About 20 medical episodes account for about 40 percent of the past half-decade's growth in employer healthcare spending, according to a new study.
Truven Health Analytics studied the claims data of 8 million commercially-insured members and found that average per-member per-year spending for employers grew at an annual rate of 4.3 percent between 2006 and 2011, from $3,739 to $4,625 in 2011.
"Spending growth is being driven mainly by outpatient medical services," and musculoskeletal conditions are "the costliest and most rapidly growing group of diseases," wrote Bill Marder, the report's author and a Truven senior VP.
Among the other costly and common conditions accounting for that 40 percent of cost growth are multiple sclerosis, births by cesarean section, complications from surgical and medical care, breast cancer, kidney failure, lower back osteoarthritis, Crohn's disease, HIV and arrhythmia.
Inpatient services for joint replacement surgery accounted for the largest share of the growth for employer plans between 2006 and 2011, with physical therapy resulting in additional outpatient spending. Most of the multiple sclerosis spending goes to prescription drugs, especially self-administered interferons and glatiramer, which more than doubled in annual treatment cost per patient over the 5-year period, the study found.
Employers (and employees paying out-of-pocket costs) can see some of those conditions compounding. Truven found complications from surgical and medical procedures "occurring more frequently in part due to the growing use of surgery to treat orthopedic conditions."
The study found that overall spending for pharmaceutical drugs slowed between 2006 and 2011 -- but that diseases associated with speciality drugs, like MS, are "growth drivers."
Another growing condition that brings on other conditions that's starting to show in employer's health costs is obesity -- "the underlying driver of many of the diseases noted in this report," Marden wrote, and "a problem that will not be solved by improved healthcare delivery alone."
Spending on healthcare for symptoms of obesity alone grew between 2006 and 2011 -- from an average of $20.65 per-member per-year to $32.24 -- along with type 2 diabetes, which grew from an average of $66.59 to $76.87.
"On the positive side, we find that a great deal of employer healthcare spending growth is being driven by preventive services," Marder said. There's been a "general increase in utilization and cost of routine checkups and cancer screenings," the report found, and "marked growth in influenza vaccination."