisco (above-average prices).

Other metros had outlier price levels among the three service categories, like Dayton, OH (inpatient), El Paso, TX (professional), and Green Bay, WI (professional).

Price Levels by Type of Service in Select U.S. Metros, 2016

Find a Metro:

Highlight a service type:

 

Overall

 

Inpatient

 

Outpatient

 

Professional

Inpatient prices apply to services rendered to patients who are kept in a health care facility overnight for treatment but not for observation.

Outpatient prices apply to services rendered to patients by sections of a hospital that provide medical services not requiring an overnight stay or hospitalization (e.g., emergency room [ER], outpatient surgery, observation room).

Professional prices apply to services rendered to patients by a health care professional. Service claims with no valid revenue code are assumed to be professional services (e.g., office and preventative visits, administered drugs).

 

4

Growth and Price Level Were Not Always Related

One might expect that a metro with high price levels in 2016 experienced substantial price growth over time. Our analysis shows that was not always the case.

In the scatterplot below, each metro’s 2016 price level is shown along the x-axis, relative to the national average. The y-axis represents each metro’s cumulative price growth from 2012 to 2016. You’ll notice a weak correlation between the two indicators, across all service categories. Price growth did not necessarily come with high prices, and vice versa.

2016 Price Level vs. Five-Year Price Growth for Select U.S. Metros

Find a Metro:

Highlight a service type:

 

Overall

 

Inpatient

 

Outpatient

 

Professional

 

5

How Did Your Area Stack Up?

Interact with our Healthy Marketplace Index data to examine health care price trends in metro areas that you select. Or have us fill in metros similar to your selected area.

Compare Health Care Price Levels and Growth in Select U.S. Metros

 

Overall

 

Inpatient

 

Outpatient

 

Professional

Inpatient prices apply to services rendered to patients who are kept in a health care facility overnight for treatment but not for observation.

Outpatient prices apply to services rendered to patients by sections of a hospital that provide medical services not requiring an overnight stay or hospitalization (e.g., emergency room [ER], outpatient surgery, observation room).

Professional prices apply to services rendered to patients by a health care professional. Service claims with no valid revenue code are assumed to be professional services (e.g., office and preventative visits, administered drugs).

PERCENT OF NATIONAL AVERAGE

-50%
 
50%
 

Click to select

 

the national average in 2016

Similar prices to ___ and ___

 
 

Selected Metros

 

 

 

 

Fill with Similar Metros

Got it!

Select New Metros

Health Care Cost Institute

Our HMI price index provides the following key takeaways, for the 112 U.S. metros we studied:

  1. Overall health care price levels varied dramatically across metro areas in 2016.
  2. Within metros, price levels also varied among certain categories of health care services.
  3. The metros with highest price levels in 2016 were not necessarily the ones with the largest 5-year price growth.

This report and price index is the first release in a multi-part Healthy Marketplace Index series examining variation in key health care spending and market indicators among U.S. metro areas. Upcoming releases will offer comparisons of service use, total spending, waste, and provider competition.