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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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Jul
29

Health Care Spending in New York Growing Faster Than Rest of U.S.

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...
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Jul
23

Comparing Commercial and Medicare Rates for Select Anesthesia, Emergency Room, and Radiology Services by State

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...
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Apr
30

Past the Price Index: Exploring Actual Prices Paid for Specific Services by Metro Area

As policymakers, employers, and patients increasingly struggle with rising health care costs, there is a lack of clarity around the actual price of health care services and why those prices are so different. Recent efforts have focused on greater price transparency as a way to impact growing prices. A range of proposals from both Congress and the White House seek to shed more light on the confusin...
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Apr
02

Shifting Care from Office to Outpatient Settings: Services are Increasingly Performed in Outpatient Settings with Higher Prices

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 ...
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Feb
11

2017 Health Care Cost and Utilization Report

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...
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Jan
21

Spending on Individuals with Type 1 Diabetes and the Role of Rapidly Increasing Insulin Prices

We used health care claims data to investigate trends in total health care spending on individuals with type 1 diabetes between 2012 and 2016. We found a rapid increase in total health care spending, driven primarily by gross spending on insulin that doubled over the period. During that time insulin use rose only modestly. While the composition of insulins used shifted, the price of all types of i...
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Nov
15

Trends In Primary Care Visits

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...
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Oct
03

Wall Street Journal: Employer-Provided Health Insurance Approaches $20,000 a Year

HCCI's 2016 Annual Report was cited in the WSJ: The HCCI findings are "pretty compelling," said Paul Ginsburg, a professor at the University of Southern California. "Higher prices from providers is the most important element in rising premiums in the past few years."  Employer-Provided Health Insurance Approaches $20,000 a Year - WSJ The average cost of health coverage offered by employers ro...
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