May 16, 2016
Higher Prices for Children’s Health Care Drove Spending Growth in 2014, While Use of Services Declined
New Report Points to Price Hikes for Prescriptions Drugs, Hospital Stays and ER Visits;
Examines State Trends in Spending for Children’s Health Care
May 16, 2016 – Rising prices were the chief driver of growth in spending for children’s health care in 2014, finds a new report from the Health Care Cost Institute (HCCI). A widespread drop in children’s use of medical care that same year—a relatively new trend in HCCI’s reporting—saw decreases in doctor visits, ER visits and hospital admissions, and lower prescription drug use, particularly for anti-infective drugs such as penicillin among younger children and babies.
Per capita spending on health care for children covered by employer-sponsored insurance (ESI) grew an annual average of 5.1 percent per year between 2010 and 2014, reaching $2,660 in 2014. At the same time, there was a general decline in the use of health care services between 2012 and 2014. Out-of-pocket spending on children increased an average annual 5.5 percent, to $472 in 2014. This growth was due in part to higher out-of-pocket spending on ER visits, which increased an average annual 11.7 percent or $21 per capita.
“The decline in children’s use of health care services is a relatively new trend that we need to continue monitoring,” says HCCI Senior Researcher Amanda Frost. “While we know that prices have fueled much of the spending growth in 2014, future research should examine whether these higher expenditures are leading to better health care outcomes for children.”
For the first time, HCCI examined children’s health care spending trends at the state level, reporting on Arizona, Connecticut, Florida, Illinois, Maryland, Ohio, Texas, Virginia, and Wisconsin, as well as the District of Columbia (DC). Among the states studied, Arizona had the lowest per capita spending ($2,151 per child in 2014), while Wisconsin had higher per capita and out-of-pocket spending than the national average in every year studied – reaching $3,017 per capita in 2014, and $577 in out-of-pocket costs. In 2014, DC had the highest rate of spending ($3,040 per capita), but lowest out-of-pocket payments ($362). High spending in DC was in part driven by an increase in the number of hospital admissions for sick newborns. Additionally, DC had the most ER visits as compared to the other states examined.
Additional Key Findings:
Prices for Brand Prescriptions More Than Doubled. Between 2010 and 2014, the average price per filled day for brand prescriptions more than doubled (from $7 per filled day in 2010 to $16 per day in 2014). As observed among other health care services, increases in spending were driven by the rise in the average price per filled day of a brand prescription, rather than use. In 2014, per capita spending for brand prescriptions rose 6.8 percent, the fastest spending growth rate for any service category that year. For generic prescriptions, the average price per filled day remained stable at $2 across all years studied.
Price Hike for Surgical Admissions. One influence on the increase in spending on acute inpatient admissions over they study period was the rising price of surgical admissions. In 2010, the average price of a surgical admission for a child was $35,423, and by 2014 it was $53,372 – a more than 50 percent price increase.
ER Prices Went Up, But Use Dropped. ER visits comprised eight percent of total health care spending per capita for children in 2014. Spending increased from $165 per capita in 2010 to $214 in 2014. The average price of an ER visit increased by $298 between 2010 and 2014. At the same time, the number of ER visits dropped from 181 in 2010 to 177 ER visits per 1,000 children in 2014.
Doctor Visits, The Most Common Service For Children, Declined. Going to the doctor was the most widely used health care service for children. In 2014, there were 3,228 doctor visits per 1,000 children, down slightly from the previous year. Doctor visits accounted for 12 percent of the total per capita spending in 2014 ($339 per child), and was the largest share of health care spending for the average child.
“In 2014, growth in health care spending was largely due to rising prices,” says HCCI Executive Director David Newman. “We hope policymakers, providers, and payers use this report to improve health care for kids.”
The report presents the most up-to-date information on health care spending trends for privately insured children under age 19. It is based on fee-for-service claims for 10.2 million children per year who were covered by ESI. About half of the children in the United States were covered by ESI in 2014.
March 2, 2016
March 2, 2016 - Contrary to expectations, giving consumers prices so they can shop for health care services may only have a modest effect on reducing health spending
February 25, 2016
February 25, 2016 - The Health Care Cost Institute (HCCI) released a set of six policy briefs assessing the impact of a range of national and state policies on health care costs and utilization.
October 29, 2015
October 29, 2015 –- Spending on health care for the privately insured in the United States grew at a steady rate over the past five years, increasing 3.4 percent in 2014
September 30, 2015
Healthy Marketplace Index Measures Health Care Prices, Productivity, and Competition from 2011-2013; Allows for Local and National Comparisons to Assess Market “Health”
July 8, 2015
July 8, 2015, Washington, DC—Spending on health care for children (ages 0–18) covered by employer-sponsored insurance (ESI) grew an annual average of 5.7 percent per year between 2010 and 2013, compared to 3.9 percent for the total population (ages 0–64) with ESI, finds a new report from the Health Care Cost Institute (HCCI).
May 7, 2015
Health Care Spending for Privately Insured Children With Diabetes Rises Sharply Between 2011 and 2013
May 7, 2015 –- Per capita health care spending for children with diabetes covered by employer-sponsored insurance (ESI) grew faster than for any other age group with diabetes, rising 7% from 2011 to 2012 and 9.6% from 2012 to 2013, according to a study released today by the Health Care Cost Institute (HCCI). Overall per capita spending for individuals younger than age 65, covered by ESI, and with diabetes rose 4.1% in 2013, nearly double the 2012 increase (2.2%).
March 5, 2015
March 5, 2015 – The Health Care Cost Institute (HCCI) and the National Academy for State Health Policy (NASHP) have announced the recipients of the State Health Policy Grant Program. The program has selected five research projects that will analyze state health reform initiatives and policy trends.
March 5, 2015
Minnesota health care executive Scott Leitz has joined the Health Care Cost Institute as its Chief Transformation Officer.
February 25, 2015
Health Care Cost Institute (HCCI) Launches Guroo – To Provide Consumers With Free Access To A Health Care Transparency Tool
February 25, 2015 – The Health Care Cost Institute (HCCI), an independent, non-partisan, non-profit organization, announced today the introduction of guroo.com, a consumer-focused website that provides national, state and local cost information for common health conditions and services using claims from multiple insurers for more than 40 million insured individuals - numbers that no one else has. The new website is free and accessible to everyone, regardless of whether they have insurance or who their insurer is.