The top 1 percent of people under 65 with commercial health insurance account for 25 percent of healthcare costs, according to a report by the IMS Institute for Healthcare Informatics.
According to the report, the impact of these patients on insurance companies may increase in 2014, when the federal healthcare reform law will start preventing insurance companies from turning away costly patients due to pre-existing conditions.
The reasons for the high cost of these patients are numerous: To begin with, 77 percent of the top 1 percent have at least one chronic condition, 16 percent have cancer and 13 percent suffer from auto-immune or other specialty conditions. Average spending for those with chronic conditions in the top 1 percent is 5-10 times higher than spending in the rest of the population for patients with the same diagnosis.
In addition, the top 1 percent of spenders among health plan members spend nearly $100,000 annually per member on healthcare services, compared to around $3,837 per member for the rest of the population.
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According to the report, the impact of these patients on insurance companies may increase in 2014, when the federal healthcare reform law will start preventing insurance companies from turning away costly patients due to pre-existing conditions.
The reasons for the high cost of these patients are numerous: To begin with, 77 percent of the top 1 percent have at least one chronic condition, 16 percent have cancer and 13 percent suffer from auto-immune or other specialty conditions. Average spending for those with chronic conditions in the top 1 percent is 5-10 times higher than spending in the rest of the population for patients with the same diagnosis.
In addition, the top 1 percent of spenders among health plan members spend nearly $100,000 annually per member on healthcare services, compared to around $3,837 per member for the rest of the population.
Related Articles on Coding, Billing & Collections:
The 2012 Payroll Tax SGR Bill: What It Means for Physicians and ASCs
Electronic Funds Transfers to Switch to One Recipient Per Claim
Oklahoma Health Exchange Proposal Would Violate Requirement to Connect With Federal Subsidies