International Federation of Health Plans

Transcription

1 International Federation of Health Plans 2011 Comparative Price Report Medical and Hospital Fees by Country

2 COMPARATIVE COST REPORT The International Federation of Health Plans was founded in 1968 by a group of health plan industry leaders. It is now the leading global network of the industry, with one hundred member companies in 30 countries. Federation member plans meet regularly to share information about health care financing and health care delivery in their home countries. 2

3 Scanning and Imaging Fees Angiogram ($US) $2,500 $2,341 $2,000 $1,500 $1,000 $500 $35 Canada $798 $665 $320 $371 $245 $123 $204 $212 $164 Spain France Switzerland Germany India Chile Argentina USA FOR ILLUSTRATIVE PURPOSES ONLY 3

4 Scanning and Imaging Fees CT Scan: Abdomen ($US) $1,800 $1,600 $1,657 $1,400 $1,200 $1,000 $800 $600 $400 $200 $98 $122 $123 $141 $148 $228 $354 $425 $584 $219 Argentina Canada Spain France India Chile Germany Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 4

5 Scanning and Imaging Fees CT Scan: Head ($US) $1,800 $1,600 $1,545 $1,400 $1,200 $1,000 $800 $600 $400 $200 $43 $78 India Argentina Canada $122 $123 $141 $184 $272 $319 $510 $95 Spain France Chile Germany Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 5

6 Scanning and Imaging Fees CT Scan: Pelvis ($US) $1,600 $1,481 $1,400 $1,200 $1,000 $800 $600 $522 $400 $319 $354 $200 $64 $89 $122 $123 $141 $158 $193 Argentina India Canada Spain France Chile Switzerland Germany USA FOR ILLUSTRATIVE PURPOSES ONLY 6

7 Scanning and Imaging Fees MRI ($US) $3,000 $2,758 $2,500 $2,000 $1,500 $1,000 $903 $1,080 $500 $116 $138 $245 $281 $478 $599 $503 Argentina India Spain France Chile Germany Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 7

8 Hospital Charges Cost Per Hospital Day ($US) $14,000 $12,000 $11,496 $10,000 $8,000 $6,000 $4,000 $3,949 $2,000 $236 $380 $515 $632 $655 $690 $934 $1,552 $1,449 India Argentina Spain Germany France Switzerland Australia Chile USA FOR ILLUSTRATIVE PURPOSES ONLY 8

9 Hospital Charges Cost Per Hospital Stay ($US) $60,000 $50,000 $49,878 $40,000 $30,000 $20,000 $15,734 $10,000 $1,473 $1,825 $2,479 $3,396 $4,948 $4,566 $5,004 $4,410 Argentina Spain Australia France Chile Switzerland Germany USA FOR ILLUSTRATIVE PURPOSES ONLY 9

10 Total Hospital and Physician Costs Normal Delivery ($US) $16,000 $15,236 $14,000 $12,000 $10,000 $9,280 $8,000 $6,000 $6,201 $8,495 $6,993 $4,000 $2,000 $1,291 $1,967 $2,157 $2,414 $2,536 $3,195 $3,589 Argentina India Germany Spain France Canada Chile Australia Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 10

11 Total Hospital and Physician Costs C-Section ($US) $30,000 $25,000 $24,339 $20,000 $15,000 $12,318 $14,374 $10,000 $9,548 $10,137 $5,000 $1,640 $2,164 $3,159 $3,441 $3,589 $4,625 $5,980 Argentina India Spain Germany Chile France Canada AustraliaSwitzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 11

12 Total Facility and Physician Costs Cataract Surgery ($US) $9,000 $8,000 $7,806 $7,000 $6,000 $5,000 $5,310 $4,000 $3,591 $3,748 $3,000 $2,000 $1,000 $597 $885 $1,356 $1,855 $2,358 $2,514 $3,140 $2,452 Argentina India France Spain Canada Germany Chile Australia Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 12

13 Total Facility and Physician Costs Appendectomy ($US) $30,000 $27,797 $25,000 $20,000 $15,000 $13,003 $10,000 $5,000 $254 $1,030 $2,615 $3,093 $3,164 $4,926 $5,509 $5,606 $5,840 India Argentina Spain Germany France Australia Chile Canada Switzerland $7,756 USA FOR ILLUSTRATIVE PURPOSES ONLY 13

14 Total Hospital and Physician Costs Hip Replacement ($US) $90,000 $80,000 $80,374 $70,000 $60,000 $50,000 $40,000 $30,000 $20,000 $10,000 $3,589 $4,308 $11,353 $11,418 $12,023 $15,684 $16,945 $17,521 Argentina India France Germany Spain Chile Canada SwitzerlandAustralia $38,017 $25,604 $23,535 USA FOR ILLUSTRATIVE PURPOSES ONLY 14

15 Total Hospital and Physician Costs Coronary Artery Bypass ($US) $160,000 $140,000 $138,050 $120,000 $100,000 $80,000 $60,000 $40,000 $20,000 $4,525 $9,319 $16,140 $16,578 $17,908 $20,505 $25,486 $38,891 $40,954 India Argentina France Germany Spain Chile Switzerland Australia Canada $67,583 $42,951 USA FOR ILLUSTRATIVE PURPOSES ONLY 15

16 Total Facility and Physician Costs Angioplasty ($US) $70,000 $60,000 $57,374 $50,000 $40,000 $30,000 $26,524 $20,000 $10,000 $2,557 $2,972 $5,857 $6,189 $8,499 $9,913 $10,060 $10,559 India Argentina France Germany Spain Australia Canada $12,212 $15,627 Chile Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 16

17 Physician Fees Routine Office Visit ($US) $180 $160 $162 $140 $120 $100 $89 $80 $60 $40 $20 $9 $11 $16 $23 $30 $40 $45 $64 $64 Argentina Spain India France Canada Germany Chile Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 17

18 Physician Fees Normal Delivery ($US) $8,000 $7,000 $7,222 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $160 $226 $340 $449 $460 Argentina Germany Spain France Canada $3,390 $2,326 $1,639 $1,048 Chile Australia USA FOR ILLUSTRATIVE PURPOSES ONLY 18

19 Physician Fees C- Section ($US) $9,000 $8,000 $8,059 $7,000 $6,000 $5,000 $4,000 $3,000 $2,000 $1,000 $185 $402 $442 $597 Argentina Germany Spain Canada $4,086 $2,783 $1,877 $1,048 $749 France Chile Australia USA FOR ILLUSTRATIVE PURPOSES ONLY 19

20 Physician Fees Cataract ($US) $2,500 $2,173 $2,000 $1,500 $1,423 $1,000 $1,152 $946 $500 $337 $433 $609 $688 $626 $150 Argentina France Spain Germany Canada Australia Chile USA FOR ILLUSTRATIVE PURPOSES ONLY 20

21 Physician Fees Appendectomy ($US) $2,500 $2,171 $2,000 $1,500 $1,463 $1,000 $1,007 $500 $148 $239 $258 $401 $577 $696 $659 Argentina Spain Germany Canada France Australia Chile USA FOR ILLUSTRATIVE PURPOSES ONLY 21

22 Physician Fees Hip Replacement ($US) $6,000 $5,379 $5,000 $4,000 $3,000 $2,000 $2,500 $2,513 $2,966 $2,051 $1,000 $462 $644 $872 $1,011 $1,123 Argentina Germany Canada France Spain Chile Australia USA FOR ILLUSTRATIVE PURPOSES ONLY 22

23 Drug Prices Nexium ($US) $400 $350 $357 $300 $250 $200 $150 $193 $176 $100 $50 $3 $19 $23 $36 India Argentina France Canada $69 $56 $52 $50 Chile Spain Germany Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 23

24 Drug Prices Plavix ($US) $200 $180 $160 $140 $172 $163 $160 $120 $109 $100 $80 $60 $40 $42 $49 $51 $61 $68 $74 $87 $20 Spain France Argentina Switzerland India Canada Chile Germany USA FOR ILLUSTRATIVE PURPOSES ONLY 24

25 Drug Prices Lipitor $160 $140 $120 $138 $119 $100 $95 $80 $74 $78 $81 $60 $40 $36 $37 $44 $20 $10 $14 India Spain Argentina France Canada Germany Chile Switzerland USA FOR ILLUSTRATIVE PURPOSES ONLY 25

26 Health Spending as % of GDP 20% 17.4% 16% 12% 9.5% 11.4% 11.6% 11.8% 8% 4% 0% Spain Switzerland Germany France United States Source: OECD Health Spending 2009 (2008 for Australia) FOR ILLUSTRATIVE PURPOSES ONLY 26

27 Submission Overview List of Federation Member Plans Source and Notes for Prices by Country Survey Data Constraints and Limitations 27

28 List of Federation Member Plans Argentina Omint Sa De Servicios Australia Australian Unity Health Limited BUPA Australia Limited GMHBA Limited HBF Health Funds Inc Hospitals contribution Fund of Australia Health Partners Medibank Private Navy Health Limited NIB Health Funds Limited Police Health RT Health Fund Teachers Federation Health Limited Teachers Union Health Belgium Medicover Association Internationale de la Mutualite Nationaal Verbond van Socialistiche Mutualiteiten Union Nationale des Mutualities Libres (MLOZ) Canada Alberta Blue Cross Plan Canassurance Hospital Service Association Group Medical Services Manitoba Blue Cross Medavie Blue Cross Pacific Blue Cross Saskatchewan Blue Cross Chile Banmedica China BUPA China Representative Office Denmark Danmark Sygeforsikring Dominican Republic Ars Humano France Malakoff Mederic Germany AXA Krankenversicherung AG Munich Health Greece Interamerican Life Insurance Company Hong Kong BUPA (Asia) Limited HSBC Medical Insurance Limited India MAX BUPA Health Insurance Limited Ireland VHI Healthcare Limited Italy Unisalute Mauritius Administrators & Consultants Limited Netherlands Achmea Health New Zealand Southern Cross Healthcare Health Fund Association of New Zealand Uniion Medical Benefits Society Nigeria Total Health Trust Limited Saudi Arabia BUPA Middle East South Africa Discovery Health Medical Scheme Bonitas Medical Fund Chartered Accountant (SA) Medical Aid Fund Discovery Health La-Health Medical Scheme Medihelp Polmed Transmed Spain Compañia de Seguros Adeslas SA Sanitas SA Switzerland Helsana Versicherungen AG Sanitas Thailand BUPA Health Insurance (Thailand) Limited United Kingdom AXA PPP Healthcare BUPA InterGlobal Insurance Company Europe Assistance Holdings Healthways International Limited Simplyhealth Group Western Provident Association Westfield Contributory Health Scheme USA Aetna Inc Emblem Foundation Health Plan Tufts Health Plan UnitedHealth Group America's Health Insurance Plans Blue Cross & Blue Shield Association HIP Health Plan of New York Kaiser Foundation Health Plan Inc The Trizetto Group Zimbabwe CIMAS Medical Aid Society The Medical Aid Society of Central Africa 28

29 Sources and Notes For Prices by Country Argentina Australia Chile Canada Prices represent a weighted average of prices across three systems: a public system (50%), a social security system (38%) and a private system (12%). Prices represent fees paid by a private health plan. Primary care, diagnostics and drugs are not covered by private health insurance. Prices represent private sector fees paid by a private health plan. Newborn care is included in normal delivery and c-section prices. There are two methodology changes from the 2010 survey. In that survey, the angioplasty price represented the cost for the stent; the cost per hospital day only included the cost for the room. The 2011 prices presented include the full costs for these procedures. This has increased the cost from those presented last year. Prices represent public sector fees for the province of Nova Scotia; the 2010 survey prices were drawn from the province of New Brunswick. Pricing varies across provinces. The price shown for Nexium reflects the price for the substitute Losec. Lipitor price reflects the generic equivalent. Cataract surgery facility and physician price reflects fees for day surgery. 29

30 Sources and Notes For Prices by Country France Germany India Spain Switzerland Prices are submitted by a private health plan, and represent a blend of public and private sector prices. Drug prices reflect prices paid by patients in pharmacies outside of hospitals. Prices represent fees paid by one private sector health plan. Cataract facility and physician price is for an inpatient setting. Newborn care is not included in normal delivery and C-section pricing. Prices represent private fees paid by one private sector health plan. Lipitor price is for generic substitute. Prices represent fees paid by one private sector health plan. Prices represent public sector fees. Public sector inpatient fees in 2010 did not include costs paid by the cantons; in this year s survey this has been corrected so that prices include these payments. Cataract surgery facility and physician price is for an outpatient setting. 30

31 Source and Notes For Prices by Country United States U.S. costs are based on commercial claims data from Thompson Reuters MarketScan Research Databases. The claims data was compiled by Deloitte Consulting LLP on behalf of Kaiser Permanente Health Plan. Any opinions or conclusions expressed herein regarding the data are not those of Deloitte Consulting LLP. Because a broad range of prices were available, the national 25 th percentile (low), average, and 95 th percentile are presented. Cataract surgery price reflects outpatient procedures. Angioplasty price reflects a blend of inpatient (67%) and outpatient (33%) prices, based on relative utilization in each setting. Appendectomy price reflects a blend of inpatient (61%) and outpatient (39%) prices, based on relative utilization in each setting. Normal delivery and C-section pricing includes prenatal and post-natal care. Cost per day and cost per admission were calculated by pooling all admissions and calculating percentiles and averages. 31

32 Survey Data Constraints and Limitations Due to data availability, public, private, mixed and/or blended fee schedules were used. Mixture of fee schedule types complicate comparisons There are different scan and imaging fee structures across countries e.g., all scans may be a single price across many scan and/or imaging procedures, while other countries have different prices depending on the type of scan / imaging procedure Drug prices may vary because of differing pricing systems. Some prices include taxes, dispensing fees, etc while others do not. Single plan s data might not be representative of the overall prices and fees. Some fees are snapshots in time (e.g., as of a specific date), while other fees represents of a certain time period (e.g. charges based on claims database). 32