Trends underlying employer-sponsored health insurance growth for Americans younger than age sixty-five

Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this popul...

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Published inHealth Affairs Vol. 32; no. 10; pp. 1715 - 1722
Main Authors Herrera, Carolina-Nicole, Gaynor, Martin, Newman, David, Town, Robert J, Parente, Stephen T
Format Journal Article
LanguageEnglish
Published United States The People to People Health Foundation, Inc., Project HOPE 01.10.2013
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Abstract Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this population between 2007 and 2011. During this period per capita spending on employer-sponsored insurance grew at historically slow rates, but still faster than per capita national health expenditures. Total per capita spending for employer-sponsored insurance grew at an average annual rate of 4.9 percent, with prescription spending growing at 3.3 percent and medical spending growing at 5.3 percent. Out-of-pocket medical spending increased at an average annual rate of 8.0 percent, whereas out-of-pocket prescription drug spending growth was flat. Growth in the use of medical services and prescription drugs slowed. Medical price growth accelerated, and prescription price growth decelerated. As a result, changes in utilization contributed less than changes in price did to overall spending growth for those with employer-sponsored insurance.
AbstractList Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this population between 2007 and 2011. During this period per capita spending on employer-sponsored insurance grew at historically slow rates, but still faster than per capita national health expenditures. Total per capita spending for employer-sponsored insurance grew at an average annual rate of 4.9 percent, with prescription spending growing at 3.3 percent and medical spending growing at 5.3 percent. Out-of-pocket medical spending increased at an average annual rate of 8.0 percent, whereas out-of-pocket prescription drug spending growth was flat. Growth in the use of medical services and prescription drugs slowed. Medical price growth accelerated, and prescription price growth decelerated. As a result, changes in utilization contributed less than changes in price did to overall spending growth for those with employer-sponsored insurance.
Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this population between 2007 and 2011. During this period per capita spending on employer-sponsored insurance grew at historically slow rates, but still faster than per capita national health expenditures. Total per capita spending for employer-sponsored insurance grew at an average annual rate of 4.9 percent, with prescription spending growing at 3.3 percent and medical spending growing at 5.3 percent. Out-of-pocket medical spending increased at an average annual rate of 8.0 percent, whereas out-of-pocket prescription drug spending growth was flat. Growth in the use of medical services and prescription drugs slowed. Medical price growth accelerated, and prescription price growth decelerated. As a result, changes in utilization contributed less than changes in price did to overall spending growth for those with employer-sponsored insurance. Adapted from the source document.
Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored health insurance. Using a new source of health insurance claims data, we estimated per capita spending, utilization, and prices for this population between 2007 and 2011. During this period per capita spending on employer-sponsored insurance grew at historically slow rates, but still faster than per capita national health expenditures. Total per capita spending for employer-sponsored insurance grew at an average annual rate of 4.9 percent, with prescription spending growing at 3.3 percent and medical spending growing at 5.3 percent. Out-of-pocket medical spending increased at an average annual rate of 8.0 percent, whereas out-of-pocket prescription drug spending growth was flat. Growth in the use of medical services and prescription drugs slowed. Medical price growth accelerated, and prescription price growth decelerated. As a result, changes in utilization contributed less than changes in price did to overall spending growth for those with employer-sponsored insurance. [PUBLICATION ABSTRACT]
Author Newman, David
Gaynor, Martin
Herrera, Carolina-Nicole
Town, Robert J
Parente, Stephen T
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CitedBy_id crossref_primary_10_1146_annurev_publhealth_040617_013544
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Cites_doi 10.1377/hlthaff.2012.0493
10.1377/hlthaff.2012.1297
10.1377/hlthaff.2012.0708
10.1016/j.jhealeco.2011.04.002
10.1377/hlthaff.2012.1206
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Cost Of Health Care
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Snippet Little is known about the trends in health care spending for the 156 million Americans who are younger than age sixty-five and enrolled in employer-sponsored...
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SubjectTerms Age
Appropriations and expenditures
Claims
Codes
Datasets
Drugs
Financing, Personal - trends
GDP
Gross Domestic Product
Health Benefit Plans, Employee - economics
Health Benefit Plans, Employee - trends
Health care expenditures
Health care policy
Health Expenditures - trends
Health insurance
Health services
Humans
Insurance
Insurance claims
Insurance coverage
Medical service
Medicare
Middle Aged
Per capita
Pharmacy
Population
Prescription drugs
Prescriptions
Prices
Studies
Trends
United States
Title Trends underlying employer-sponsored health insurance growth for Americans younger than age sixty-five
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