Webcast Presents Second Annual FAIR Health Indicators and Index

On May 14, FAIR Health President Robin Gelburd hosted a webcast on the second annual edition of two FAIR Health resources, FH Healthcare Indicators® and the FH Medical Price Index®. Entitled “FH Healthcare Indicators and FH Medical Price Index 2019: Continuing Clarity in a Rapidly Changing Environment,” the webcast attracted numerous attendees from throughout the healthcare sector, including payors, providers, consultants, researchers and government officials.

The webcast began with FH Healthcare Indicators, which analyze utilization and cost trends in retail clinics, emergency rooms (ERs), urgent care centers, telehealth and ambulatory surgery centers (ASCs). “FH Healthcare Indicators pull back the curtain on the major transformation underway in the healthcare industry in terms of where consumers are accessing care,” said Ms. Gelburd.

Among the findings Ms. Gelburd reported:

  • From 2016 to 2017, ER utilization fell 10 percent in rural areas, 1 percent in urban areas and 2 percent nationally.
  • In 2017, utilization of urgent care centers was highest in those aged 31 to 40, with high rates also seen in those aged 23 to 30 and 41 to 50.
  • The median charge amount in 2017 for CPT®1 99203, a 30-minute new patient office or outpatient visit, ranged from $213 in an urgent care center to $207 in an office to $129 in a retail clinic.
  • The number one reason individuals used telehealth in 2016 was “mental health reasons,” but this dropped to the fifth largest diagnostic category in 2017, with injuries at number one.
  • Although more claim lines were submitted for females than males in all adult age groups in ASCs in 2017, the reverse was true in the pediatric age range (0-18).

Ms. Gelburd then presented the FH Medical Price Index, which tracks average median charge and allowed amounts for six medical procedure categories: professional evaluation and management (E&M), hospital E&M, surgery, pathology and laboratory, medicine and radiology. “The indices allow you to come on a journey into our billions of claims and see movement in the healthcare sector that can inform, justify or amend different courses of action,” said Ms. Gelburd.

Ms. Gelburd showed that charges for hospital E&M services had risen at a faster rate from May 2012 to November 2018 than those for professional E&M services. The hospital E&M charge amount index increased from 1.00 to 1.40, while the professional E&M charge amount index increased from 1.00 to 1.28.

Both indices increased more than Consumer Price Index (CPI) Inflation and Medical Care Inflation rates for that period, as tracked by the US Bureau of Labor Statistics. In contrast, the charge increases in surgery and radiology were lower than CPI Inflation. The charge increase in pathology and laboratory was higher than CPI Inflation but lower than Medicare Care Inflation; the charge increase in medicine tracked closely with Medical Care Inflation.

“We look forward to having these healthcare indicators and indices add further understanding to this complex healthcare environment,” said Ms. Gelburd.

The two resources are available free in the form of a recently published white paper. In addition, FAIR Health makes available customized indicators and indices that offer specific data subsets (e.g., based on clinical category, geographic region, time period) of particular interest to stakeholders. For more information, email us at info@fairhealth.org or call us at 855-301-3247, Monday through Friday, 9 am to 6 pm ET.

To view the free, archived webcast, click here.

1. CPT © 2018 American Medical Association (AMA). All rights reserved.