Truven issues regular reports on employer health benefits spending, based on a claims database on 220 employer plans covering 15.5 million people. (Truven Report) According to its data, from 2007 to 2012 employers had spending growth per covered person of about 4.6% annually, and Truven expected that growth to be between 3 and 4% for 2013 and 2014. Over the same period employee out-of-pocket expenses increased around 11.4% per year. From September 30, 2011 to September 30, 2012, per covered person costs averaged $4,751. Medical expenses were rising at a 6.9% rate while pharmacy was growing 5.5%. Inpatient cost growth slowed in 2012, primarily because admissions declined to 57 per 1000 members and average length of stay also decreased. Average cost per admission, however, rose by 4.6%, largely driven by price increases. In regard to outpatient services, both price and utilization rose; use by 5.6% and price by 2.1%. In the outpatient category, dialysis, emergency room, surgery, diagnostic testing and radiology all showed double-digit growth rates. Prescription drug use rose 4.3% and price increased 3.6%. These overall figures, however, mask the effect of generics, which moderate or lower trend, and of specialty drugs, which continue to grow in both utilization and cost. Consistent with other reports, Truven’s data shows specialty growth exceeding 20% annually. About 18% of all drug costs were actually incurred through the medical benefit, reflecting the expanding use of specialty drugs, which often must be administered in physician offices or other sites of care. And also consistent with other research, Truven’s studies show that dispensing the same specialty drug in a hospital outpatient setting costs about twice what it would in a physician’s office. Fifteen common chronic medical conditions account for about 17% of medical spend in 2012. Osteoarthritis, back pain, heart disease, breast cancer, depression and diabetes are the most expensive conditions. In general, people in the Truven database receive good rates of preventive screenings, with diabetes eye exams and colorectal screening being notable exceptions. According to health risk assessment data, about 35% of covered people were obese according to body mass index and another 35% were overweight.
Employer Health Care Costs
By Kevin RocheJune 4, 2014Commentary
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected]lthy-skeptic.com.
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Another example of over-priced companies trying to find some way to survive in the post-epidemic financial world. Transcarent, which does something, somehow to “access high quality, affordable care” is buying...
March 6, 2023
In an attempt to swiftly revive two floundering health care companies, a PE firm has announced the merger and recapitalization of Revive Health and SwiftMD. You know they are...
January 30, 2023
Investors have not yet learned their lesson, as Pearl Health gathers a new round of $75 million in capital for its business of supporting physicians who want to participate in...
January 30, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace
March 27, 2023
Why You Can’t Trust People Who Make Up Stuff About Vax Safety
A couple of studies offer a far better explanation for heart issues in athletes and…
March 25, 2023
Coronamonomania Lives Forever, Part 201
Tired of March Madness? A boringly refreshing dip into some CV-19 research summaries is recommended.
March 24, 2023
The CDC Is a Font of Methodological and Statistical Error
Several times in the last three years I and others have pointed out serious flaws…