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Commercial Health Plan Trends

By April 26, 2023Commentary

The Health Care Cost Institute was founded to use information from large commercial health plans to elucidate spending and utilization trends and issues.  It has had problems over the years in maintaining a steady flow of good data, but still puts out reports that are useful, particularly for analyzing private health plans.  It recently released an analysis of 2021 spending.  2020 was the first year of the epidemic and had a substantial impact on health care use and spending, as people were deterred from seeking care.  By the end of 2020, however, medical care utilization had returned to near-pre-epidemic levels.  For 2021 per person health care spending rose by 15%, to $6500, from the prior year.  13% of this increase was due to utilization and 2% to price increases, as more lower-intensity services were utilized.  If you compare to the pre-epidemic year of 2019, the increase was around 12%.  Consumer out-of-pocket spending grew from $725 on average to $825.  That does not include premium contributions.

Keep in mind this is largely a commercial population.  Professional services, i.e., mostly physician charges, were 31% of all spending, outpatient hospital services were 27.5%, drugs comprised 21.6% and inpatient hospital was 19.3%.  Price is the biggest cause of spending growth by far over the last five years.  By category, inpatient hospital spending rose 20%, but use actually declined by 6.4%, while prices rose 28%.  Drug spending grew by 29%, and prices rose 17%, professional services spending increased by 19% with prices up only 7% in this category, and outpatient hospital spending grew by 19% with prices rising 9%.

If you want to understand what is happening with health care spending, this report will be very helpful, lots of good data and easy to read charts.   (HCCI Report)

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