Report: Privately Insured Residents’ Out-of-Pocket Costs Grew by 4.8%

The increase in privately insured individuals' out-of-pocket health spending in 2012 slightly outpaced the overall growth rate of health care spending among privately insured individuals under age 65, according to a report by the Health Care Cost Institute, Modern Healthcare reports (Evans, Modern Healthcare, 9/24).

The study analyzed data from 156 million U.S. residents younger than age 65 who have employer-sponsored health coverage (Lowrey, "Economix," New York Times, 9/24). It focused on medical bills submitted to Aetna, Humana and UnitedHealthcare from 2009 to 2012 (Modern Healthcare, 9/24).

The study found that:

• Privately insured individuals' health spending increased by 4%, to $4,701, from 2011 to 2012;
• Out-of-pocket spending increased by 4.8% to $768 per person;
• Adults ages 55 to 64 spent around $1,265 out of pocket, an increase of 2.5%;
• Individuals younger than age 18 spent $427 out of pocket, an increase of 5.4%;
• Women's out-of-pocket costs were more than $200 greater than men's out-of-pocket costs ("Economix," New York Times, 9/24); and
• Consumers paid out-of-pocket for 16.3% of their health costs in 2012, compared with 16.1% in 2010 (Modern Healthcare, 9/24);

According to Modern Healthcare, the increase in out-of-pocket spending correlates with the increased financial burden placed on consumers as employers move to offering health plans with higher deductibles, coinsurance and fees (Modern Healthcare, 9/24).

HCCI Executive Director David Newman said the study shows that "utilization start[ed] to change health care trends for prescription drugs and professional procedures" in 2012. He added that "[p]reliminary evidence suggests this may be indicative of a larger shift in care as people search for lower-cost care alternatives" ("Economix," New York Times, 9/24).