Commercially Insured
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Price Markups for Clinical Labs: Employer‑based Insurance Pays Hospital Outpatient Departments 3X More Than Physician Offices and Independent Labs for Identical Tests
Read more: Price Markups for Clinical Labs: Employer‑based Insurance Pays Hospital Outpatient Departments 3X More Than Physician Offices and Independent Labs for Identical TestsThe Health Care Cost Institute (HCCI) in collaboration with West Health conducted an analysis of the high prices that employer-based insurance pays hospital outpatient departments for clinical lab tests. We found that insurers are paying 3 times more for identical tests (such as simple blood and urine tests) when billed by hospital outpatient departments compared to…
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Average Payments for Childbirth Among the Commercially Insured and Fee-for-Service Medicaid
Read more: Average Payments for Childbirth Among the Commercially Insured and Fee-for-Service MedicaidIt is well-established that the rates hospitals and physicians are paid to provide health care services are significantly lower in Medicaid than in private health insurance. In this brief, we provide new data on this payment gap in the context of childbirth, an especially relevant area of care since Medicaid and ESI together cover the…
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The Price of Childbirth in the U.S. Tops $13,000 in 2020
Read more: The Price of Childbirth in the U.S. Tops $13,000 in 2020As HCCI has previously documented, the price of childbirth in the U.S. is higher than in many other countries. When prices are high, patients with health insurance pay directly through coinsurance (i.e., cost-sharing calculated as a percent of what their insurer pays for the service) and over time, as higher prices charged to insurers are…
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Birthing People in the U.S. Pay Nearly $2,000 Out-of-Pocket to Have a Baby
Read more: Birthing People in the U.S. Pay Nearly $2,000 Out-of-Pocket to Have a BabyThe birth of a child is momentous for any person and family. New parents may face a range of challenges, including a lack of paid family leave, the rising costs of childcare, and potential health-related complications for the birthing person and new baby. In the midst of this major life transition, parents also face new…
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As COVID-19 Hit, Birthing People Spent Less Time in the Hospital for Delivery
Read more: As COVID-19 Hit, Birthing People Spent Less Time in the Hospital for DeliveryThe COVID-19 pandemic has impacted Americans in a myriad of ways, including their use of the health care system for both COVID- and non-COVID related services. In this brief, we explore the ways in which the first year of the pandemic affected people for one of the most common hospital services – childbirth. In 2020,…
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COVID Tests Cost $0 for Most People in 2020
for Most People in 2020″ style=”border-radius:5px;width:100%;height:100%;object-fit:cover;” decoding=”async” loading=”lazy” />Read more: COVID Tests Cost $0 for Most People in 2020COVID-19 testing has become a regular part of life for many Americans over the last two years. In addition to facilitating individual returns to work, school, and other activities, testing is a crucial component of the public health strategy to monitor and address the spread of the virus. Even as testing becomes more available, there…
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Comparing Commercial and Medicare Professional Service Prices
Read more: Comparing Commercial and Medicare Professional Service PricesPeople in the United States routinely cite health care and health care costs as top concerns.1,2,3,4 For the more than 160 million people who get insurance from their employer, the cost of health care is high, growing, and outpacing growth in wages.5,6,7 Across the country, health care costs show up in the form of higher premiums and…
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Commercial Prices Relative to Medicare Vary Within Metro Areas Across Specialties and by Type of Service
Read more: Commercial Prices Relative to Medicare Vary Within Metro Areas Across Specialties and by Type of ServiceEarlier HCCI research found that at the national level, commercial payers paid prices that were, on average, 122% of Medicare. However, we found that commercial professional service prices varied dramatically across states from 98% of Medicare in Alabama to 188% of Medicare in Wisconsin. There was similar variation within states, such as California, and also…
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Charge Amounts for Professional Procedures to Commercial Insurance and Traditional Medicare
Read more: Charge Amounts for Professional Procedures to Commercial Insurance and Traditional MedicareIn the start of 2019, Centers for Medicare and Medicaid Services finalized federal policies that required hospitals to publish the amount they charge for common services, documents commonly referred to as chargemasters. While similar policies have been in place at the state level since the early 2000s, this was the first federal mandate to require…
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ADRD Prevalence in Various Insurance Populations: A Collaboration with The Alzheimer’s Association
Read more: ADRD Prevalence in Various Insurance Populations: A Collaboration with The Alzheimer’s AssociationAlzheimer’s disease and related dementias (ADRD) represent a significant and growing cost to the United States health care system. While the prevalence and cost of ADRD related to Medicare Fee-for-Service beneficiaries is documented in the Center for Medicare and Medicaid Services’ Chronic Conditions Warehouse, less is known about the prevalence and cost of ADRD among…