This report, 2013 Health Care Costs and Utilization, is the fourth in a series of annual reports by the Health Care Cost Institute (HCCI) on the health care activity of individuals who are younger than age 65 and covered by employer-sponsored health insurance (ESI). The report's study period (2011 -2013) covers the years after passage of the Affordable Care Act (ACA) and prior to the opening of health insurance exchanges. As in previous years, the report details the levels and changes in per capita expenditures ("spending"), utilization ("use"), and prices of medical and prescription services used by the ESI population. Also, for the first time, it details patterns of spending and service use by age-gender groups of the ESI population. In 2013, spending for the national ESI population grew 3.9% (Table 1). Spending was driven up by rising prices of medical services and brand prescriptions (see "Key definitions"), while use of inpatient and outpatient services and brand prescriptions fell (Table 2). Separately, the use of filled days of generic prescriptions grew 4.5%, while the average price fell by 0.5%.
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