The Health Care Cost Institute (HCCI) has signed research license agreements with 12 leading research, actuarial, and government organizations to license access to HCCI’s detailed claims data from over 50 million privately insured Americans for faculty, association and government research studies, and PhD dissertations. As part of the partnership, HCCI is forming an academic research advisory panel with representatives from each participating institution.

Academic Research Partners

  • American Academy of Actuaries
  • Congressional Budget Office
  • Dartmouth College
  • Medicare Payment Advisory Commission (MedPAC)
  • The National Bureau of Economic Research (NBER)
  • Northwestern University’s Kellogg School of Management
  • Society of Actuaries
  • University of Michigan
  • University of Minnesota
  • University of Pennsylvania
  • University of Texas M.D. Anderson Cancer Center
  • Weill Cornell Medicine

Our partners will have academic institutional access to HCCI’s large private claims database for three years to further health care research and better understand what drives health spending and use of services.

Current Projects

THE EFFECTS OF HEALTH CARE REFORM ON COST AND QUALITY. A University of Michigan research team led by Brahmajee Nallamothu, Lena Chen, and Andrew Ryan, is leveraging HCCI claims data to address the effects of health reform on cost and quality for the commercially insured. The team will evaluate whether commercial prices are primarily responsible for regional differences in acute episode costs and outcomes. As well, the team will assess whether the Quality Bonus Payment Demonstration improved quality of care for people covered by Medicare Advantage. The first paper from this project, “Out-of-Pocket Spending for Hospitalizations Among Nonelderly Adults”, evaluates out-of-pocket spending associated with hospitalizations and to assess how this spending varied over time and by patient characteristics, region, and type of insurance.

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HEALTH CARE USE AND SPENDING AMONG PERSONS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. A research team from the Leonard David Institute (LDI) at the University of Pennsylvania is conducting empirical research on the effects of insurance changes on health care utilization and spending among individuals with a mental health or substance use disorder. Collaborators including Colleen Barry, David Mandell, Andrew Epstein, and Steve Marcus are particularly interested in how federal and state policy changes (including the federal parity law and state insurance coverage mandates) have affected the health care received by individuals with these health conditions.

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ACTUARIAL COST MODELING. Rebecca Owen of the Society of Actuaries (SOA) is developing an actuarial cost model with the HCCI data. Her project includes calculating utilization and cost metrics per unit for the HCCI population with specific focus on the high-cost claimant subset.

EXPLAINING THE VARIATION IN PHYSICIAN PAYMENT RATES WITHIN AND ACROSS MARKETS. A research team from the Medicare Payment Advisory Commission (MedPAC), led by Jeff Stensland, is investigating how payment rates for physician services differ within and across markets. The study will examine whether there are characteristics of physician practices or markets that help explain why some physician practices are paid higher rates from commercial insurers than others.

VARIATION AND DETERMINANTS OF PRIVATE SECTOR PRICES FOR HOSPITAL CARE. A Congressional Budget Office (CBO) research team led by Jared Lane Maeda and Lyle Nelson is using HCCI claims data to examine the prices that private insurers pay for hospital care and investigate the determinants of those prices. Their team will compare commercial, Medicare Advantage, and Medicare FFS prices across and within markets. They will also explore how those prices vary with hospital and market characteristics.

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EFFECTS OF ACO CONTRACTING ON COST AND QUALITY. Led by Carrie Colla, a Dartmouth College research team will be studying the impact of health care payment reforms, including accountable care organization (ACO) contracting, on costs and quality for the commercial population. This study will also use data from the National Survey of ACOs to determine characteristics and capabilities of successful ACO performance.

TECHNOLOGY DIFFUSION IN CANCER: UTILIZATION COSTS, OUTCOMES, AND REGIONAL VARIATIONS. A University of Texas MD Anderson Cancer Center research team led by Ya-Chen Tina Shih is using HCCI claims data to examine regional variations in healthcare utilization and the associated costs and outcomes for cancer patients, with a special focus on the use of new medical technologies.

THE ASSOCIATION OF INFORMATION FROM ALL-PAYER CLAIMS DATABASES WITH NEGOTIATED HOSPITAL PRICES. This project will be completed as a doctoral dissertation by Betsy Q. Cliff and advised by Richard Hirth, both of the University of Michigan.

PROMOTING HEALTHCARE VALUE IN COMMUNITIES THROUGH TECHNOLOGY AND FINANCIAL INCENTIVES. A University of Michigan research team led by John Ayanian is using the HCCI data to examine the effects of two highly visible and interrelated policy levers on the use and quality of surgical care delivery — technology diffusion and cost sharing. These analyses will yield insights on healthcare delivery that will be of interest to providers and policy makers trying to understand the impact of recent initiatives.

VARIATION AND DETERMINANTS OF PRIVATE SECTOR PRICES FOR PHYSICIANS’ SERVICES. This project, led by Daria Pelech at the Congressional Budget Office, is using HCCI claims data to examine the prices that private insurers pay for physicians’ services and investigate the determinants of those prices. This project will expand understanding of the variation in and determinants of physician prices paid by private insurers for commercial and Medicare Advantage plans.

MECHANISMS FOR QUALITY IN COMMERCIAL ACOs. This dissertation project by William Pajerowski at the University of Pennsylvania’s Wharton School is using the HCCI claims data to ask the question: Does the adoption of Accountable Care Organization (ACO) type contracts, which reimburse providers conditionally using quality and cost benchmarks, in fact affect physician treatment behavior and subsequent patient outcomes? This study estimates the effects of commercial ACO adoption on various claims-based treatment and quality measures to identify mechanisms for quality determination and improvement in such organizations.

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THE AFFORDABLE CARE ACT AND MEDICAL CARE PRICES AND UTILIZATION FOR PRIVATELY INSURED PATIENTS. Researchers Craig Garthwaite, David Dranove, and Christopher Ody from Northwestern University are using the HCCI data to look at whether the Affordable Care Act (ACA)’s coverage expansions in general, and the Medicaid expansions in particular, are affecting the prices of medical care for privately insured patients and the practice patterns of providers.

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ADOPTION OF NEW TESTS, DEVICES, AND PROCEDURES IN CANCER CARE. A University of Pennsylvania research team led by Peter Groeneveld is studying patient-level, physician-level, hospital-level, and market-level factors driving the adoption of new diagnostic tests, diagnostic and therapeutic devices, and high-technology procedures for the care of adult patients with four common cancers (lung, breast, prostate, and colorectal). This research aims to inform future policymaking to increase the delivered value of future innovations and to reduce unequal access to new treatments.

READMISSION RISK. A team of researchers from the University of Pennsylvania and Children’s Hospital of Philadelphia led by Scott Lorch are using the HCCI dataset to develop a real-time predictor of readmission risk for pediatric patients. The goal of this work is to develop a calculator of readmission risk to allow providers to target interventions to the patients at highest risk for hospital readmission, in order to reduce the likelihood of hospital readmission, and improve case-mix adjustment for hospitals and other health care providers when assessing care quality.

PRESCRIPTION DRUG MONITORING PROGRAMS, PRESCRIPTION OPIOID MISUSE, AND TREATMENT OF OPIOID ABUSE AND DEPENDENCE. The Weill Cornell Medicine research team, led by Yuhua Bao, will assess the effects of recent state policies governing the use of Prescription Drug Monitoring Programs (PDMPs). Researchers will examine use of prescription opioids, use of medication-assisted treatment for opioid use disorder, and opioid overdose-related adverse health care events and costs, among commercially insured individuals in the U.S. The goal of this study is to provide evidence to guide state policy-making to realize the full potential of their PDMPs.

PRICES, HIGH UTILIZERS, QUALITY AND COSTS. Led by Larry Casalino, this research team from Weill Cornell Medicine is focusing on high utilizers of health care and the relationship between the prices paid to provider organizations and their quality and overall cost of care for high utilizers and other patients. This project would provide the first systematic information on high-priced provider organizations’ quality and cost of care for high utilizers and for other patients.

REFERENCE PRICING FOR SHOPPABLE SERVICES: IMPACT ON TOTAL HEALTHCARE COSTS AND OUT OF POST SPENDING. A research team from the American Academy of Actuaries, led by Steve Jackson, will use HCCI data to estimate the impact on total healthcare costs and on out-of-pocket costs of implementing reference pricing for shoppable medical services.  If reference pricing were introduced nationally for all shoppable services, how much might healthcare spending for these services be reduced?