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Neonatal Intensive Care Units (NICUs) provide critical, often life-saving, care to over 300,000 infants every year. The specialized care and technology available in NICUs have allowed preterm and otherwise vulnerable babies to survive and thrive even in the face of a host of potentially life-threatening complications and are recognized as contributing to the decline in infant mortality over the pa...

There is substantial evidence that people in the U.S. receive health care services judged to be of low-value. These services are identified as low value based on recommendations from the U.S. Preventive Services Task Force (USPSTF) and professional medical societies that there is little to no clinical value associated with their provision and potential for harm in specific clinical scenarios. Thes...

High out-of-pocket costs for health care services can put necessary care and medications out of reach for many people. In one survey, nearly half of adults reported difficulty paying for health care services. In this brief, we used HCCI's commercial claims dataset, which includes health care spending information for over one-third of the population who receives health insurance through their job, ...

The population with employer-sponsored health insurance (ESI) includes individuals who receive health insurance coverage from an employer, including employees and their dependents, such as spouses and eligible children. Half of the children in the U.S. are covered by ESI, making this form of coverage the largest source of insurance for American children. In this report, we present data on health c...

Half of American children have health insurance coverage through an employer (typically as a dependent on a parent's coverage). Therefore, a major asset of employer-sponsored insurance (ESI) claims data is the opportunity to understand more about how children use and experience the health care system. In this brief, we use HCCI's unique national dataset encompassing health care claims for over one...

HCCI's 2019 HCCUR was featured in a Health Affairs article on increases in health care spending.  From the article: "Price increases in most years have been highest in the commercial market. While there is some variation across states, a national analysis of commercial claim data by the Health Care Cost Institute found that from 2015 to 2019, approximately two-thirds of the increase in spendi...

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...

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...

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...

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 ...

COVID-19 testing has become a regular part of life for many Americans over the last two years. In addition to facilitating individual returns to work, school, and other activities, testing is a crucial component of the public health strategy to monitor and address the spread of the virus. Even as testing becomes more available, there is widespread concern and frustration about the high and variabl...

Abstract:  IMPORTANCE  By 2020, nearly all states had adopted oncology parity laws in the US, ensuring that patients in fully insured private health plans pay no more for orally administered anticancer medications (OAMs) than infused therapies. Between 2013 and mid-2017, 11 states implemented parity with out-of-pocket spending caps, which may further reduce patient out-of-pocket spending...

HCCI's research on spending for individuals with employer-sponsored health insurance was featured in an article for Modern Healthcare. From the article: "Spending per person with employer-sponsored insurance was about $5,900 in 2018, according to the Health Care Cost Institute's latest data." Caring for Medicare Advantage patients now a growth business Medicare Advantage patients are the unlikely ...

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...

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...

The postpartum period is a vulnerable time for both birthing parent and newborn and is critically important to their health and well-being. The American College of Obstetricians and Gynecologists (ACOG) recommends ongoing, comprehensive care, including physical, social, and psychological services, during the postpartum period. In large part because of an increasing maternal mortalit...

 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...

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...

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...

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...

HCCI's report with the New York State Health Foundation on health care spending in New York was recently featured in a Wall Street Journal article. From the article:  "Health-care spending on New Yorkers who get insurance through work is higher and rising more sharply than the national average. The main reason, according to a new report, is price growth. Rising prices of doctor visits, i...

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...

HCCI's research on consumer-directed health plans was recently used to support the second in a series of articles by the Los Angeles Times on high-deductible health plans. From the article:  "New research conducted in partnership with The Times for this project also shows that sick Americans use less healthcare when their plan requires them to pay more out of pocket. Analyzing data from ...

​HCCI research presented at this year's AcademyHealth Annual Research Meeting on emergency room spending was recently featured in a story in USA today.  From the article:  "Hospital emergency rooms are more likely to charge pricier levels of care than a decade ago, generating bigger bills that consumers increasingly must pay with their own money, according to a new report. The nonprofit ...