Niall Brennan's slides from the Center for Health Journalism webinar, "‘It’s the Prices, Stupid’: How sky-high prices are crippling our health care system," 12.6.17 More info: https://www.centerforhealthjournalism.org/content/its-prices-stupid-how-sky-high-prices-are-crippling-our-health-care-system

1. Health Care Prices in the United States
Niall Brennan
President
Health Care Cost Institute
@N_Brennan
December 6, 2017
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2. Why was HCCI founded?
 Prior to HCCI’s formation:
 Access to payer data was piecemeal with researchers primarily
relying on Medicare data for research and analysis
 There was little to no transparency in health care pricing/prices
 HCCI was founded to:
 Promote independent, nonpartisan research and analyses on the
causes of the rise in U.S. health spending
 Inform the public policy process and assist in developing new
solutions to long-term problems confronting the health care
system
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Any informed debate about health care reform relies on access to
data from commercial payers

3. HCCI Data Holdings
 Commercial Claims
 Years 2008-2015
 ~50 million individuals per year
 Employer-sponsored, individual
and Medicare Advantage (Part C)
 All 50 states and D.C.
 Updated annually
 De-identified, HIPAA and anti-
trust compliant
 Medicare fee-for-service claims
(via the Qualified Entity
Program)
 Years 2012-2015
 Parts A & B (100%)
 Part D (~40%)
 Additional years of current
contributors’ data
 2016 data is currently being
constructed and is expected to
be available in January 2018
 2016 Medicare claims will be
available in February 2018
 Administrative data from
additional payers
 State APCDs
 Medicaid and CHIP
Current Future

4. HCCI Data Coverage
• 2015 Coverage Map of HCCI ESI Claims Data

5. HCCI Research and Reports
Issue briefs, academic publications, and
blog posts released throughout the year
All HCCI reports are free and available online
Annual cost and utilization
report released in the fall

6.  HCCI’s current academic partners include:
 HCCI has also facilitated data access and research
support through external funding partnerships:
Academic Research
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7. WSJ Exclusive
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August 31, 2017

8. Collaborations With Media
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1,500,000+ impressions on Twitter!

9. Spending per Person - 2016
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Inpatient
$1,032
Professional
$1,821
Outpatient
$1,507
Prescription
Drugs
$1,030
Total: $5,407

10. Spending per person over time
 How is health care spending distributed in the commercially insured population?
 HCCI examined health care spending for commercially insured individuals (under 65)
with continuous coverage from 2014-2015
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NEJM Catalyst Blog Featuring this Data is Imminent

11. Recent Trends in Health Care Pricing
• Analyzed data from 2012 -2016
• Highest cumulative price growth = brand skin and
mucous membrane agents, 153%
• Highest average price in 2016 = $41,702 for inpatient
surgery (and that price grew 30% from 2012-16)
– Every inpatient category (except hospice and SNF) grew by at
least 18% over the timeframe
• More notables:
– Outpatient ER price grew by 31.5% (2016 average price =
$1,917)
– Administered drugs grew by 41.7% (2016 average price = $581)
– 5 of our 9 brand drug classes’ price grew more than 100%
– Generic cardio drugs went down to $0 (avg. price in 2015 and
2016)
• The only generic drug class that is increasing in price is skin and
mucous membrane agents, which rose by 100% (avg. price from $3 to
$6)
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12. ER Spending
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13. We Can Help……maybe
• We are a small non-profit with limited resources
• That being said we are willing to work with news
organizations on the right stories
• We will also be making more datasets available
online for you to download and analyze yourself
• Don’t forget there are other great data resources
out there especially CMS datasets that allow you
to understand and decompose Medicare
spending
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