international federation of health plansuhrs/ufcbc/pubs/2011ifhppricereportgraphs_ver… ·...

International Federation of

Health Plans

2011 Comparative Price Report

Medical and Hospital Fees by Country

2

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.

COMPARATIVE COST REPORT

FOR ILLUSTRATIVE PURPOSES ONLY 3

$35 $123 $204 $212

$245 $320 $371

$665

$164

$798

$2,341

$-

$500

$1,000

$1,500

$2,000

$2,500

Canada(Nova

Scotia)

Spain France Switzerland Germany India Chile Argentina USA

Scanning and Imaging FeesAngiogram ($US)

USA Commercial Average USA Commercial Low USA Commercial 95th Percentile


$98 $122 $123 $141 $148

$228

$354 $425

$219

$584

$1,657

$-

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800

Argentina Canada(Nova

Scotia)

Spain France India Chile Germany Switzerland USA

Scanning and Imaging FeesCT Scan: Abdomen ($US)



$43 $78 $122 $123

$141 $184

$272 $319

$95

$510

$1,545

$-

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800

India Argentina Canada(Nova

Scotia)

Spain France Chile Germany Switzerland USA

Scanning and Imaging FeesCT Scan: Head ($US)



$64 $89 $122 $123 $141

$158

$319 $354

$193

$522

$1,481

$-

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

Argentina India Canada(Nova

Scotia)

Spain France Chile Switzerland Germany USA

Scanning and Imaging FeesCT Scan: Pelvis ($US)



$116 $138 $245 $281

$478

$599

$903

$503

$1,080

$2,758

$-

$500

$1,000

$1,500

$2,000

$2,500

$3,000

Argentina India Spain France Chile Germany Switzerland USA

Scanning and Imaging FeesMRI ($US)



$236 $380 $515 $632 $655 $690

$934 $1,552 $1,449

$3,949

$11,496

$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

India Argentina Spain Germany France Switzerland Australia Chile USA

Hospital ChargesCost Per Hospital Day ($US)



$1,473 $1,825 $2,479 $3,396 $4,948 $4,566

$5,004 $4,410

$15,734

$49,878

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

Argentina Spain Australia France Chile Switzerland Germany USA

Hospital ChargesCost Per Hospital Stay ($US)



$1,291 $1,967

$2,157 $2,414 $2,536

$3,195 $3,589

$6,201

$8,495

$6,993

$9,280

$15,236

$-

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

Argentina India Germany Spain France Canada(Nova

Scotia)

Chile AustraliaSwitzerland USA

Total Hospital and Physician CostsNormal Delivery ($US)



$1,640 $2,164 $3,159

$3,441 $3,589 $4,625

$5,980

$9,548

$12,318

$10,137

$14,374

$24,339

$-

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

Argentina India Spain Germany Chile France Canada(Nova

Scotia)

AustraliaSwitzerland USA

Total Hospital and Physician CostsC-Section ($US)



$597 $885

$1,356

$1,855 $2,358 $2,514

$3,140

$3,591

$5,310

$2,452

$3,748

$7,806

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

Argentina India France Spain Canada(Nova

Scotia)

Germany Chile AustraliaSwitzerland USA

Total Facility and Physician CostsCataract Surgery ($US)



$254 $1,030

$2,615 $3,093 $3,164

$4,926 $5,509 $5,606 $5,840

$7,756

$13,003

$27,797

$-

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

India Argentina Spain Germany France Australia Chile Canada(Nova

Scotia)

Switzerland USA

Total Facility and Physician CostsAppendectomy ($US)



$3,589 $4,308

$11,353 $11,418 $12,023 $15,684

$16,945 $17,521

$25,604 $23,535

$38,017

$80,374

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$80,000

$90,000

Argentina India France Germany Spain Chile Canada(Nova

Scotia)

SwitzerlandAustralia USA

Total Hospital and Physician CostsHip Replacement ($US)



$4,525 $9,319

$16,140 $16,578 $17,908 $20,505

$25,486

$38,891 $40,954 $42,951

$67,583

$138,050

$-

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

India Argentina France Germany Spain Chile SwitzerlandAustralia Canada(Nova

Scotia)

USA

Total Hospital and Physician CostsCoronary Artery Bypass ($US)



$2,557 $2,972 $5,857 $6,189

$8,499 $9,913 $10,060 $10,559

$12,212 $15,627

$57,374

$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

India Argentina France Germany Spain Australia Canada(Nova

Scotia)

Chile Switzerland USA

Total Facility and Physician CostsAngioplasty ($US)

$26,524



$9 $11 $16

$23 $30

$40 $45

$64 $64

$89

$162

$-

$20

$40

$60

$80

$100

$120

$140

$160

$180

Argentina Spain India France Canada(Nova

Scotia)

Germany Chile Switzerland USA

Physician FeesRoutine Office Visit ($US)



$160 $226 $340 $449 $460

$1,048

$1,639

$2,326

$7,222

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

Argentina Germany Spain France Canada(Nova

Scotia)

Chile Australia USA

Physician FeesNormal Delivery ($US)

$3,390



$185 $402 $442 $597

$749 $1,048

$1,877

$2,783

$4,086

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

Argentina Germany Spain Canada(Nova

Scotia)

France Chile Australia USA

Physician FeesC- Section ($US)

$8,059



$150

$337 $433

$609 $688

$1,152

$1,423

$626

$946

$-

$500

$1,000

$1,500

$2,000

$2,500

Argentina France Spain Germany Canada(Nova

Scotia)

Australia Chile USA

Physician FeesCataract ($US)

$2,173



$148 $239 $258

$401

$577

$696

$1,463

$659

$-

$500

$1,000

$1,500

$2,000

$2,500

Argentina Spain Germany Canada(Nova

Scotia)

France Australia Chile USA

Physician FeesAppendectomy ($US)

$2,171

$1,007



$462 $644

$872 $1,011

$1,123

$2,500 $2,513

$2,051

$-

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Argentina Germany Canada(Nova

Scotia)

France Spain Chile Australia USA

Physician FeesHip Replacement ($US)

$5,379

$2,966



$3 $19 $23

$36 $50

$52 $56

$69

$176

$193

$357

$-

$50

$100

$150

$200

$250

$300

$350

$400

India Argentina France Canada(Nova

Scotia)

Chile Spain Germany Switzerland USA

Drug Prices Nexium ($US)



$42 $49

$51 $61

$68

$74 $87

$109

$160

$163

$172

$-

$20

$40

$60

$80

$100

$120

$140

$160

$180

$200

Spain France Argentina Switzerland India Canada(Nova

Scotia)

Chile Germany USA

Drug PricesPlavix ($US)



$10 $14

$36 $37 $44

$74 $78 $81

$95

$119

$138

$-

$20

$40

$60

$80

$100

$120

$140

$160

India Spain Argentina France Canada(Nova

Scotia)

Germany Chile Switzerland USA

Drug PricesLipitor



9.5%

11.4%11.6% 11.8%

17.4%

0%

4%

8%

12%

16%

20%

Spain Switzerland Germany France United States

Health Spending as % of GDP

Source: OECD Health Spending 2009 (2008 for Australia)

27

List of Federation Member Plans

Source and Notes for Prices by Country

Survey Data Constraints and Limitations

Submission Overview

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

Compaia 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

29

Sources and Notes For Prices by Country

Argentina Prices represent a weighted average of prices across three systems: a

public system (50%), a social security system (38%) and a private system

(12%).

Australia Prices represent fees paid by a private health plan. Primary care,

diagnostics and drugs are not covered by private health insurance.

Chile 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.

Canada 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.

30

France 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.

Germany 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.

India Prices represent private fees paid by one private sector health plan. Lipitor

price is for generic substitute.

Spain Prices represent fees paid by one private sector health plan.

Switzerland Prices represent public sector fees. Public sector inpatient fees in 2010 did

not include costs paid by the cantons; in this years survey this has been

corrected so that prices include these payments. Cataract surgery facility

and physician price is for an outpatient setting.

Sources and Notes For Prices by Country

31

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 25th 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.

Source and Notes For Prices by Country

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 plans 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).

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