Issue Brief: Under Pressure – Adults with Hypertension are Spending Increasingly More on Health Care

This issue brief compares trends in health care spending from 2012 to 2016 for adults with employer-sponsored insurance who were diagnosed with hypertension to those not diagnosed with hypertension. It also considers how changes in prescription drug spending compare to changes in prescription drug use for adults with a hypertension diagnosis.
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Issue Brief: Top Spenders Among the Commercially Insured Increased Spending Concentration and Consistent Turnover from 2013 to 2015

This issue brief explores the distribution of health care spending among commercially insured individuals, with a focus on the top 5 percent of spenders and turnover within that group from year to year. It considers the share of spending incurred by this group of top spenders, how those dollars are distributed among the health care service categories, turnover within the group of top spenders, and how new top spenders differ from persistent top spenders.

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Data Brief: Trends in Total and Out-of-Pocket Spending in Metro Areas: 2012-2015

This data brief examines geographic variation in health care per capita spending, with a focus on consumer per capita out-of-pocket spending across geographies (2012-2015). It also explores whether the proportion of people enrolled in consumer-directed health plans (CDHPs) and the proportion not utilizing health care services had any influence on out-of-pocket spending.

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Data Brief: Non-Shoppable Health Care Services – Inpatient Hospitalizations

This data brief reports on spending and utilization in populations likely unable to shop for a hospital prior to seeking care, comparing spending and length-of-stay for individuals who were admitted through the emergency department (ED) to that of individuals who needed ambulance services the day of their admission through the ED.

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Data Brief: Medicare Advantage Health Care Utilization – Observation Stays

This data brief reports on outpatient observations stays in the Medicare Advantage population from 2010 through 2014. The results show that the rate of observations stays increased in total as well as following hospitalizations.

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Data Brief: Medicare Advantage Health Care Utilization – Hospital Readmissions

This data brief, reports on five readmission rate measures for the Medicare Advantage (MA) population: 30-day all-cause hospital-wide readmissions and 30-day all-cause readmissions following acute myocardial infarction (AMI), heart failure, chronic obstructive pulmonary disease (COPD), and pneumonia. The results show that MA readmission rates have been declining over the past five years.

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Issue Brief: Consumer-Driven Health Plans: A Cost and Utilization Analysis

This data brief examines the health care use and spending from 2010-2014 for people who are enrolled in consumer-driven health plans (CDHPs), and compares these trends to non-CDHP enrollees. Findings indicate that although fewer total dollars were spent on health care for CDHP enrollees, they had higher per capita out-of-pocket spending on deductibles, copays, and coinsurance.

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Data Brief: Necessary versus Sufficient Claims Data

This data brief compares membership characteristics and health care service prices in non-ERISA and ERISA populations. The results suggest that non-ERISA data may be sufficient for policy relevant analyses, even when ERISA data is not available.

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Data Brief: The Price-Quality Paradox in Health Care

This data brief compares average state-level prices against quality measures for asthma, diabetes and hypertension care and finds that higher prices for medical services are not always indicative of higher quality of care.

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Issue Brief: Spending on Shoppable Services in Health Care

This issue brief examines health care spending on shoppable services in 2011. Contrary to expectations, giving consumers prices so they can shop for health care services may only have a modest effect on reducing health spending.

Key Takeaways Include:

  • In 2011, about 43% of the $524.2 billion spent on health care services for commercially insured people was considered shoppable.
  • About 15%—nearly $81 billion—of the total spent on health care for the commercially insured was spent out of pocket.
  • Of the total amount spent, about 7%—$37.7 billion—was spent on shoppable services out of pocket by consumers.
  • Most out-of-pocket dollars (44%) were spent on shoppable ambulatory doctor services.

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Read the accompanying blog post in Health Affairs co-authored with Lynn Quincy of Consumers Union: Health Care Consumerism: Can The Tail Wag The Dog

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