The Health Care Cost Institute (HCCI) — a health cost think tank created by health insurers — has created a keepsake from the days before the major Patient Protection and Affordable Care Act (PPACA) commercial health insurance provisions took effect.
Some PPACA insurance provisions, including a provision requiring insurers to cover a basic package of preventive services without imposing out-of-pocket costs on the insureds, were already in effect. But the most sweeping changes — a ban on use of personal health information in decisions about whether to offer coverage, a ban on use of personal health information other than age and tobacco use in decisions about pricing coverage, and the new public exchange health insurance system — took effect Jan. 1, 2014.
The HCCI report shows what U.S. health care costs looked like as what today’s agents and brokers think of as the traditional health insurance world ended and a new world came to life.
Here are three visualizations based on the data in that report.
1. Actual changes in spending were not that bad.
Because of some combination of a soft economy, PPACA cost control provisions, cost-conscious purchasing decisions and free-market competition, employer spending on health premiums increased just 3.9 percent, and consumers’ spending on medical services increased just 3.9 percent.
In spite of all of the commotion about employers passing more out-of-pocket costs on to health plan enrollees, the enrollees’ insurance-related out-of-pocket costs held steady as a share of overall health spending.
2. Prices of health care goods and services rose, but actual use of the goods and services fell.
Inpatient hospital care prices rose 6.7 percent, and the cost of outpatient services increased 6.4 percent. The price of brand name prescription drugs jumped more than 21 percent.
But patients weren’t actually paying those prices, at least all that often. Outpatient utilization fell a little, inpatient admissions fell a little more, and (all the hype about liver pills aside) use of brand-name drugs sank like a rock.
3. PPACA helped young women hold down out-of-pocket spending.
One major PPACA change was already in effect in 2013: A provision that requires most non-grandfathered, PPACA-compliant individual medical policies and group plans to pay for birth control products without imposing any out-of-pocket charges on the patients.
Partly because of that provision, which was created by a U.S. Department of Health and Human Services (HHS) PPACA preventive service package implementation regulation, out-of-pocket spending by women ages 19 to 25 held steady at $662.
Although insurance-related out-of-pocket spending held steady, overall out-of-pocket on all kinds of health-related goods and services increased about 4 percent, to $800 per person.