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Sep
21

Rates of Gynecological Care Services Suggest Underdiagnosis of Uterine Fibroids and Endometriosis

Uterine fibroids can affect up to 80% of women by age 50. Endometriosis affects 1 in 10 women of reproductive age. Together, they are two of the leading conditions among reproductive-aged women causing infertility, chronic pelvic pain, fatigue, nausea, and heavy menstruation. Symptoms of uterine fibroids and endometriosis are also associated with abdominal pelvic pain, heavy and painful menst...

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ESI
Sep
05

More Children Visit the Emergency Room for Asthma during School Months Compared to Summer Months

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...

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Aug
04

Trends in Asynchronous Health Communication

The COVID-19 pandemic led to an increase in the use of telehealth services and online asynchronous health communication, commonly referred to as emails. These tools allow patients to ask their physicians and other clinicians questions regarding medication changes, symptoms, and to check in regarding management of chronic conditions. In March 2020, CMS expanded Medicare telehealth billing to includ...

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Jul
25

NICU Admissions and Spending Increased Slightly from 2017-2021

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...

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Jun
12

HCCI Data Byte: Unintended effect of federal COVID vaccine policy on claims billing patterns

In HCCI's most recent Health Care Cost and Utilization Report, we observed substantial growth in spending on vaccines among individuals with employer-sponsored health insurance (ESI), which we attributed largely to uptake of COVID-19 vaccinations in 2021. Although they may be largely responsible for this trend, federal procurement complicates analyses of COVID-19 vaccines using claims data. Resear...

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Jun
06

Facility Fees and How They Affect Health Care Prices: Policy Explainer

In this brief, we explain the basics of "facility fees," which have been gaining attention at the state and federal levels. We discuss what a facility fee is, why patients might receive a bill for a facility fee for non-hospital services, why there is controversy around these bills, and what policymakers are doing to address them. Download and read the brief below. As described in the br...

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Jun
01

Out-of-Pocket Spending Grew Over 200% among ESI Enrollees Diagnosed with Cancer

Cancer diagnoses can have devastating psychological and financial tolls on patients and their families. Previous research shows that Medicare beneficiaries who are newly diagnosed with cancer experience health care costs that can reach close to a quarter of household income in the year following diagnosis. People with employer-sponsored insurance (ESI) may experience even greater financial burden ...

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May
25

Use of and Spending on Top Prescription Drugs in Employer Sponsored Insurance, 2021

Recent policy and other initiatives aim to reduce spending on prescription drugs. At the federal level, the Inflation Reduction Act targets reductions in drug spending in Medicare through price negotiation, capping out-of-pocket spending by patients, and requiring drug manufacturers to pay rebates when prices rise faster than inflation. At the state level, there are initiatives to increase drug pr...

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May
23

Over 80% of ESI Enrollees Used Evaluation and Management Services in 2021, with Primary Care and Telehealth the Most Commonly Used

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...

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May
12

The Price of Childbirth Can be Twice as High Even in the Same Hospital

According to HCCI's data, the price of a hospital admission for childbirth among birthing people with employer-sponsored health insurance (ESI) varies by a factor of three across hospitals within a local area. Even within the same hospital and within the same type of delivery, some births cost twice as much as others. Different prices for the same service in the same hospital with the same type of...

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May
12

From Prenatal through Postpartum Care, it Cost More Than $24,000 to Have a Baby on Average

Total Spending Averaged $24,336 across the Prenatal, Childbirth, and Postpartum Periods among ESI Enrollees HCCI has highlighted the high cost of childbirth in the United States, but delivery is only one component of the full financial cost of having a baby. The cost of prenatal and postpartum care may cause people to forgo appropriate services, even as this care could help improve maternal health...

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Apr
25

Focusing on Seven Services Could Eliminate More Than Two-Thirds of Low-Value Care in HCCI's ESI Data

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...

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Jan
24

​HCCI Data Brief: Sexual and Reproductive Health Among People with Employer-Sponsored Insurance

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...

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Dec
20

ESI Enrollees Paid $853 on Average Out-of-Pocket for Health Care in 2020, But Some People Paid Over Four Times as Much

High out-of-pocket costs for health care services can put necessary care and medications out of reach for many people. In one survey, nearly half of adults reported difficulty paying for health care services. In this brief, we used HCCI's commercial claims dataset, which includes health care spending information for over one-third of the population who receives health insurance through their job, ...

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Nov
12

HCCI Spotlights National Diabetes Month: ESI Enrollees with Diabetes Face High Out-of-Pocket Costs. A Cap on Insulin Costs Would Help Many.

Diabetes is a chronic health condition that affects over 10% of the U.S. population. It is possible for people  who are diagnosed with diabetes to live a healthy, long life if the condition is managed properly. However, management often involves significant health care use, which can be costly for patients. Over the past few months, we used HCCI's commercial claims dataset to e...

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Oct
11

Greater Share of Children’s Emergency Room Visits were for Mental Health Needs in 2020

In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association, declared a National State of Emergency in Children's Mental Health associated with the COVID-19 pandemic, including the loss of caregivers, school closures, social isolation, and gaps in health care (see citations below). Understanding the effect of the COV...

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Sep
07

COVID-19 Disrupted On-Time Vaccination Rates In ESI and Medicaid in 2020

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...

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Aug
31

Use of and Spending on Firearm-Related Injuries Increased among People with Employer-Sponsored Health Insurance from 2016-2020

The Centers for Disease Control and Prevention (CDC) reports that there were more than 45,000 firearm-related deaths in 2020; in addition, evidence suggests that there were an additional 2-3 nonfatal firearm injuries seen per death. Recent studies estimate that more than 200 people are injured by firearms each day, and the notable tragedies in 2022, along with the daily toll of firearm-related inj...

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Aug
24

Employer-Sponsored Health Insurance Plays a Significant Role in Vulnerable and Rural Communities

Health care insurance claims data capture what health care services people use and how much they pay. These data are crucial for understanding the state of the U.S. health care system, including aspects that function well, those that need improvement, and how to achieve better health and access to care across populations. In this report, we look at the characteristics of individuals who have emplo...

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Jun
09

One-Third of Births Occurred by C-Section in ESI and Medicaid in 2020

Caesarean sections (c-sections) are often life-saving procedures that can prevent injury and death among birthing people and newborns. At the same time, when they are not medically necessary, c-sections may have higher risks to babies and birthing people than vaginal births. Monitoring rates of c-sections among birthing people is an important component of efforts to improve the quality of mat...

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