Utahns on average spend less on their health care each year than residents of any other state, due partly to more active lifestyles and abstaining from tobacco and alcohol.
But a new report says that per-capita health costs in the state are nevertheless rising fast — and not because Utahns are seeking more health care. Rather, the trend is primarily tied to hospitals and other providers steadily raising rates, and sometimes, charging widely different amounts for common procedures, the report by the nonpartisan Utah Foundation suggests. The authors say higher costs of medical devices, pharmaceuticals, over-treatment and several other factors were key drivers in that trend.
In one example, researchers found a hospital in Murray had charged $41,136 for an angioplasty — the surgical repair of a blood vessel — while an Ogden hospital charged more than twice that, $91,250.
The Utah Foundation report, released Wednesday, was compiled in response to a survey last year that found Utahns were concerned about health care costs more than any other issue, said Peter Reichard, the group’s president. He said Utah Foundation plans additional reports on health insurance and Medicaid.
Polls show that rising health care costs remain a chronic concern for Utahns, and Americans as a whole. A recent University of Utah study, for example, found most patients in Utah valued affordable out-of-pocket costs above a host of other aspects in their health care, including provider expertise and getting timely appointments. The same poll found 88 percent of Utahns strongly or somewhat agree that the cost of U.S. health care is too high.
Utah spends relatively little on health care per-capita compared to their national counterparts, estimated at about $6,000 in 2014. That’s in part due to a “strong health profile” among its residents, says the foundation report, entitled “Bills of Health: What’s Driving Medical Service Costs in Utah.”
Utahns are generally more physically active, and they tend not to smoke or abuse alcohol, which are both eschewed by active members of The Church of Jesus Christ of Latter-day Saints, Utah’s predominant faith. The state also has the lowest average age in the country, at about 31 years.
In addition, Utah hospitals have the shortest average length of stay in the nation, which helps drive costs down. Doctor visits in the state are, on average, cheaper than elsewhere in the U.S. — though foundation researchers said that “might be in part because Utah is among the states with the highest percentage of adults who did not see a general doctor in 2014.”
And there are other, less positive factors pushing down Utahns’ health spending. The state has fewer hospital beds per 1,000 people than all but one other U.S. state. It also has among the lowest Medicare and Medicaid enrollment numbers in the country, and an uninsured rate of 8.8 percent, well above the national average.
“If you don’t have insurance,” Reichard said, “you’re less likely to seek medical care.”
Nonetheless, Utahns’ medical care spending is going up — like elsewhere, outpacing the general rate of inflation, Reichard said.
The report says over roughly the past two decades, the state’s total health care expenditures grew by an average of 8.7 percent annually, the third fastest in the country. Meanwhile, Utah’s per capita spending growth from 1991 to 2014 fell more in the mid-range compared to other states.
By comparison, overall health spending for the U.S. as a whole increased by 5.8 percent in 2015 and 4.3 percent in 2016, according to a report published Thursday by analysts at the federal Centers for Medicare and Medicaid Services.
One key factor in that growth was Utah’s expanding population. But other main drivers, in Utah as elsewhere, include a high cost of new medical devices and fast-rising pharmaceutical prices. Over-treatment of patients — such as overuse of CT scans and other diagnosis equipment — is also a factor, the report states, and so is the consolidation among healthcare providers
“You’d think consumers could get savings based on economies of scale,” Reichard said. ”But it seems to yield higher costs because of less competition.”
Also adding to overall costs is more “administrative complexity” — which is forcing medical professionals to spend more time on paperwork, researchers say.
“For instance, one health care official told Utah Foundation that a major Utah-based health provider has doubled its administrative compliance staff since the passage of the Affordable Care Act in 2010,” the report notes.
And then there are the widely different rates that providers charge for procedures — ranging from pneumonia treatment to knee replacement. The researchers, using Utah PricePoint, a consumer tool for comparing prices, found charges at some hospitals were three or four times higher than others.
“One thing we would like to see, on behalf of the public, is more information” provided about pricing, Reichard said.