Abstract: Using the Health Care Cost Institute (HCCI) database, which contains claim information on approximately 47 million members annually over a seven-year time period, we examined which characteristics best predict and describe high-cost members. We found that cost history, age, gender and prescription drug coverage are all predictors of future high costs, with cost history being the most pre...
ABSTRACT: The prices that insurers pay physicians ultimately affect beneficiaries' health insurance premiums. Using 2014 claims data from three major insurers, we analyzed the prices insurers paid in their Medicare Advantage (MA) and commercial plans for 20 physician services, in and out of network, and compared those prices with estimated amounts that Medicare's fee-for-service (FFS) program...
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 for...
HCCI's emergency room analysis has been highlighted by Politico! "Emergency room spending essentially doubled between 2009 and 2016, even though the number of patients treated remained flat, according to an analysis of insurer claims data recently published by the Health Care Cost Institute. The growth is being driven entirely by the most expensive claims. Costs stemming from the two most expensiv...
By: Niall Brennan Health care spending is exceedingly difficult to control for our nation, the states, and private payers, but also for individual patients and providers. While there has been some moderation in spending in recent years in programs like Medicare, the health share of gross domestic product (GDP) is projected to continue to rise from 17.9 percent in 2016 to 19.7 percent in 2026 (see ...
