SHADAC Expertise

Health Care Cost and Affordability

Health Care Cost and Affordability

Cost and affordability of health care are understandably at the forefront of consumer concerns as studies show rising health care spending across the nation. SHADAC’s work on these subjects ranges from studies involving primary data collection to assess costs of care, such as care coordination costs; to secondary data analyses of individuals who forgo needed medical care or make changes to prescription drugs due to cost; and of increasing premiums and deductibles in our annual employer-sponsored insurance report. SHADAC staff have also modeled the projected use and cost of Medicaid spending on long-term services and supports for Medicaid enrollees.

Related SHADAC Work:
Click on any title below to learn more about the project.

Factors in Financial Burdens Related to Health Care for Californians 
Though robust Affordable Care Act (ACA) implementation efforts in California have resulted in larger numbers of residents with health care coverage, Californians are now facing coverage-related issues regarding rising costs of care and increasing financial burdens as a result of lack of affordable health care. In a brief prepared for the California Health Care Foundation (CHCF), SHADAC utilized a multitude of measures from the California Health Insurance Study (CHIS) to measure affordability of health care coverage in California in 2018.

2018 State-level Estimates of Medical Out-of-Pocket Spending for Individuals with Employer-sponsored Insurance Coverage
As part of SHADAC’s work monitoring trends in coverage, access, and affordability, this brief highlights the affordability of coverage for those with employer-sponsored health insurance (ESI). Using data from the Current Population Survey (CPS), SHADAC estimated family out-of-pocket costs for people with employer coverage across all 50 states and the District of Columbia (D.C.). Additional analysis looked at family median out-of-pocket costs by state and estimated the high medical cost burden where family out-of-pocket spending is greater than 10% of household income.

Affordability and Access to Care in 2018: Examining Racial and Educational Inequities across the United States (Infographic)
A SHADAC analysis examines Americans’ access and ability to afford medical care, focusing on inequities related to race/ethnicity and education, and using two measures from SHADAC’s State Health Compare: Adults Who Forgo Needed Medical Care and Adults with No Personal Doctor.

A Deeper Dive on Employer-sponsored Health Insurance: Costs in Five States in Comparison with the United States (Infographics)
Using data from Medical Expenditure Panel Survey Insurance Component (MEPS-IC), SHADAC conducted a deeper dive into a state-level analysis of ESI trends in order to better understand which states are most affected by increasing premiums and deductibles or might have a population with high enrollment in High Deductible Health Plans (HDHPs). Costs were compared across four categories—HDHP enrollment, average annual deductibles, average annual premiums, and annual employee contributions for single and/or family coverage—for individual states and the United States.

Minnesota Health Care Home Care Coordination Cost Study
The Minnesota Department of Human Services and Health contracted with SHADAC to conduct a study of the costs of Health Care Home care coordination for adults. In order to estimate the cost of care coordination, SHADAC used a case study approach and developed a list of activities (or “ingredients”) that define care coordination and collected information about the costs associated with each of these activities at six non-acute, primary care clinics.