The May U.S. Health Care Price Index (USHPI), the first national resource to publicly document the price of cash-pay medical care in America, found the price that Americans paid for health care in the growing cash-pay market increased from an average of $36.80 in May 2022 to an average of $42.50 per visit in May 2023.
The broad-based increase in the cash-pay price Americans paid for health care over last year suggests higher demand for cash-pay appointments due to two factors:
- More people in the cash-pay healthcare market: It’s estimated between five and 14 million people could lose Medicaid coverage due to the end of Medicaid continuous enrollment protection in the Public Health Emergency. Hundreds of thousands of people have already lost Medicaid coverage since redeterminations began April 1st, driving more demand for cash-pay telehealth appointments, driving a higher price over last year. In addition, in the US there are nearly 30 million uninsured, and a record number of people (estimated to be 55%) enrolled in high-deductible health insurance plans; both of these groups tend to be cash payers.
- Increased demand for telehealth services: The COVID-19 pandemic accelerated the demand for telehealth services, and that rapid growth is expected to continue as more providers and patients adopt these services. Increased prices for telehealth appointments for people paying out-of-pocket for services is reflected in higher prices for telehealth services over last year.
The May 2023 USHPI found demand for cash-pay healthcare drove higher costs from a year ago across the most common visits:
- Telehealth consultation: 15% increase
- COVID-19 screening: 16% increase
- Mental health visit: 5% increase
- Prescription refill: 11% increase
- UTI visit: 16% increase
- Skin consultation: 7% increase
The USHPI, the first national resource to publicly document the price of cash-pay medical care in America, features pricing data for routine medical services in all 50 states – from primary care and mental health to women’s health and more. In addition to regional and state comparisons, the USHPI tracks price variance and market trends on a monthly basis. The entire USHPI database of monthly cash prices can be found here: https://sesamecare.com/compare/ushpi.
WHAT IS THE CASH PRICE OF MEDICAL CARE?
Simply put, the cash price is what a doctor or health care provider charges a consumer when a third-party payer – like insurance or a government entity – is not involved in the transaction. This could be because a patient does not have insurance, has a high-deductible health plan or chooses to pay their provider directly, without involving a middleman.
WHAT IS THE METHODOLOGY USED TO COLLECT THE DATA?
The data comes from Sesame, one of the largest cash-pay health care marketplaces in the United States. It covers the thousands of healthcare providers resident in the marketplace that charge cash prices for their services. Sesame analyzed thousands of primary care and specialty care appointments made on its platform, leveraging pricing data for patient appointments that occurred during April 2023.