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2014 Health Care Cost and Utilization Report for Privately Insured

The Health Care Cost Institute is out with its annual report on health care spending and use for those covered by employer-sponsored health insurance. Here are some of the report’s findings:

  • Growth in annual per capita spending has held fairly steady since 2011. Annual expenditures grew 3.4% in 2014.
  • Prices increased for all health services. Acute inpatient admissions rose 4.6% per capita from 2013 to 2014.
  • Spending on brand prescriptions jumped by $45 per capita in 2014, despite a nearly 16 percent decrease in use.
  • No surprise here — per capita costs increased with age, ranging from $2660 for those aged 0-18 to $$9466 for pre-Medicare adults aged 55-64.
  • In 2014 the average out-of-pocket expense for those covered by employee health plans increased $17 to $810 a year. Women’s out-of-pocket health costs were higher than for men: $927 compared to $690.
  • Use of health services declined in all categories except for generic prescriptions.
  • The volume of annual acute inpatient care admissions continued its decline, with an admission rate of 53 per 1000 individuals in 2014 compared to 59 per 1000 in 2010.

Source: 2014 Health care cost and utilization report. Health Care Cost Institute, Oct. 2015. http://www.healthcostinstitute.org/2014-health-care-cost-and-utilization-report

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

TRENDS: National health expenditures $3.2 trillion in 2015

Total national health expenditures are expected to grow from $3.2 trillion in 2015 to $5.4 trillion in 2024, according to projections prepared by the Centers for Medicare and Medicaid Services.  Federal government economists expect that the annual growth in national health expenditures will be 5.3 percent this year, increasing to 6.2 percent in 2024.  Another often cited metric, national health expenditures as a percent of the gross domestic product (GDP) is expected to increase from 18 percent in 2015 to 19.6 percent in 2024.


U.S. Centers for Medicare and Medicaid Services. (2015, July 30). National health expenditure data: Projected. Retrieved from https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nationalhealthaccountsprojected.html

Keehan, S.P., Cuckler, G.A., and others. (2015, Aug.). National health expenditure projections, 2014-24: Spending growth faster than recent trends. Health Affairs, 34(8), 1407-1417. Retrieved from http://content.healthaffairs.org/content/early/2015/07/15/hlthaff.2015.0600.abstract  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

ACA Insurance Expansion and Uncompensated Hospital Care Costs

Hospital uncompensated care costs were $7.4 billion less in 2014 than they would have been if insurance coverage had remained at 2013 levels. That’s according to an updated analysis by HHS, based on estimated 2014 growth in insurance coverage due to the Affordable Care Act. It’s a 21% decrease in hospital uncompensated care between 2013 and 2014.

Medicaid expansion accounted for a significant portion of the uncompensated cost savings in states that expanded Medicaid versus those states that didn’t. An additional $1.4 billion in uncompensated costs might have been saved if the the non-expansion states had increased Medicaid coverage.

Here are the numbers from the report:

Hosp uncompensated care reduction & ACA

Furthermore, HHS analyzed hospital financial reports and found the volume of uninsured/self-pay admissions has fallen in major hospital systems, with a significant drop in states with Medicaid expansion.


Source: Insurance expansion, hospital uncompensated care, and the Affordable Care Act. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_UncompensatedCare.pdf

Related resources:

Economic impact of the Medicaid expansion. US Dept. of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 23, 2015. http://aspe.hhs.gov/health/reports/2015/MedicaidExpansion/ib_MedicaidExpansion.pdf

Uncompensated hospital care cost fact sheet. American Hospital Association, Jan. 2015. http://www.aha.org/content/15/uncompensatedcarefactsheet.pdf

See also earlier post: https://aharesourcecenter.wordpress.com/2014/09/26/impact-of-insurance-expansion-on-hospital-uncompensated-costs-in-2014/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

How many health care group purchasing organizations (GPOs) are there?

The Healthcare Supply Chain Association has a brief FAQ-type primer that has some interesting statistics about group purchasing organizations (GPOs).

  • 600+ organizations provide group purchasing services
  • About 30 of these are big GPOs
  • On average, 72 percent of hospital purchases are made through GPOs
  • Just about all hospitals use GPOs
  • The first GPO was the Hospital Bureau of New York, created in 1910

Source: Healthcare Supply Chain Association. A Primer on Group Purchasing Organizations: Questions and Answers. Retrieved from http://c.ymcdn.com/sites/www.supplychainassociation.org/resource/resmgr/research/gpo_primer.pdf Posted by AHA Resource Center (312) 422-2050, rc@aha.org


Guroo.com Shows Prices for Most Common Medical Diagnoses and Tests

A new web site, Guroo.com, is available for consumers to view the average cost for 70 of the most common healthcare conditions, ‘care bundles’, or tests. The average cost for each is available at the national, state, and local level.

Guroo is produced by the Health Care Cost Institute, an organization that collects data from the major private insurers, including Aetna, Assurant, Humana, and UnitedHealthcare. The average costs are based on what the insurance companies actually pay, not the provider ‘retail’ charges before any discounting that my be negotiated by individual insurers.

Costs of additional conditions, care bundles, and tests will be added in the future, including prescriptions costs. A Spanish language version is also in the works.

Guroo.com information is not yet available for individual providers nor does it currently link to any data on the quality of care. That may be added later as well.


Health Care Cost Institute (HCCI) launches Guroo — to provide consumers with free access to a health care transparency tool. Health Care Cost Institute press release, Feb. 25, 2015. http://www.healthcostinstitute.org/news-and-events/health-care-cost-institute-hcci-launches-guroo-%E2%80%93-provide-consumers-free-access-healt

Hancock J. Attention, shoppers: prices for 70 health care procedures now online! Kaiser Health News, Feb. 25, 2015. http://kaiserhealthnews.org/news/new-online-tool-gives-patients-insight-into-the-cost-of-medical-care/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

HOSPITAL COST CUTTING: Don’t cut support staff

Five mistakes managers should avoid in approaching hospital cost cutting are explored in this analysis based on research done in conjunction with the Institute for Healthcare Improvement.  Tips drawn from this research indicate that managers should:

  • Hire enough support staff to allow caregivers to practice at the top of their license
  • Invest in space and equipment to allow clinicians to decrease idle time spent waiting for resources
  • Examine how individual physicians consume supplies
  • Allow physicians enough time during patient visits to counsel and teach
  • Explore benchmarks and standardization

Source: Kaplan, R.S., and Haas, D.A. (2014, November). How not to cut health care costs: the missteps that keep us paying too much for treatment. Harvard Business Review. 92(11), 116-122.  Click here for access to publisher’s website: http://hbr.org/2014/11/how-not-to-cut-health-care-costs/ar/1  Posted by AHA Resource Center (312) 422-2050, rc@aha.org




Benchmarks: Hospitals’ IRS Schedule H Community Benefit Reporting

Hospitals and systems allocated 12.3% of their total expenses toward community benefit in 2011, according to a new analysis of Schedule H filings. That’s up from 11.3% in 2009. [Tax-exempt hospitals report their community benefits to the IRS in a form called Schedule H.]

Community benefit expenditures covered charity care and financial assistance for patients, bad debt, absorption of underpayments from Medicaid and Medicare programs, community and population health improvement, underwriting of medical research and health professions education, and subsidization of high cost essential health services.

Benchmark community benefit costs are presented for systems and by hospital size, type, and location. Spending percentages are broken out for types of community benefits as well. Also benchmarked are practices on threshold use of federal poverty guidelines for determining free and discounted care for patients.

Source: Ernst & Young LLP. Results from 2011 tax-exempt hospitals’ schedule H community benefit reporting. American Hospital Association, Aug. 2014. http://www.aha.org/content/14/schedhreport.pdf

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org