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Jun
09

One-Third of Births Occurred by C-Section in ESI and Medicaid in 2020

Caesarean sections (c-sections) are often life-saving procedures that can prevent injury and death among birthing people and newborns. At the same time, when they are not medically necessary, c-sections may have higher risks to babies and birthing people than vaginal births. Monitoring rates of c-sections among birthing people is an important component of efforts to improve the quality of mat...
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Jun
08

Effects of COVID-19 on Health Care Spending Were Concentrated in April-May 2020

The COVID-19 pandemic shaped health care spending and use over the past two years in numerous ways. We recently released our Health Care Cost and Utilization Report which provides data from the first year of the pandemic on health care use, spending, and prices across different types of services for approximately 55 million individuals enrolled in employer-sponsored health insurance. In the report...
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May
10

The Price of Childbirth in the U.S. Tops $13,000 in 2020

As HCCI has previously documented, the price of childbirth in the U.S. is higher than in many other countries. When prices are high, patients with health insurance pay directly through coinsurance (i.e., cost-sharing calculated as a percent of what their insurer pays for the service) and over time, as higher prices charged to insurers are passed along to individuals through higher premiums. We exa...
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May
10

Birthing People in the U.S. Pay Nearly $2,000 Out-of-Pocket to Have a Baby

The birth of a child is momentous for any person and family. New parents may face a range of challenges, including a lack of paid family leave, the rising costs of childcare, and potential health-related complications for the birthing person and new baby. In the midst of this major life transition, parents also face new financial burdens. A major cost – even among those with health insurance – is ...
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Feb
28

JAMA: Variability in Prices Paid for Hemodialysis by Employer-Sponsored Insurance in the US From 2012 to 2019

Abstract: Recent proposals have sought to limit the amount dialysis clinics charge private payers, but little is known about the prices that private insurers actually pay for dialysis. In this study, we provide novel evidence on dialysis prices based on claims data for a large national sample of private employer-sponsored insurance carriers.
Jan
21

CBO: The Prices That Commercial Health Insurers and Medicare Pay for Hospitals’ and Physicians’ Services

Abstract: CBO examined potential reasons that the prices paid by commercial health insurers for hospitals' and physicians' services are higher, rise more quickly, and vary more by area than the prices paid by the Medicare fee-for-service program.
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Sep
30

NPR: The Bill For His COVID Test In Texas Was A Whopping $54,000

HCCI's President and CEO Niall Brennan was quoted in an NPR report on a shockingly high bill for a COVID-19 test. From the article: ' "People are going to charge what they think they can get away with," says Niall Brennan, president and CEO of the Health Care Cost Institute, a nonprofit that studies health care prices. "Even a perfectly well-intentioned provision like this can be hijacke...
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May
21

2019 Health Care Cost and Utilization Report

The 2019 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2015 through 2019 for individuals under the age of 65 who receive health insurance coverage through an employer. This report examines trends within four categories of service: inpatient admissions, outpatient visits and procedures, professional services, ...
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Apr
12

Reader's Digest: A Blood Test in This State Will Run You 25 Times More Than in Other States

HCCI's 2019 Past the Price Index report was featured in Reader's Digest. From the article:  "'Generally, Texas had some of the highest blood test median prices in the country, with 5 of the 12 highest prices studied,' the HCCI authors wrote. For instance, a blood test in Beaumont costs 25 times more than a blood test in Toledo, Ohio." A Blood Test in This State Will Run You 25 Times...
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Nov
19

Kaiser Health News: Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs

HCCI's President and CEO Niall Brennan was quoted in a Kaiser Health News article on the CMS Transparency in Coverage Final Rule.  From the article:  " 'If the information is presented to consumers so they realize they are paying a higher price without the benefit of the rebates, you'll get a lot of angry consumers,' said Niall Brennan, CEO of the Health Care Cost Ins...
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Nov
12

Past the Healthy Marketplace Index, Volume II: Exploring Changes in Actual Prices Paid for Specific Services by Metro Area from 2013 to 2017

In the first brief of the Past the Healthy Marketplace Index series, we explored how prices compared across the country and found that, in 2017, health care prices for specific services varied by as much as 22-fold across metro areas and even up 40-fold within them. In this next brief, we looked at variation in price growth and examined if that variation was related to the substantial observed dif...
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Nov
12

Past the Healthy Marketplace Index, Volume I: Exploring Actual Prices Paid for Specific Services by Metro Area

How much people spend on health care from place to place reflects multiple, interwoven, and dynamic factors, such as the cost and use of services. Health care spending and its driving factors change over time, differ across geographies, and vary by type of service. The Health Care Cost Institute's (HCCI) Healthy Marketplace Index (HMI) provides a number of metrics illustrating how health care spen...
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Nov
10

The New York Times: These Towns Trusted a Doctor to Set Up Covid Testing. Sample Patient Fee: $1,944.

HCCI's research on prices for COVID tests and other panel testing was featured in The New York Times.  From the article: "Insurers typically reimburse the panel test at a higher rate, often paying six times what they would for a regular coronavirus test, according to data provided by the nonprofit Health Care Cost Institute." These Towns Trusted a Doctor to Set Up Cov...
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Oct
26

GAO: Anesthesia Services: Differences between Private and Medicare Payments Likely Due to Providers’ Strong Negotiating Position

HCCI's 2018 HCCUR report was cited in a GAO study on Medicare payments for anesthesia services.  From the report: "The Health Care Cost Institute calculated that in 2017 private insurance payments ranged from 2 to 7 times Medicare payments, on average, across six common services provided by anesthesiologists in 33 states. Wide state-to-state variation within specific services was reported." U...
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Aug
31

STAT: Seeing the ‘Deep Pocket’ Effect When Insurers Pay for Health Care

HCCI's Guroo tool was cited in a STAT article on direct versus insurance-covered health care service prices.   From the article: "I compared prices from this health system's booklet to the average allowed amounts for the same services reported by the Health Care Cost Institute's Guroo tool for hospitals in the state of Pennsylvania. For all services for which insurers pay more than ...
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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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Aug
01

ProPublica: How a $175 COVID-19 Test Led to $2,479 in Charges

HCCI's President and CEO Niall Brennan was recently quoted in a ProPublica article on extremely high coronavirus test billing rates by out-of-network providers.  From the article: "The SignatureCare charges shocked experts who study health care costs. Charging $2,479 for a drive-thru COVID-19 test is a 'nauseating' example of profiteering during a pandemic, said Niall Bren...
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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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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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Feb
13

2018 Health Care Cost and Utilization Report

The 2018 Health Care Cost and Utilization Report presents data on health care spending, utilization, and average prices from 2014 through 2018 for individuals under the age of 65 who receive health insurance coverage through an employer. The report draws on data from more than 2.5 billion medical and prescription drug claims for approximately 40 million individuals enrolled in employer-sponsored h...
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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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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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Nov
07

Air Ambulances – 10 Year Trends in Costs and Use

Air ambulances are either fixed wing (airplane) or rotary wing (helicopter) aircraft used to transport people in often time-sensitive medical situations. Air ambulances have become a frequent topic in the news due to their high cost and propensity to lead to surprise bills. Our analysis shows that although air ambulances are not frequently used and their use declined over the 2008 to 2017 period, ...
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