Cost of healthcare for family of 4 with average PPO coverage is $28K this year, plus 5 other findings

Healthcare costs arise from various factors and present a struggle for Americans as they take greater financial responsibility for their care.

To put context around these trends, here are six findings on healthcare costs:

1. The cost of healthcare for a hypothetical American family of four insured by an average employer-sponsored preferred provider organization health plan is $28,166 in 2018, according to the annual Milliman Medical Index report. That's an increase of $1,222 from 2017.

2. A study published in the International Journal of Health Services found immigrants spend half to two-thirds less on healthcare than people born in the U.S. The finding was true across all ages and despite immigration status.

3. Americans are concerned about healthcare costs. A survey from the Nationwide Retirement Institute found 60 percent of Americans 50 and older are concerned about how medical expenses may disturb their retirement plans, and 73 percent said potentially out-of-control healthcare costs are among their top retirement concerns. Additionally, a Bankrate survey found 22 percent of U.S. adults said they or a close family member in their household chose not to receive necessary medical care due to cost.

4. Healthcare prices in the U.S. reflect the complexity and high costs of treating patients, but they also reflect huge administrative costs. A study published in Health Affairs examined data from 2010 and 2011 to determine how administrative costs of U.S. hospitals compared with hospital administrative costs in Canada, England, Scotland, Wales, France, Germany and the Netherlands. It found that 25.3 percent of total U.S. hospital costs went toward administrative expenses. The U.S. had the highest hospital administrative costs, followed by the Netherlands (19.8 percent) and England (15.5 percent). Scotland and Canada had the lowest hospital administrative costs.

5. Eighty-seven percent of healthcare providers told an NEJM Catalyst Buzz survey they believe pharmaceutical/biotech companies have the biggest effect on healthcare costs, followed by payers, such as health plans, health maintenance organizations and insurers (81 percent). Only 28 percent said they believe individual clinicians have a strong effect.

6. Seventy-six percent of respondents to the NEJM Catalyst Buzz survey said the cost to practice/system is considered in clinical decisions at their organization. 

Editor's note: This story was updated on Aug. 23.


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