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In HCCI's Health Care Cost and Utilization Report (HCCUR), we report per person spending on health care services of $5,607 in 2020. Of this spending, $1,514 (27%) was on services that occurred in a hospital outpatient setting and $1,071 (19%) was on services that occurred in a hospital inpatient setting. These spending amounts do not include spending on professional services that a patient receive...

ABSTRACT Importance Physician management companies (PMCs), often backed by private equity (PE), are increasingly providing staffing and management services to health care facilities, yet little is known of their influence on prices. Objective To study changes in prices paid to practitioners (anesthesiologists and certified registered nurse anesthetists) before and after an outpatient facility cont...

Per-Person Health Care Spending Grew 18% from 2014 to 2018, Driven Mostly by Prices After remaining stable for several years, utilization increased slightly in 2018 Access the report here. WASHINGTON D.C. — Average employer-sponsored insurance (ESI) spending rose to $5,892 per person in 2018, according to the Health Care Cost Institute's annual Health Care Cost and Utilization Report, which analyz...

When a person unknowingly receives health care services from a provider that is outside of their insurer's network, it gives rise to the potential for a "surprise bill". Congress continues to consider legislation aimed at reducing the financial burden of "surprise bills" for patients. The approach approved by committees in both the House and Senate is to set a benchmark for the amount that can be ...

Spending per person in employer-sponsored plans reaches all-time high of $6,335 Health care spending for the average New Yorker with employer-sponsored health insurance is increasing faster in New York State than the rest of the country, according to a new analysis released today by the New York State Health Foundation (NYSHealth) and the Health Care Cost Institute (HCCI). Per-person spending grew...

Committees in both the House and Senate have advanced legislation that includes measures to address "surprise bills." A surprise bill results when a person unknowingly receives medical care from a provider that is not part of their insurer's network. Both pieces of legislation set a benchmark for out-of-network payments. Those benchmarks are determined based on the median in-network amount paid by...

Where people receive health care matters, especially in terms of costs. The same services may have a much higher price tag when performed in one setting rather than another, but this price difference is rarely publicized to patients. To understand what settings people used and how prices differed, we looked at the utilization and average price paid from 2009 to 2017 for a set of services commonly ...

Watch the Webinar HCCI recently held a webinar to discuss the 2017 Annual Health Care Cost and Utilization Report.    Download PDF File Here

The 2017 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.2 percent, the second year in a row of spending growth over four percent. Price increases were the primary driver. The report covers the period 2013 through 2017 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedH...

Abstract: Evidence suggests that growth in providers' prices drives growth in health care spending on the privately insured. However, existing work has not systematically differentiated between the growth rate of hospital prices and that of physician prices. We analyzed growth in both types of prices for inpatient and hospital-based outpatient services using actual negotiated prices paid by insure...

Office visits to primary care physicians (PCPs) declined 18 percent from 2012 to 2016 for adults under 65 years old with employer-sponsored health insurance, while office visits to nurse practitioners (NPs) and physician assistants (PAs) increased 129 percent. Comparing 2012 to 2016, there were 273 fewer office visits per 1,000 insured individuals to primary care physicians over that span, while v...

ABSTRACT Using a national sample of health care claims data from the Health Care Cost Institute, we found that total spending per capita (not including premiums) on health services for enrollees in employer-sponsored insurance plans increased by 44 percent from 2007 through 2016 (average annual growth of 4.1 percent). Spending increased across all major categories of health services, although the ...

​HCCI data was featured in The Wall Street Journal showing that insurers pay higher prices for some services performed on an outpatient basis that could also be performed in doctors offices. Read the Article

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...

The 2016 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.6 percent, faster than in previous years. Price increases were the primary driver. The report covers the period 2012 through 2016 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare.​  The data in the report can al...

This issue brief compares trends in health care spending from 2012 to 2016 for adults with employer-sponsored insurance who were diagnosed with hypertension to those not diagnosed with hypertension. It also considers how changes in prescription drug spending compare to changes in prescription drug use for adults with a hypertension diagnosis.   Excel Data Tables Machine-Readable Data   D...

 This issue brief explores the distribution of health care spending among commercially insured individuals, with a focus on the top 5 percent of spenders and turnover within that group from year to year. It considers the share of spending incurred by this group of top spenders, how those dollars are distributed among the health care service categories, turnover within the group of top spender...

By: Laura Dyrda The Health Care Cost Institute issued the "Healthy Marketplace Index: Medical Service Category Price Index" report for 2017 in April. The report calculates metrics comparing aspects of price, competition and productivity of healthcare markets over time, which shows trends for potential future research. The report includes data for inpatient, outpatient and physician medical service...

The 2015 Health Care Cost and Utilization Report shows that spending per privately insured averaged $5,141 in 2015, up $226 from the year before. Key Findings  ​Health care spending averaged $5,141 per individual in 2015, up $226 from the year before.Out-of-pocket spending rose 3.0 percent in 2015, to an average of $813 per capita.Spending on prescription drugs grew faster than spending on an...

The 2014 Health Care Cost and Utilization Report tracks changes in health care prices, utilization, and spending for people younger than 65 covered by employer-sponsored health insurance (ESI). The 2014 Health Care Cost and Utilization Report shows that spending per privately insured person grew 3.4% in 2014, with more dollars going to brand-name drugs than in prior years.   Download Report A...

The 2013 Health Care Cost and Utilization Report shows that spending per privately insured grew 3.9% in 2013, as falling utilization offset rising prices. The 2013 Health Care Cost and Utilization Report tracks changes in health care prices, utilization, and spending for people younger than 65 covered by employer-sponsored health insurance (ESI).   Download Report Appendix Tables  Key Fi...

The 2012 Health Care Cost and Utilization Report shows that the growth rate of health care spending among privately insured people under age 65 remained low in 2012, growing 4.0 percent, slightly lower than in 2011 (4.1%).   Download Report Appendix Tables Key Findings ​Spending grew fastest for young adults, women, and people living in the Northeast.Out-of-pocket spending rose more quickly t...

 The Health Care Cost and Utilization Report: 2011 provides the first broad look at 2011 health care spending among those with employer-sponsored insurance (ESI). HCCI found that average dollars spent on health care services for that population climbed 4.6 percent in 2011, reaching $4,547 per person. This was well above the 3.8 percent growth rate observed in 2010. Download Report Appendix Ta...

Findings from HCCI's Health Care Cost and Utilization Report: 2011    Download PDF File Here

The 2010 HCCI Health Care Cost and Utilization Report is the first report of its kind to track changes in expenditures and utilization of health care services by those younger than 65 covered by employer sponsored, private health insurance (ESI). This report assesses the levels and changes in prices and utilization (including changes in the mix of services) focusing on 2009 and 2010. This report i...