Consumers used the same amount of healthcare or less in 2016 than in 2015, but paid more for it because of rising prices, and that pace is accelerating, according to a new report from the Health Care Cost Institute (HCCI).

"It is time to have a national conversation on the role of price increases in the growth of healthcare spending," said Niall Brennan, president of HCCI. "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. Rising prices, especially for prescription drugs, surgery, and emergency department [ED] visits, have been primary drivers of faster growth in recent years."

The report covers the period 2012 through 2016 and includes national claims data from Aetna, Humana, Kaiser Permanente, and UnitedHealthcare.

Over the 5 years examined in the survey, prescription drug spending had cumulative growth of 27%, despite flat or decreasing generic drug pricing, and a decline in the use of brand-name prescription drugs. The increase in spending was driven by double-digit price increases from 2012-2016 for brand prescription drugs.

The overall number of ED visits rose only slightly over the 5-year period, but the average price for an ED visit increased 31.5%.

The average price for surgical admissions increased by nearly $10,000, or 30%, over the 5-year period, despite a 16% cumulative decline in use. The price for outpatient surgery rose more than 19% over the 5-year period.

Total spending per person is now growing at faster rates than prior years, with 4.6% growth in 2016 compared with 4.1% growth in 2015, which followed 2 years of sub-3% growth from 2012 to 2014.

Utilization of most healthcare services remained unchanged or declined, both year-over-year and over the 2012-2016 period.

Consumer out-of-pocket spending per person increased, but grew more slowly than total spending. This difference in growth led to a decline in out-of-pocket spending as a share of total spending.

"While consumers, especially those with employer-sponsored insurance, may not feel the direct impact of these charges via out of pocket payments, they ultimately pay through increased premiums and decreased benefits," Brennan said.

PhRMA (Pharmaceutical Research and Manufacturers of America) has challenged the HCCI findings.

"The latest annual report from HCCI overlooks key data published on drug prices included in the years covered by the report. More recent data provides key insights into the spending and costs of prescription medicines," PhRMA said in an email.

Specifically, in 2016, spending on retail medicines grew just 1.3%, as reported by the Centers for Medicare and Medicaid Services (CMS).

Also, 2016 spending rates published by a number of sources cited a decline in medicine cost growth, on average of 3%-5% for the year (Express Scripts, CMS, CVS/Caremark, Quintiles).

"In addition, HCCI does not factor for discounts drug makers provide to payers," PhRMA said. "In 2015, more than $100 billion in savings for patients were negotiated with drug manufacturers. That number is increasing year on year. These discounts rebate more than one-third of the list price back to payers and others in the supply chain."

to spur

urychlovat, popohánět; podněcovat povzbuzovat

pace

tempo, rychlost; krok

spending

výdaje, útrata

to rise

stoupnout, narůstat; zvednout se

despite

navzdory, přes, přesto

value-based

založený na hodnotě

driver

hnací faktor

national claims data

celostátní údaje o účtech za zdravotní pojištění

brand-name

značkový

double-digit

dvouciferný

admission

příjem, přijetí

rate

rychlost; míra, stupeň; poměr

utilization

využití, použití, užívání; spotřebování; zužitkování

year-over-year

meziročně

out-of-pocket

placený z vlastní kapsy; v hotovosti

share

podíl; účast; akcie

ultimately

nakonec; v zásadě vzato

premium

pojistné; příplatek; prémie, odměna

to overlook

přehlédnout, přezírat; nedbat

insight

vhled, porozumění, pochopení

retail

maloobchodní

to factor

zahrnovat; ovlivnit

to negotiate

vyjednat, sjednat, smluvit; zprostředkovat

to rebate

slevit, refundovat

supply chain

dodavatelský řetězec