Chart showing increase The steadyincrease across all service areas is notable at a time of upheavalin the health care markets, most notably the implementation of theAffordable Care Act. (Photo: Shutterstock)

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Health care spending rose steadily over thepast decade, with spending increases found in most major categoriesof service, according to a newreport in Health Affairs. The study, using claimsdata from the HealthCare Cost Institute, found that total health spending percapita for enrollees in employer-sponsored insurance plans increased by44 percent from 2007 through 2016.

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The report looked at spending for four major service categories:inpatient hospital, outpatient facility, professional services, andprescription drugs. The research focused onspending on services rather than premium increases.

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Related: 4 reasons employer-sponsored health insurance won'tgo away

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Overall the report finds an annual average per capita growthrate of 4.1 percent—although there was quite a bit of variationfrom year to year. In 2009, the growth rate was 6.3 percent; in2014 it was 2.6 percent. Although the 44 percent growth over 10years may seem dramatic, the annual health care spending increasesare comparable to historic standards—a 2007Health Affairs study found that the average rate ofspending growth in the U.S. was 4.3 percent between 1970 and2002.

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The study's authors noted that the steady increase across allservice areas is notable at a time of upheaval in the health caremarkets. The last ten years includes the implementation of theAffordable Care Act (ACA), by far the largesthealth reform legislation to be passed in decades.

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“The past decade has been a transformational time in U.S. healthcare market with policy changes and innovation disrupting practicemodels and standards of care,” Niall Brennan, MPP, president andCEO of HCCI and one of the study's co-authors, said in a statement.“However, what is remarkable is that even within these dramaticchanges, the share of spending across service areas has remainedfairly consistent.”

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The report found that prescription drugs were the area wherespending increased the most. Other areas with higher rates ofspending increases included emergency department visits andoutpatient surgery. Spending on inpatient medical and surgical caredropped during the period, with the researchers suggesting thatthis may reflect an ongoing shift in care from hospitals tooutpatient settings. The authors noted that the study was limitedin some ways (for example, it did not include spending from publichealth plans), and called for more research to be done in thisarea.

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“Health care expenditures are projected to continue to rise overthe next decade, but without meaningful research on the health careutilization and spending trends for people with employer-sponsoredhealth insurance—the single largest block of insured people in thecountry, it will be difficult to develop appropriate and effectivepolicies,” said Brennan. “There is a need for more research on thehealth care trends in this population to understand the complexsystems affecting the overall rising cost of U.S. health care.”

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