From 2018 to 2022, Eating Disorder Claim Lines Increased 65 Percent Nationally as a Percentage of All Medical Claim Lines

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Nov 15, 2023, 08:36 ET

In That Period, 72 Percent of Eating Disorder Patients Were Diagnosed with One or More Co-occurring Mental Health Conditions, according to New FAIR Health Study

NEW YORK, Nov. 15, 2023 /PRNewswire/ -- From 2018 to 2022, eating disorder claim lines increased 65 percent nationally as a percentage of all medical claim lines.¹ All eating disorders studied increased during this period, but at different rates: avoidant/restrictive food intake disorder (ARFID) by 305 percent,² binge-eating disorder by 81 percent, anorexia nervosa (anorexia) by 73 percent and bulimia nervosa (bulimia) by 3 percent. These and other findings on eating disorders are reported in a FAIR Health white paper released today: Spotlight on Eating Disorders: An Analysis of Private Healthcare Claims.

Spotlight on Eating Disorders: A FAIR Health White Paper, November 2023

Eating disorders are a diverse group of mental health conditions associated with severe disturbances in eating behaviors. In this white paper, FAIR Health delves into its repository of over 43 billion private healthcare claim records—the largest such database in the nation—to shed new light on eating disorders from 2018 to 2022. The study examines changes in the percentage of claim lines for eating disorders over time at national and regional levels, as well as states, age and gender, places of service, specialties and co-occurring mental health conditions. Among the key findings:

In the period 2018-2022, 72 percent of patients with eating disorders were also diagnosed with one or more co-occurring mental health conditions that were not eating disorders. This ranged from 65 percent of ARFID patients to 78 percent of bulimia patients, the highest such percentage with one or more co-occurring mental health conditions. Over 20 percent of patients with eating disorders also had a substance use disorder.
- Forty-one percent of patients with an eating disorder also had a diagnosis for generalized anxiety disorder, and 39 percent had a diagnosis for major depressive disorder. They are not exclusive categories; one person could have both diagnoses.`
Patients with eating disorders in the period 2018-2022 were over five times as likely to have a mental health condition (that was not an eating disorder) and over four times as likely to have a substance use disorder as all patients who received medical services.
In 2022, binge-eating disorder was the eating disorder most commonly diagnosed without other accompanying eating disorders; 24.3 percent of all eating disorder patients were diagnosed with binge-eating disorder as the only eating disorder. This was closely followed by anorexia only, which accounted for 24.1 percent. Bulimia, without any other eating disorder, accounted for 6.2 percent of all eating disorder patients, and ARFID for 5.3 percent. Multiple eating disorders were diagnosed in 10.1 percent of patients.
The increase in eating disorder claim lines as a percentage of all medical claim lines varied by US census region from 2018 to 2022. The largest increase was in the South (84 percent), where eating disorders accounted for the lowest percentages of medical claim lines among all regions in both 2018 and 2022. The smallest increase was in the Northeast (51 percent), where eating disorders accounted for the highest percentage of medical claim lines in 2018, but the second highest percentage in 2022, when the West had the highest percentage.
In 2022, eating disorder claim lines as a percentage of all medical claim lines varied by state. The top five states, highest to lowest, were all states in northern latitudes: Rhode Island, Massachusetts, Minnesota, Montana and Oregon. The bottom five states, lowest to highest, were all states in southern latitudes: Mississippi, Arkansas, Louisiana, New Mexico and West Virginia.
From 2018 to 2022, the age distribution of eating disorder claim lines changed. The largest share in 2018 was accounted for by the age group 19-24 and the second largest by the age group 14-18; in 2022, those positions were reversed, with the largest share associated with individuals 14-18 and the second largest with those 19-24.
Different eating disorders had different age distributions in the period 2018-2022. For example, ARFID was the eating disorder that most affected the youngest age groups (0-9 and 10-13), while binge-eating disorder most affected older age groups (31-40, 41-50 and 51-65).
In every year from 2018 to 2022, females accounted for more than 89 percent of eating disorder claim lines, compared to less than 11 percent for males. In 2022, the age group 0-9 was the only age group that had more males than females associated with eating disorder claim lines. Gender disparities for specific eating disorders in 2022 ranged from 94 percent female, 6 percent male, for anorexia to 68 percent female, 32 percent male, for ARFID.
Telehealth utilization for treatment of eating disorders increased by over 10,000 percent from 2018 to 2022, making telehealth the most common place of service for eating disorders in 2022. During the same period, office-based healthcare utilization for eating disorders fell by 55 percent, and offices declined from the number one place of service in 2018 to number two in 2022.
Among the top 10 specialties treating patients with eating disorders, the greatest increase from 2018 to 2022 was for services by psychiatric nurses, which rose by 108 percent. This increase was part of a larger trend of increases in the percentage of services for eating disorders rendered by nonphysician professionals.

FAIR Health President Robin Gelburd stated: "The findings in this report have implications for stakeholders across the healthcare spectrum, including eating disorder patients and the providers who treat them, as well as payors and policy makers. FAIR Health hopes that these findings will also be starting points for further research on eating disorders."

For the complete white paper, click here.

About FAIR Health
FAIR Health is a national, independent nonprofit organization that qualifies as a public charity under section 501(c)(3) of the federal tax code. It is dedicated to bringing transparency to healthcare costs and health insurance information through data products, consumer resources and health systems research support. FAIR Health possesses the nation's largest collection of private healthcare claims data, which includes over 43 billion claim records and is growing at a rate of over 2 billion claim records a year. FAIR Health licenses its privately billed data and data products—including benchmark modules, data visualizations, custom analytics and market indices—to commercial insurers and self-insurers, employers, providers, hospitals and healthcare systems, government agencies, researchers and others. Certified by the Centers for Medicare & Medicaid Services (CMS) as a national Qualified Entity, FAIR Health also receives data representing the experience of all individuals enrolled in traditional Medicare Parts A, B and D; FAIR Health includes among the private claims data in its database, data on Medicare Advantage enrollees. FAIR Health can produce insightful analytic reports and data products based on combined Medicare and commercial claims data for government, providers, payors and other authorized users. FAIR Health's systems for processing and storing protected health information have earned HITRUST CSF certification and achieved AICPA SOC 2 Type 2 compliance by meeting the rigorous data security requirements of these standards. As a testament to the reliability and objectivity of FAIR Health data, the data have been incorporated in statutes and regulations around the country and designated as the official, neutral data source for a variety of state health programs, including workers' compensation and personal injury protection (PIP) programs. FAIR Health data serve as an official reference point in support of certain state balance billing laws that protect consumers against bills for surprise out-of-network and emergency services. FAIR Health also uses its database to power a free consumer website available in English and Spanish, which enables consumers to estimate and plan for their healthcare expenditures and offers a rich educational platform on health insurance. An English/Spanish mobile app offers the same educational platform in a concise format and links to the cost estimation tools. The website has been honored by the White House Summit on Smart Disclosure, the Agency for Healthcare Research and Quality (AHRQ), URAC, the eHealthcare Leadership Awards, appPicker, Employee Benefit News and Kiplinger's Personal Finance. For more information on FAIR Health, visit fairhealth.org.

Contact:
Rachel Kent
Senior Director of Communications and Marketing
FAIR Health
646-396-0795
[email protected]

¹ A claim line is an individual service or procedure listed on an insurance claim.
² To put ARFID's greater increase in context, its diagnosis code was introduced relatively recently (in 2017) and it rose from a lower base than the other disorders.

SOURCE FAIR Health