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The World Health Organization reported that, following the COVID-19 pandemic, there was a 25% increase in the prevalence of anxiety and depression worldwide. Mental health crises following months and years of social isolation and other effects of the pandemic have renewed national interest in mental health care access. Understanding how mental health services, including medications used to treat m...

Asthma is the most common chronic condition among children in the U.S. and one of the leading reasons for pediatric emergency room (ER) visits. Schools play an important role in managing asthma among children since kids spend most of their time in school and school buildings may have environmental factors such as poor air quality and mold which can trigger asthma flare-ups. When asthma is uncontro...

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...

Evaluation and Management (E&M) services provide an entry point for many people into the health care system. This category of services includes most office visits to a primary care physician or specialist, including behavioral health services, as well evaluation and management services provided in an emergency room or outpatient setting. These visits typically involve a physician or other heal...

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...

Reproductive and sexual health services play an important role in daily life and wellbeing for many people. These services include preventive services (such as screenings for sexually transmitted infections and reproductive cancers), contraceptive services, and services relating to pregnancy and childbirth. The objective of this report is to provide national and state data on the use of repro...

Pre-exposure prophylaxis (PrEP) for HIV are medications that reduce an individual's chances of contracting HIV. The CDC estimates that 1.2 million people are at risk of HIV infection and may benefit from a PrEP prescription. We analyzed health insurance claims for 55 million Americans with employer-sponsored insurance in order to examine utilization and spending on these drugs between 2016 and 202...

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...

It is no secret that the COVID-19 pandemic upended the U.S. health care system in 2020, with effects still being felt in 2022. HCCI previously published a brief that showed precipitous drops in the utilization of several preventive health care services in early 2020. Several news outlets have also covered the effect of the pandemic on routine services, including childhood vaccination rat...

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...

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...

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...

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, ...

HCCI's research on utilization of preventive care services during the coronavirus pandemic was featured in Modern Healthcare.  From the article: "A Health Care Cost Institute analysis of data from various payers found mammograms were down 24% and colonoscopies were down 33% as of August." Targeting high-risk cancer patients with genetics As cancer screening rates have dwindled amid the COVID-...

HCCI's research on non-urgent medical care during the coronavirus pandemic was featured in The New York Times.   From the article:  "Vaccinations dropped by nearly 60 percent in April, and almost no one was getting a colonoscopy, according to new data from the nonprofit Health Care Cost Institute. The data, drawn from millions of health insurance claims, shows a consistent patt...

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...

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...

 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...

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...

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...

% 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...

Using data from the Health Care Cost Institute (HCCI) and Centers for Medicare & Medicaid Services (CMS), we examined trends in inpatient hospital admissions and post-acute care (PAC) utilization among Medicare Advantage (MA) and Fee-for-Service (FFS) beneficiaries. Specifically, we compared how frequently individuals in each group were discharged from the hospital, whether they had evidence o...

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, ...

Depression is a common mood disorder that affects how people feel, think, and conduct daily activities. Approximately 17 million adults (1 in 14) had at least one major depressive episode in 2017. Surveys have found that antidepressant prescribing has increased over the past two decades. For example, a 2017 National Center for Health Statistics survey found that, among people age 12 and ...

Changes in opioid utilization correlated with state-level policy changes aimed at decreasing opioid prescription rates. Previous research by HCCI illustrated that national opioid utilization in pills per person fell 27% between the years of 2008 and 2017, driven by declines in the use of hydrocodone (Vicodin). In addition to giving insight into prescription opioid utilization by the commercially i...