Health Care Spending Influenced by Price and Utilization

A new report by the Health Care Cost Institute (HCCI) is providing a look into health care expenditures and utilization by those younger than 65 covered by private employer sponsored health insurance. The study evaluated millions of health claims from 2009 and 2010 provided by Aetna, Humana, Kaiser Permanente and United Healthcare.

Health Care Prices

The report showed that increases in per capita health care expenditures between 2009 and 2010 were due to higher unit prices and other factors such as utilization (amount) or intensity (mix) of services.

• Inpatient hospital admission increased to $14,662 in 2010 from $13,954 in 2009, a 5.1 percent increase.
• Inpatient surgical admission rose to $27,000 in 2010 from $25,000 in 2009, a 6.4 percent increase.
• Mental health and substance abuse admissions were less expensive than average payments but had an increase to $7,114 in 2010 from $6,549 in 2009, an 8.6 percent increase.
• All outpatient visits (emergency room, outpatient surgery, and observation) rose to$2,224 in 2010 from $2,019, a 10.1 percent increase.
• Emergency room visits increased to $1,327 in 2010 from $1,195 in 2009, an 11 percent from 2009 to 2010.
• Outpatient surgeries rose to $3,443 in 2010 from $3,163 in 2009, an 8.9 percent increase.

Although HCCI did not have plan information, they were able to separate amounts paid by payers and beneficiaries to determine what patients paid out-of-pocket.

• Inpatient admissions decreased by 3.3 percent from 2009 to 2010.
• Outpatient facility visits decreased by 3.1 percent from 2009 to 2010.
• Outpatient procedures increased by 2 percent from 2009 to 2010.
• Prescriptions increased by 0.9 percent.
• Office visits for primary care decreased by 5.5 percent while office visits for specialists increased by 3.9 percent.

HCCI was created in 2011 to provide data on health care costs and to promote nonpartisan research and analysis on the rise of health spending in the U.S. The complete report can be found on the HCCI website.