ANN ARBOR — Truven Health Analytics, formerly the health care business of Thomson Reuters, has released research which projects that health plans will incur a 4.8 percent growth in allowed medical and pharmacy costs in 2013.

The new report, titled “U.S. Health Plan Benchmarks, Trends, and Best Practices for Healthcare Risk Management,” uses real-world insurance claims data for more than 139 clients representing 10 million covered members to track healthcare costs between 2007 and 2011, and project costs for 2012 and 2013.

Following are some of the paper’s key findings:

* Cost Growth Slows, But Continues to Climb: From 2007-2011, Truven Health observed a 5.4 percent per-member, per-year rise in allowed medical and pharmacy costs. The research projects that costs will slow, but continue to increase by 4.8 percent in 2012 and 2013.

* Inpatient/Outpatient Cost Trends: Inpatient costs increased by 2.8 percent between 2010 and 2011, driven by a 3.3 percent increase in the cost per day and a 1.7 percent decrease in the days per 1,000. The allowed amount PMPY for outpatient medical costs increased 3.7 percent between 2010 and 2011, driven by an increase of 2.8 percent in the average cost per outpatient service.

* Small Employers Bear Larger Burden: The median trend rate was a 2.8 percent hike in medical and pharmacy costs PMPY. Large employers (50,000 employees or more) experienced a 2.6 percent increase, while small employers endured a 3.8 percent hike, and medium-sized groups experienced a 2.7 percent rise.

“As key provisions of the Patient Protection and Affordable Care Act begin to take hold, it is paramount for health plans across the country to efficiently manage their costs,” said Jody Amodeo, vice president at Truven Health Analytics. “By utilizing data-driven strategies to identify specific cost drivers and manage population health, plans can maximize their cost-saving opportunities and minimize their exposure to existing volatility.”

All benchmark data and projections were derived from the Truven Health MarketScan databases, a repository of healthcare claims for inpatient and outpatient services. The MarketScan database is the leading resource for studying real-world treatment patterns and costs for the privately-insured, containing longitudinal data for more than 60 million covered lives.

To learn more about how organizations can purchase Truven Health Analytics Health Plan Benchmarks, visit


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