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


Issue Brief: Per Capita Health Care Spending on Diabetes: 2009-2013

This issue brief examines health care spending for adults and children with diabetes relative to those without diabetes, both in terms of total per capita health care spending and out-of-pocket costs from 2009-2013.

This issue brief examines health care spending for adults and children with diabetes relative to those without diabetes, both in terms of total per capita health care spending and out-of-pocket costs from 2009-2013.

Key Takeaways Include:

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Shopping for Health Care Makes “Cents” for Consumers

This data brief looks at:

  • Per capita out-of-pocket spending rates nationally and statewide
  • Average differences in consumer prices for a set of five common medical procedures: office visit for the evaluation of a new patient, colonoscopy, cataract removal, lower leg MRI; and ultrasound for pregnancy nationally and in nine states: Arizona, Colorado, Florida, Georgia, Maryland, New Jersey, Ohio, Texas, and Wisconsin

It finds consumer out-of-pocket spending for common health care procedures can vary from $10 to nearly $1,000, depending on the procedure.

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Issue Brief: Out-of-Pocket Spending Trends (2013)

This issue brief accompanies the 2013 Spending Cost & Utilization Report and examines trends in out-of-pocket expenditures per capita for the national, younger than age 65 population covered by employer-sponsored insurance for the period of 2011 through 2013.

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Issue Brief: Selected Health Care Trends for Young Adults: 2007-2012

This issue brief is one of the first to examine health care trends for young adults (ages 19-25) with employer-sponsored insurance before and after implementation of Section 1001 of the Affordable Care Act that allows parents to include their adult children in family health plans.

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Issue Brief: Key Findings from Children’s Health Spending: 2009-2012

This issue brief summarizes the main findings of the Health Care Cost Institute’s (HCCI’s) Children’s Health Spending: 2009-2012.

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