Out-of-Pocket Healthcare Spending

Privately Insured Adults Are Satisfied With Health Plan Coverage

February 27, 2024 - Privately insured adults are generally satisfied with their health plan coverage, valuing their low out-of-pocket costs and premiums, provider networks, and prescription drug coverage, according to data from the Employee Benefit Research Institute (EBRI) and Greenwald Research. The Consumer Engagement in Health Care Survey (CEHCS) included...


More Articles

Medicare Part D Low-Income Subsidy Loss Tied to Higher Out-of-Pocket Costs

by Victoria Bailey

Beneficiaries who temporarily lost their Medicare Part D low-income subsidy experienced higher out-of-pocket drug costs and fewer prescription fills, a study published in JAMA Health Forum...

OOP Costs Greater for Cancer Patients in High-Deductible Health Plans

by Victoria Bailey

Patients with cancer enrolled in high-deductible health plans had higher out-of-pocket medical costs compared to those in traditional health plans, according to a study published in JAMA...

2022 National Healthcare Spending Growth Slowed to Pre-COVID Levels

by Kelsey Waddill

In 2022, national health expenditures hit $4.5 trillion, a 4.1 percent increase, with a couple of key spending areas seeing growth rates return to pre-pandemic levels, CMS announced in a fact...

Lawmakers Urge CMS to Improve Data Collection in Medicare Advantage

by Victoria Bailey

Four United States Senators have called on CMS to improve data collection and reporting in the Medicare Advantage program to help regulators understand how plan design impacts care quality, cost, and...

Drug Price Negotiation Would’ve Reduced Prices, OOP Spending in 2021

by Victoria Bailey

If the drug price negotiation program had been in effect in 2021, Part D drug prices would have fallen 63 percent and out-of-pocket spending would have declined 23 percent, research from Mathematica...

How Much Members Spend on Diabetes Chronic Disease Management

by Kelsey Waddill

Members with diabetes spend between $3,300 and $4,600 per year in out-of-pocket costs for chronic disease management, including lost wages, according to a new report from GoodRx Health. These...

3 Ways That Large Employers Influence Health Insurance Costs, Coverage

by Kelsey Waddill

Traditionally, health insurance companies have been the face of the payer industry, for better or for worse. But companies have incredible sway in the health insurance world, particularly large employers. Employers offer and manage...

How to Evaluate Benefits to Ensure Health Equity for All Members

by Kelsey Waddill

Although the healthcare system has made great strides in health equity awareness and promotion, women pay more and get less out of their employer-sponsored health benefits than men do. Employed women are more likely to hit their...

Beneficiaries with Cancer Spend Less Out-of-Pocket in Medicare Advantage

by Victoria Bailey

Medicare Advantage beneficiaries with cancer experienced lower out-of-pocket costs and had access to more benefits than those in Medicare fee-for-service (FFS), research conducted by ATI Advisory and...

Medicare Part D Patients with HIV May See Lower Drug Costs Under IRA

by Kelsey Waddill

The Inflation Reduction Act’s Medicare Part D redesign may improve affordability for beneficiaries with HIV, but stakeholders will need to take steps to ensure beneficiaries get the most out of...

Consumers Blame Payers, Utilization Management for Delays in Care

by Kelsey Waddill

Consumers do not agree that insurers are protecting them from high out-of-pocket costs and find that utilization management practices—such as prior authorization and formulary...

Members with Anxiety, Depression Face Higher Out-of-Pocket Spending

by Kelsey Waddill

Individuals with depression, anxiety, or both who are enrolled in large employer-sponsored health plans have higher out-of-pocket spending than individuals without such diagnoses, according to an issue...

End of COVID-19 Policies Will Influence National Healthcare Spending

by Kelsey Waddill

CMS’s Office of the Actuary reported that the average annual growth in national healthcare spending between 2022 and 2031 will exceed the average annual growth in gross domestic product...

Experts Assess the Effects of the No Surprises Act on Surprise Billing

by Kelsey Waddill

The No Surprises Act may have successfully defended consumers from surprise billing but requires reworking in other areas, an issue brief from Urban Institute and the Robert Wood Johnson Foundation...

Out-of-Pocket Spending for Pediatric Hospitalizations Reached $3,000

by Victoria Bailey

The average out-of-pocket spending per non-birth-related pediatric hospitalization was $1,313 for privately insured children, but spending varied depending on the time of the year, chronic condition...

AHIP Argues In Favor of the Copay Coupon Accumulator Rule

by Kelsey Waddill

AHIP submitted an amicus brief in favor of the HHS copay coupon accumulator rule, which would allow states to decide whether pharmaceutical manufacturers’ copay coupons should contribute to...

How Overall, Out-of-Pocket Costs of Obesity Escalated in 10 Years

by Kelsey Waddill

Obesity was linked to higher healthcare spending and higher out-of-pocket costs for individuals in employer-sponsored health plans, according to a Peterson-Kaiser Family Foundation (KFF) Health System...

MA Beneficiaries Satisfied With Coverage but Face Financial Barriers

by Victoria Bailey

Medicare Advantage beneficiaries face more financial barriers than Medicare Supplement beneficiaries, but plan satisfaction is high for both groups, an eHealth report found. The report reflects survey...

CA VBID Program Boosted Primary Care Use, Contained Healthcare Costs

by Victoria Bailey

California’s value-based insurance design (VBID) program was associated with a higher probability of primary care use, a lower probability of inpatient admissions, and no change in total costs...