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Private Payer Health Care Cost and Utilization Report: 2010

The newly formed Health Care Cost Institute has released its first report on the nation’s health care costs and utilization. What’s unique about this report? For the first time, it provides a comprehensive look at the privately-insured, based on over 3 billion medical claims from 3 of the nation’s largest private insurers – Aetna, Humana, and UnitedHealthcare. The next report covering 2011 will also include claims data Kaiser Permanente when released later this year.

Here are some highlights from the report covering 2010:

  • The annual expenditure for each under age-65 beneficiary of an employer-sponsored health plan — averaged across all plan members whether or not they filed a claim — was $4,255, with an annual growth of 3.3%. This overall mean expenditure included an average $893 for inpatient care, $1,126 for outpatient care, $1,472 for professional services, and $765 for prescription drugs.
  • However, the average inpatient claim paid price was $14,662, an increase of 5.1% over 2009, while the average outpatient paid claim cost $2,224, up 10.1% from the previous year.
  • The report documents a general overall decline or flat growth in the usage rate of health services since 2007. Economic factors may play a role. In 2010 the average out-of-pocket cost per beneficiary grew to $689, up over 7% from 2009. Out-of-pocket costs represented 16.2% of the total claim price, with the insurer covering nearly 84%.

Source: Health care cost and utilization report: 2010. Health Care Cost Institute, May 2012. http://www.healthcostinstitute.org/2010report

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