Truven Health Analytics Report Dissects Drivers Behind Employer Healthcare Costs

Study Shows Declines in Inpatient Treatment Costs, Slower Growth in Outpatient and Drug Spending

ANN ARBOR, Mich.--()--The drivers behind last year’s slowing in the growth of employer healthcare costs included a decline in inpatient costs, as well as slower growth in outpatient spending and prescription drug costs, according to the Truven Health AnalyticsTM MarketScan® Employer Norms report.

The report, which is prepared semi-annually, finds that both the utilization of inpatient services and the cost of these services per employee decreased from 2012-2013. Inpatient costs were 1.5 percent lower from the first quarter of 2012 to the first quarter of 2013, as employers spent $916 on inpatient care per employee in Q1 2013 compared to $931 in Q1 2012. Previously, the report had observed a 2.9 percent increase in inpatient spending from Q3 2011 to Q3 2012.

The study’s key findings include:

  • Inpatient Admission Declines: The driving factor behind reduced inpatient spending was a steady decline in admissions. Q3 2011 observed 57.7 inpatient admissions per 1000 persons. That figure fell to 57.6 in Q1 2012, 57 in Q3 2012, and 56.4 in Q 1 2013, helping to account for the observed change in spending.
  • Outpatient Spending Slows: While outpatient spending still showed growth, the spending was curtailed significantly. Outpatient services net costs tapered from an eight percent year-over-year hike to a 4.1 percent annual rise from Q1 2012 to Q1 2013.
  • Employee Costs Stay Flat: Overall employer net medical and pharmacy payments showed a year-over-year increase of 3.1 percent (from $3,688 in Q1 2012 to $3,802 in Q1 2013), but employee out-of-pocket payments stayed flat from the last reported quarter. Q3 2012 and Q1 2013 reflected only a $2 difference per employee. This trend reflected a modest increase in medical out-of-pocket offset by a generics-driven decrease in pharmacy out-of-pocket.
  • Prescription Drug Spending Eases: A driver of the cost slowdown was the diminished growth of prescription drugs spending, punctuated by a continued shift towards generic drugs, and a lower usage rate of prescriptions. These trend drivers were offset by continued double digit growth in specialty pharmacy spending, which increased by 13.4% to $218.90 PMPY from Q1 2012 to Q1 2013; specialty pharmacy increased from 20.8% to 22.6% of total pharmacy spending during this time period. Funds allocated for employees’ prescription drug needs decreased from a 7.4 percent growth rate in Q3 2011 to Q3 2012 to a 5.6 percent rate from Q1 2012 to Q2 2013.

“In a post-reform world, employers are searching for sharper tools and deeper insights to provide effective, preventive care, while limiting the economic strain on their bottom lines,” said Barbara Graovac, Senior Vice President at Truven Health Analytics. “The MarketScan Norms study provides that insight based on the combined healthcare experiences of millions of American workers, giving their employers unparalleled visibility into the impacts of their employee benefits programs.”

The MarketScan Norms report is a complete compendium of de-identified healthcare claims data reflecting the real-world medical care of over 220 employers and 15.5 million insured lives across a full spectrum of industry types, health plans, and pharmacy benefit managers (PBMs).

To learn more about MarketScan Norms, visit http://truvenhealth.com/2013trends.

About Truven Health Analytics

At Truven Health Analytics, we’re dedicated to delivering the answers our clients need to improve healthcare quality and access, and reduce costs. Our unmatched data assets, technology, analytic expertise, and comprehensive perspective have served the healthcare industry for more than 30 years. Everyday our insights and solutions give hospitals and clinicians, employers and health plans, state and federal government, life sciences researchers, and policymakers the confidence they need to make the right decisions, right now, every time.

Truven Health Analytics owns some of the most trusted brands in healthcare, such as Micromedex, ActionOI, 100 Top Hospitals, MarketScan, and Advantage Suite. Truven Health has its principal offices in Ann Arbor, Mich.; Chicago; and Denver. For more information, please visit www.truvenhealth.com.

Contacts

J. Roderick, Inc.
For Truven Health Analytics
Brian Erni, 631-584-2200
brian@jroderick.com

Release Summary

Truven Health Analytics Report Dissects Drivers Behind Employer Healthcare Costs: Study Shows Declines in Inpatient Treatment Costs, Slower Growth in Outpatient and Drug Spending

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Contacts

J. Roderick, Inc.
For Truven Health Analytics
Brian Erni, 631-584-2200
brian@jroderick.com