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HCCI Study Finds CMS-Specified Shoppable Services Accounts for 12% of 2017 Health Care Spending Among Employer-Sponsored Insured

A new Health Care Cost Institute (HCCI) study found spending on 70 services deemed “shoppable” by the recently finalized Centers for Medicare & Medicaid Services (CMS) rule accounted for less than 12% of commercial medical spending in 2017 (prescription drug spending was not included).

As these 70 services (74 codes) accounted for just over one fifth of the services hospitals will have to report (300), HCCI also updated their previous, broad analysis of shoppable services which includes 429 codes. They estimate that approximately 36 percent of 2017 total spending (including prescription drug spending) and 43 percent of out-of-pocket spending was attributed to shoppable services. This is in comparison to their 2016 analysis of 2011 employer-sponsored insurance data that found that, at most, 43 percent of total health care spending (including prescription drug spending) was spent on shoppable services and just under half (approximately 47 percent) of out-of-pocket spending was on shoppable services.

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