Report: Americans with employer-sponsored insurance are spending more on healthcare, despite using less

Americans who get health insurance through their employers are spending more than ever on healthcare, despite using less healthcare services, according to a new report. 

The report, from the Health Care Cost Institute, found that healthcare spending per person reached a new high of $5,407 in 2016 among those with employer-based health plans. That figure is an increase of 4.6% compared to 2015, and marked the highest annual spending growth found between 2012 and 2016. 

The major factor driving this increase in spending is increasing prices, according to the report. The largest growth was in the price of drugs, which increased by 24.9% between 2012 and 2016. The price of inpatient care also increased significantly in that window, jumping 24.3%. 

Utilization, however, trended down between 2012 and 2016. Use of inpatient services dropped by 12.9%, though use of prescription drugs ticked up slightly in that same time period, by 1.8%. Despite an overall drop in healthcare use, the report found an increase in visits to specialists, which jumped by 31%. At the same time, visits to primary care providers dropped by 18%. 

"It is time to have a national conversation on the role of price increases in the growth of healthcare spending," Niall Brennan, HCCI's president, said in an announcement (PDF). "Despite the progress made in recent years on value-based care, the reality is that working Americans are using less care but paying more for it every year." 

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When accounting for people enrolled in public insurance, overall healthcare spending growth slowed in 2016, according to the Centers for Medicare & Medicaid Services. However, CMS found that out-of-pocket spending increased and per capita spending topped $10,000 for the first time. 

Among people with employer-sponsored insurance, out-of-pocket spending did increase slightly in 2016 but grew at a slower rate than overall spending, so it represented a smaller share of overall spending numbers, HCCI found. 

People who have insurance through their employers may not feel the impact of increased out-of-pocket costs as strongly as people with other types of insurance, but they ultimately pay higher premiums or face decreased benefits, Brennan said. 

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The findings raise several questions that HCCI said it would like to research in the future. For example, why are people visiting primary care less often and visiting specialists more often? One possible explanation, the report said, is that changes in plan design may impact access to either type of physician. 

The report also does not address the growth of high-deductible health plans, which can lessen healthcare use both for needed and unneeded services, previous research has said.