Outpatient spending is expected to be the largest driver of premium increases in 2017, according to a new analysis of proposed rate filings in Connecticut and eight other states from a national healthcare advisory company.
Outpatient spending accounts for 29.9 percent of 2017 rate increases in Avalere’s analysis of plans in the nine states’ individual and small group markets. Outpatient spending represented 27.4 percent of spending in these plans in 2015 allowed claims, similar to 2016 premium trends, Avalere said.
In a previous analysis of final premiums data, Avalere found that outpatient spending accounted for 28.9 percent of premium increases — the highest across the six categories. The analysis of proposed rate filings includes data from Connecticut, Maryland, Maine, Ohio, Oregon, Rhode Island, Virginia, Vermont, and Washington.
Prescription drugs represent a smaller portion of rate increases than their share of overall healthcare spending based on proposed rates made by individual and small group plans across the nine states analyzed. Drugs are responsible for 14.3 percent of premium growth in 2017, lower than 2015 claims experience, which shows plans spent 17.7 percent of total medical spending on drugs.
Costs for inpatient care appear to be leveling off and are expected to contribute 15.4 percent of 2017 premium increases, despite being 19.6 percent of spending in 2015, according to Avalere.
“The data underscore the need to look across services and settings of care when considering premium drivers,” Elizabeth Carpenter, senior vice president at Avalere, said in the release. “In addition, experiences vary dramatically by state, underscoring the local nature of healthcare markets.”
