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Table 1 2012 U.S. National Health Expenditures, percent billing and insurance-related (BIR), and BIR proportion considered “added”

From: Billing and insurance-related administrative costs in United States’ health care: synthesis of micro-costing evidence

Sector

2012 NHE (projected, in billions)

% for BIR costs

Source/reference for % BIR

Proportion considered “added”

Source for proportion added

Physician practices

$542.9

13%

Three studies of BIR costs in physician practices in the U.S. [5],[7],[9]

0.73

U.S. & Canadian physician survey [5]

Hospitals

$873.1

8.5%

Midpoint BIR for hospitals [7]

0.73

U.S. & Canadian physician survey [5]

Other health services and supplies

$938.8

10%

Assumption (mean percentage from physician practices and hospitals)

0.73

U.S. & Canadian physician survey [5]

Private insurers

$884.4

18%

2010 mean admin expenses, including profit, as % premium revenue for a sample of large and small private insurers, weighted by insured enrollment (Authors’ analysis of SEC data)

0.92

Private insurer overhead vs. Medicare overhead (1.5%) [13]

Public insurers

$1,139.5

3.1%

Blended average overhead for Medicare (1.5%) and Medicaid (4.6%) [13] based on authors’ calculations using 2011 NHEA data

0.52

Public insurer overhead vs. Medicare overhead [13]