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Sep
11

American Journal of Managed Care: Policies to Address Surprise Billing Can Affect Health Insurance Premiums

 Abstract:  Objectives: To quantify the proportion of health plan spending on services for which surprise billing is common—provided by radiologists, anesthesiologists, pathologists, emergency physicians, emergency ground ambulances, and emergency outpatient facilities—and estimate the potential impact of proposed policies to address surprise billing on health insurance premiums. Study D...
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Aug
28

AHCJ: Report Shows Wide Variation in What Insurers Pay Providers Versus What Medicare Would Have Paid

HCCI's research on comparing commercial and Medicare professional service prices was featured in the newsletter of the Association of Health Care Journalists. From the article:  "In Comparing Commercial and Medicare Professional Service Prices, HCCI researchers compared what health insurers paid to physicians and other providers with what Medicare pays for those services. This repor...
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Aug
13

Comparing Commercial and Medicare Professional Service Prices

People in the United States routinely cite health care and health care costs as top concerns.1,2,3,4 For the more than 160 million people who get insurance from their employer, the cost of health care is high, growing, and outpacing growth in wages.5,6,7 Across the country, health care costs show up in the form of higher premiums and higher out-of-pocket costs (for services that are both...
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Aug
13

Commercial Prices Relative to Medicare Vary Within Metro Areas Across Specialties and by Type of Service

Earlier HCCI research found that at the national level, commercial payers paid prices that were, on average, 122% of Medicare. However, we found that commercial professional service prices varied dramatically across states from 98% of Medicare in Alabama to 188% of Medicare in Wisconsin. There was similar variation within states, such as California, and also substantial variation within Metro Area...
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Jun
26

Charge Amounts for Professional Procedures to Commercial Insurance and Traditional Medicare

In the start of 2019, Centers for Medicare and Medicaid Services finalized federal policies that required hospitals to publish the amount they charge for common services, documents commonly referred to as chargemasters. While similar policies have been in place at the state level since the early 2000s, this was the first federal mandate to require this type of transparency. These policies have bee...
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Jun
19

ADRD Prevalence in Various Insurance Populations: A Collaboration with The Alzheimer’s Association

Alzheimer's disease and related dementias (ADRD) represent a significant and growing cost to the United States health care system. While the prevalence and cost of ADRD related to Medicare Fee-for-Service beneficiaries is documented in the Center for Medicare and Medicaid Services' Chronic Conditions Warehouse, less is known about the prevalence and cost of ADRD among individuals covered by employ...
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Jun
16

The New York Times: Most Coronavirus Tests Cost About $100. Why Did One Cost $2,315?

 HCCI's research with iFHP on international comparisons of health care prices was cited in an article in The New York Times on COVID-19 test prices.  From the article:  "How can a simple coronavirus test cost $100 in one lab and 2,200 percent more in another? It comes back to a fundamental fact about the American health care system: The government does not regulate health care price...
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Jun
12

Impact of New Technology on Prices and Use: A Case Examination of Robot-Assisted Surgeries

Surgery accounts for the largest share of inpatient and outpatient spending among individuals with employer-sponsored insurance, representing 49 percent of inpatient spending and 37 percent of outpatient spending in 2018 according to HCCI's most recent annual report. In recent years, the number of surgical procedures performed using robot assistance has increased dramatically. Intuitive, Inc., whi...
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Jun
10

Consumer-Directed Health Plan Enrollment Rises in All Cities over 10 Years (2008 to 2017)

Recent analysis by HCCI finds that enrollment in consumer-directed health plans (CDHPs) increased dramatically since 2008. Nationally, nearly a third of commercially insured individuals were enrolled in a CDHP in 2017, up from 7.5% in 2008. Over ten years, enrollment in CDHPs doubled in 85 of the 88 metro areas studied. High-deductible health plans (HDHPs) have become increasin...
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May
28

How often do providers bill out of network?

In recent analysis, we document extensive variation across states and metropolitan areas in the frequency of out-of-network visits among individuals with health insurance provided by an employer. These differences raise the question of whether individual providers bill out of network at dissimilar rates. To explore whether a small group of providers are responsible for most out-of-network billing,...
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May
13

Understanding Variation in Spending on Childbirth Among the Commercially Insured

Childbirth is the most frequent reason for an inpatient admission in the United States, and Cesarean-section (C-section) is the most common operating room procedure in an inpatient hospital stay. Among people who get insurance through an employer, the combination of labor, delivery, and newborn care makes up nearly one in six dollars spent on inpatient care. Childbirth accounts for an estimated fo...
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May
01

Health Affairs: Physician Prices And The Cost And Quality Of Care For Commercially Insured Patients

Abstract:  We analyzed the relationship between prices paid to 30,549 general internal medicine physicians and the cost and quality of care for 769,281 commercially insured adults. The highest-price physicians were paid more than twice as much per service, on average, as the lowest-price physicians were. Total annual costs for patients of the highest-price physicians were $996 (20 percent) hi...
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Apr
01

Compared to What? Baseline Understanding of the Distribution of Hospital Care

The pandemic of a new coronavirus, COVID-19, is increasing demand on hospitals as unprecedented numbers of people with respiratory disease seek treatment. In addition to straining hospital resources directly related to care of COVID-19, the outbreak may also displace other types of care. In this analysis, we hope to inform the understanding of the distribution of care provided in hospitals and how...
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Mar
01

The Dallas Morning News: Texans are paying more for health insurance — and using it less

 HCCI's 2017 Annual Report and Healthy Marketplace Index were featured in an article in The Dallas Morning News.  Texans are paying more for health insurance — and using it less Nearly everyone is spending more on health care, often a lot more. But did you realize people are using it less? Utilization of health care is growing... https://www.dallasnews.com/business/health-care/2020/03/01...
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Feb
07

Kaiser Health News: Women Shouldn’t Get A Bill For An IUD … But Sometimes They Do

HCCI data was recently cited in a Kaiser Health News story on IUD billing.  From the article:  "In all likelihood, most women probably won't get a bill for IUD insertion or a birth control prescription. Data compiled by the Health Care Cost Institute, an independent research group funded by insurers, suggested that in 2017 fewer than 5% of women had an out-of-pocket bill for the insertio...
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Jan
30

The Washington Post: The Health 202: Health-care costs might decline if hospitals are forced by the Trump administration to disclose their prices

HCCI research on the potential effects of price transparency on price variation was cited in a recent Washington Post article. "There is more wiggle room on the high side — it could make up for price increases on the lower side," said Kevin Kennedy, one of the study researchers. The Health 202: Health-care costs might decline if hospitals are forced by the Trump administration to disclose the...
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Jan
29

What if Price Transparency Reduced Commercial Price Variation?

As previous reports have indicated, there is widespread price variation in the U.S. commercial health care system. Many studies have shown that prices are dramatically different not only across geographies, but they vary substantially even within the same market for the same service. For example, we found that prices for the same blood tests could vary 39-fold within Tampa, Florida and the cost of...
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Jan
16

CMS-specified shoppable services accounted for 12% of 2017 health care spending among individuals with employer-sponsored insurance

% Total Medical Spending % Out-of-Pocket Medical Spending % Medical Charges% Medical  Utilization All Medical Care 11.8 15.6 12.317.2Inpatient Care7.95.68.04.8Outpatient Care13.116.513.717.2 In response to high and growing health care spending, policymakers have proposed improving price transparency as a solution. Several such proposals rely on consumers taking action on publicly av...
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Dec
27

The New York Times: In the U.S., an Angioplasty Costs $32,000. Elsewhere? Maybe $6,400.

HCCI's work with iFHP on international comparisons of health care prices was featured in a New York Times article.   In the U.S., an Angioplasty Costs $32,000. Elsewhere? Maybe $6,400. - The New York Times Enter some description here... https://www.nytimes.com/2019/12/27/upshot/expensive-health-care-world-comparison.html?smid=nytcore-ios-share
Dec
17

Los Angeles Times: Not everyone has eye-popping deductibles: How one union kept medical bills in check

HCCI's 2017 Health Care Cost and Utilization Report was cited in a Los Angeles Times article.  From the article:  "Between 2013 and 2017, the average price nationally for an inpatient hospital admission rose more than 15%, almost three times the rate of general inflation, according to an analysis of commercial insurance data by the Health Care Cost Institute, a Washington think tank. The...
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Dec
17

Vox: A CT scan costs $1,100 in the US — and $140 in Holland

HCCI's work with iFHP on international comparisons of health care price was featured in a Vox article.   America’s health care costs problem, explained in 4 charts - Vox America’s health care prices problem, in four charts. https://www.vox.com/policy-and-politics/2019/12/17/21024614/us-health-care-costs-medical-prices
Dec
17

International comparisons of health care prices from the 2017 iFHP survey

The International Federation of Health Plans (iFHP), a CEO network of the global health insurance industry based in London, in partnership with the Health Care Cost Institute (HCCI) in the United States, and iFHP member companies in eight countries, today published the latest International Comparison of Health Prices Report. The report compares the median prices paid by a sample of private he...
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Dec
10

JAMA Research Letter: Primary Care Spending in the Commercially Insured Population

​Using HCCI's data, we assessed the share among individuals younger than 65 years covered by employer-sponsored insurance from 2013 to 2017.  We assessed primary care spending using 2 main definitions: a definition which included the total spending on services rendered by primary care clinicians (broad definition) and one where only CPT codes for specific services specified as prima...
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Dec
09

The Wall Street Journal: White House Applauds Bipartisan Congressional Deal to Curb Surprise Medical Bills

HCCI's work on out-of-network billing was cited in a Wall Street Journal article on a congressional deal to curb surprise billing.  From the article:  "In surprise bills, patients can be charged nondiscounted rates from out-of-network providers. An insurance plan may not cover that bill, or may pay part of the cost at a lower rate than the doctor charges. Ending such bills has been ...
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Nov
25

Health Affairs: Surprise Bills, Benchmarks, And The Problem Of Indexation

​HCCI data was cited in a Health Affairs blog article on surprise billing.   From the Article: "Over the past year, the congressional debate over surprise billing has converged on two policy options to resolve out-of-network payments—1) a simple benchmark, in which a health plan pays out-of-network providers the median rate agreed with local in-network providers in the same specialty, or...
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