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HCCI's commercial claims dataset includes claims for over one-third of the population with health insurance through their job (employer-sponsored insurance, or ESI). There are a number of unique features of these data that make them valuable for answering important health care and health policy questions. One such feature is the 5-digit zip codes of ESI enrollees (i.e., where people live) and thei...

The International Federation of Health Plans (iFHP), an executive network of the global health insurance industry based in London, in partnership with the Health Care Cost Institute (HCCI) in the United States, and iFHP member companies in multiple countries, today published the latest International Health Cost Comparison Report. The report compares the median prices paid by a sample of private he...

HCCI's research on comparing commercial and Medicare professional service prices was featured in the newsletter of the Association of Health Care Journalists. From the article:  "In Comparing Commercial and Medicare Professional Service Prices, HCCI researchers compared what health insurers paid to physicians and other providers with what Medicare pays for those services. This repor...

HCCI's research on geographic variation in health insurance spending in the employer-sponsored health insurance population was cited in Bloomberg Opinion.  From the article: "A new study from the Health Care Cost Institute in Washington has found a similar dynamic for employer-sponsored insurance: When a beneficiary moves to an area with 10% higher health-care spending, that person's spending...

The COVID-19 pandemic has resulted in a previously unimaginable impact both in the United States and globally. It is increasingly clear as we enter the fifth month of the pandemic, with rising caseloads and deaths, that the United States will need to continue to address the COVID-19 pandemic for the foreseeable future. Each day, we learn more – about the virus clinically, about the people and...

Recent analysis by HCCI finds that enrollment in consumer-directed health plans (CDHPs) increased dramatically since 2008. Nationally, nearly a third of commercially insured individuals were enrolled in a CDHP in 2017, up from 7.5% in 2008. Over ten years, enrollment in CDHPs doubled in 85 of the 88 metro areas studied. High-deductible health plans (HDHPs) have become increasin...

Congress is considering legislation to address "surprise bills", which occur when a person visits an in-network facility, but receives services from a provider that is outside of their insurer's network. Bills in both the House and Senate include provisions to determine a benchmark rate for out-of-network payments based on what in-network providers of the same specialty are paid for delivering sim...

When a person unknowingly receives health care services from a provider that is outside of their insurer's network, it gives rise to the potential for a "surprise bill". Congress continues to consider legislation aimed at reducing the financial burden of "surprise bills" for patients. The approach approved by committees in both the House and Senate is to set a benchmark for the amount that can be ...

People who get health insurance through their jobs pay more than twice as much for insulin at the beginning of the year than they do at the end of the year, on average. New analysis of HCCI data shows that, nationally, in January 2017, average out-of-pocket spending on insulin was $105. This spending declined every month throughout the calendar year, likely as enrollees met their annual deductible...

Changes in opioid utilization correlated with state-level policy changes aimed at decreasing opioid prescription rates. Previous research by HCCI illustrated that national opioid utilization in pills per person fell 27% between the years of 2008 and 2017, driven by declines in the use of hydrocodone (Vicodin). In addition to giving insight into prescription opioid utilization by the commercially i...

Spending per person in employer-sponsored plans reaches all-time high of $6,335 Health care spending for the average New Yorker with employer-sponsored health insurance is increasing faster in New York State than the rest of the country, according to a new analysis released today by the New York State Health Foundation (NYSHealth) and the Health Care Cost Institute (HCCI). Per-person spending grew...

Among people who get health insurance from their employers (56% of the population in 2017), prescription opioid use peaked in 2010/2011 and declined every year from 2012 to 2017. In a new study using the Health Care Cost Institute's commercial claims data from 2008 to 2017, we observed a decline regardless of how utilization was measured. We also found that utilization trends were driven by three ...

HCCI's research on out-of-network billing was recently cited by a CBS Evening News report on the topic. Family hit with $3,700 bill for out-of-network anesthesiologist - CBS News When Adam and Laura Parkinson chose their hospital and obstetrician for the birth of their son, they didn't think they would get hit with a surprise bill for the epidural https://www.cbsnews.com/news/out-of-netwo...

 Out-of-network billing practices have increasingly garnered attention as individuals with commercial health insurance continue to experience "surprise billing." A surprise medical bill commonly describes a charge to a patient for care delivered by an out-of-network (OON) professional who works within an in-network facility. We used the Health Care Cost Institute's (HCCI) vast commercial...

Recently, the Health Care Cost Institute (HCCI) published its Healthy Marketplace Index (HMI) – Price Index report, examining relative health care prices in 112 different metropolitan areas. This report is the first in a new series of releases from the HMI project, funded by the Robert Wood Johnson Foundation, which compares commercial health care markets across the country. We found widespread va...

 ABSTRACT: Policies and practices have proliferated to optimize prescribers' use of their states' prescription drug monitoring programs, which are statewide databases of controlled substances dispensed at retail pharmacies. Our study assessed the effectiveness of three such policies: comprehensive legislative mandates to use the program, laws that allow prescribers to delegate its use to offi...

The 2016 Health Care Cost and Utilization Report shows that spending per privately insured person grew by 4.6 percent, faster than in previous years. Price increases were the primary driver. The report covers the period 2012 through 2016 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare.​  The data in the report can al...

HCCI recently expanded its reporting on emergency room (ER) spending trends to include the most recent data available (2016). We characterize trends in spending, price, and utilization for the five Current Procedural Terminology (CPT) codes designed to capture the level of severity and complexity of every ER visit. While average prices for all five ER CPT codes were higher in 2016 than in 2009, th...

By: Kelly Gooch  A newly revised study reveals insights into monopoly pricing, finding hospital market structure is strongly linked with pricing and insurer contract structure. For the study, researchers primarily examined private insurance claims data from Aetna, Humana and UnitedHealth. The data, provided by the Health Care Cost Institute, covers healthcare received by 28 percent of America...

Valentine's Day is the second-most popular day to pop the question, and millions of couples are expected to get engaged today. According to The Knot's 2017 Jewelry and Engagement Study, the average national cost for an engagement ring in the U.S. is $6,351, just under $1,000 more than average national health care spending per person ($5,407 in 2016). And just like average health care costs, the av...

Past literature has found links between higher opioid use and local economic conditions for people enrolled in public health programs, but there has been little discussion of whether this relationship occurs among the privately insured. Using HCCI claims data and county level income data from the US Census Bureau, we examined how a county's median household income relates to long-term opioid use a...

HEALTH AFFAIRS BLOG: "As policymakers consider actions to address challenges with the Affordable Care Act and ongoing growth in health spending, the importance of understanding local health care market dynamics is more important than ever. Traditionally, policy makers and other stakeholders have evaluated commercial health care markets' total spending and often attributed high spending to high pri...

In honor of National Diabetes Month, our inaugural blog post focuses on a topic of particular interest to people with diabetes: the price of insulin. Insulin is the hormone responsible for the body's ability to use sugar and prevent dangerously high and potentially deadly levels of blood sugar. Diabetics are unable to make enough insulin to support their bodies' needs, and thus many are dependent ...

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.​   Download PDF File H...

By: Laura Dyrda The Health Care Cost Institute issued the "Healthy Marketplace Index: Medical Service Category Price Index" report for 2017 in April. The report calculates metrics comparing aspects of price, competition and productivity of healthcare markets over time, which shows trends for potential future research. The report includes data for inpatient, outpatient and physician medical service...