Statement Volume - Health Insurance 4
In 2018, an estimated 3.445 billion health insurance claims were filed in the U.S. In addition, an estimated 2.3 statements are sent per claim in the U.S. We were able to estimate both the number of health insurance claims and the average number of bills/statements sent per claim by health insurance companies annually in the U.S. via triangulated calculations that we formulated based on available data. Those step-by-step calculations, along with the supporting data we found, is all explained in detail below.
Annual Number of Health Insurance Claims
- According to our data-based, triangulated calculation, there are an estimated 3.445 billion health insurance claims in the U.S. annually.
- The most-recent data we could find about the number of health insurance claims in the U.S. was from 2012. However, we were able to estimate how that number has changed between 2012 and 2018, in order to provide the most up-to-date information in light of the available data.
- According to the Council for Affordable Quality Healthcare, it was estimated that 40% of the people in the U.S. with health insurance constituted 1.3 billion health insurance claims in 2012.
- Since the aforementioned number of claims didn't pertain to all people with health insurance, we determined the number of health insurance claims for the entire U.S. population with health insurance through a cross-calculation that we formulated. That calculation was as follows: 1.3 billion is to 40% as X is to 100. Next, we multiplied 1.3 billion by 100 and divided that value by 40 (representing 40%), which equals 3.25 billion (number of claims for entire U.S. population with health insurance).
- To update that 2012 data, we found that there has been a 6% increase in health insurance enrollment between 2012 and 2017. We determined that from the facts that the uninsured percentage was 15% in 2012 and the uninsured percentage was 9% in 2017, so 15% — 9% = 6%.
- Accordingly, we multiplied the estimated number of 2017 health insurance claims in the U.S. (3.25 billion) by 0.06 (representing the aforementioned 6% health insurance enrollment increase between 2012 and 2017), which equals 195 million (estimated increase in the number of health insurance claims).
- We then added 195 million to the estimated number of health insurance claims in 2017 (3.25 billion), which equals 3.445 billion (estimated number of U.S. health insurance claims in 2017).
Average Number of Bills/Statements Sent Per Health Insurance Claim
- According to our data-based, triangulated calculation, U.S. health insurance companies send an average of 2.3 bills/statements per claim (estimated).
- To calculate the average number of bills/statement, we first needed to find the average healthcare spend per person in the U.S., which is $10,348.
- Next, we needed to calculate the average number of health insurance claims per person in the U.S. To do so, we divided the previously calculated number of U.S. health insurance claims in 2017 (3.445 billion (estimated)) and divided that by the number of people with health insurance in the U.S. (294.6 million in 2017), which equals 11.7 (estimated, average number of health insurance claims per person).
- To calculate the average number of bills/statement sent per claim, we divided the average healthcare spend per person in the U.S. ($10,348) by 11.7 (estimated, average number of health insurance claims per person), which equals $884.4 (estimated spend per person per claim, rounded to the nearest tenth).
- Next, we divided $884.4 by the average monthly claim spend per person in 2018 among people with individual market health insurance ($392), which equals 2.3 (estimated number of months to pay off a claim, rounded to the nearest tenth). We used the average monthly claim spend among people with individual market health insurance because that was the most-directly applicable data we could find.
- Accordingly, an average of 2.3 bills/statements per claim (estimated) are sent by health insurance companies.
We began our research by looking for articles about the number of health insurance claims and the average number of bills/statements sent per claim by health insurance companies annually in the U.S. Not one article directly provided that information, and we reviewed many articles published by reputable sources such as Becker's Hospital Review and CNBC, among others, when reserching for that information. Those sources did, however, provide related data points, which we logged throughout our research.
For our second research method, we reviewed several credible reports about health insurance claims, payments, and the health insurance market in general. We thought that perhaps the data requested might have been included therein. While there was a lot of data packed into those reports, the exact data we were looking for wasn't directly stated. An example of one such source that we consulted for those reports was the Kaiser Family Foundation, and we did ultimately cite data from that source in our findings above. Just like with the articles, there were some related insights we found from the report sources that we reviewed, which we also noted.
As a third research method, we turned our efforts to determining the requested data points through triangulated calculations, since the available data alone didn't directly provide the information we were looking for. The data we used for those triangulated calculations came from a combination of reputable sources, which included the Council for Affordable Quality Healthcare for example. All the data we used in our triangulated calculations is specific to the U.S. only.