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:
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Employer-Sponsored Insurance (2019-2021): A National-Level Look at Cost and Coverage Rates 

Throughout the United States, a majority of Americans and their families receive health insurance coverage through their employer. In 2021, the number of individuals enrolled in this type of coverage–known as employer-sponsored insurance or ESI–exceeded 62.2 million. In this blog, infographic, and companion documents, SHADAC researchers use data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to analyze the private-sector ESI landscape in 2021 on a national level and within the states.

State and Federal Relief Prevented Deep Backslide in Health Care Affordability in California in 2020

There were well-founded fears that the pandemic, and the concurrent economic crisis, could make health insurance and health care unaffordable for even more people — already a long-standing problem in California.  This analysis of the California Health Insurance Survey (CHIS) shows that Californians were largely protected from experiencing a major erosion in their ability to pay for health insurance and care. Despite this overall positive finding, the 2020 CHIS data on health care affordability continued to demonstrate clear inequities by income and race/ethnicity.

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

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.

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.