People With Multiple Chronic Conditions Drive Bulk of Group Health Plan Spending

The share of group health insurance plan enrollees with high health care spending increased from 2013 to 2021, and over 80% of them in 2021 had one or more chronic diseases, according to two studies from the Employee Benefit Research Institute.

By analyzing health care claims of millions of enrollees in a group health plan from the Merative MarketScan Commercial Database, the study found that the share of enrollees incurring spending $100,000 or more per year on health care went up 50%, from 0.6% in 2013 to 0.9% in 2021. The group with the highest spending ($2,000,000 or more) was 2.5 times larger in 2021 compared to 2013.

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Jinghong Chen

Jinghong Chen Reporter

Jinghong has been producing infographics and data stories on employer-sponsored insurance, public health insurance programs and prescription drug coverage for AIS Health’s Health Plan Weekly and Radar on Drug Benefits since 2018. She also manages AIS Health’s annual executive compensation database for top insurers and Blue Cross and Blue Shield affiliates. Before joining AIS Health, she interned at WBEZ, Al Jazeera English and The New York Times Chinese. She graduated from Missouri School of Journalism with a focus on data journalism and international reporting.

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