Telehealth and Urgent Care Centers Showed Largest Growth in Utilization from 2018 to 2019, among Venues of Care Studied

In 2019, the Median Charge for a 30-Minute New Patient Office Visit Ranged from $150 in a Retail Clinic to $217 in an Office to $239 in an Urgent Care Center

Fourth Annual FAIR Health Report Captures State of the Healthcare System Pre-Pandemic

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FAIR Health

Mar 31, 2021, 10:03 ET

NEW YORK, March 31, 2021 /PRNewswire/ -- From 2018 to 2019, telehealth increased in utilization by 73 percent, urgent care centers by 47 percent, retail clinics by 39 percent, emergency rooms (ERs) by 33 percent and ambulatory surgery centers (ASCs) by 30 percent. These are among the findings in a new FAIR Health white paper containing the fourth annual edition of FH^® Healthcare Indicators and FH^® Medical Price Index.

FH Healthcare Indicators and FH Medical Price Index 2021: An Annual View of Place of Service Trends and Medical Pricing

Like the previous editions, this year's edition of FH Healthcare Indicators and FH Medical Price Index is intended to provide clarity to all healthcare stakeholders in a rapidly changing healthcare environment. FAIR Health, a national, independent nonprofit organization dedicated to bringing transparency to healthcare costs and health insurance information, bases the reports on its database of over 32 billion privately billed healthcare claim records—the largest such repository in the country.

FH Healthcare Indicators reveal trends and patterns in the places where patients receive healthcare. Focusing on alternative places of service—retail clinics, urgent care centers, telehealth and ASCs—as well as ERs, FH Healthcare Indicators evaluate changes in utilization, geographic and demographic factors, diagnoses, procedures and costs. For example, FH Healthcare Indicators show that in 2019, the median charge amount for a 30-minute new patient office visit (CPT^®1 99203) ranged from $150 in a retail clinic to $217 in an office to $239 in an urgent care center.

FH Medical Price Index
FH Medical Price Index reports shifts in costs and facilitates useful comparisons among medical prices in six procedure categories from May 2012 to November 2020:

Professional evaluation and management (E&M²; excluding E&Ms performed in a hospital setting);
Hospital E&M (excluding E&Ms performed in a professional setting, such as typical office visits);
Medicine (excluding E&Ms);
Surgery (procedures for which the physician would bill);
Pathology and laboratory (technical and professional components, i.e., both equipment and professional services); and
Radiology (technical and professional components).

The reports reflect professional fees and related costs; they do not reflect facility fees.

For the period November 2019 to November 2020:

Of the six procedure categories, hospital E&Ms had the greatest percent increase in charge amount index, 6 percent, and in allowed amount index, 10 percent.
The radiology charge amount index decreased one percent, the only decrease in either charge amount or allowed amount indices.
Radiology had the lowest percent increase in allowed amount index, three percent.

In this edition, as in previous editions, FH Healthcare Indicators and FH Medical Price Index each advance one year in the data they report: FH Healthcare Indicators to 2019 and FH Medical Price Index to 2020. For this reason, FH Healthcare Indicators do not include data from the COVID-19 pandemic year (next year's edition will extend to 2020), whereas FH Medical Price Index does. Indeed, this year's FH Healthcare Indicators present a valuable picture of the nation's healthcare environment just before COVID-19 arrived in the United States, while FH Medical Price Index offers an account of healthcare pricing trends in the midst of the pandemic.

FAIR Health President Robin Gelburd stated: "As in previous years, FH Healthcare Indicators and FH Medical Price Index are highly relevant to understanding the nation's healthcare system. We hope that this new edition continues to inform decision making throughout the healthcare sector by payors, providers, government officials, policy makers, academic researchers and others."

For the new white paper FH^® Healthcare Indicators and FH^® Medical Price Index 2021: An Annual View of Place of Service Trends and Medical Pricing, 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 32 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 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 and an English/Spanish mobile app, which enable consumers to estimate and plan for their healthcare expenditures and offer a rich educational platform on health insurance. 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. FAIR Health also is named a top resource for patients in Dr. Marty Makary's book The Price We Pay: What Broke American Health Care—and How to Fix It and Elisabeth Rosenthal's book An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. For more information on FAIR Health, visit fairhealth.org.

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

¹ CPT © 2020 American Medical Association (AMA). All rights reserved.
² An E&M is a patient-provider visit, such as for an examination, to diagnose illness or to determine or manage treatment. Professional E&Ms are typically done in a professional setting, such as a doctor's office, while hospital E&Ms are done in a hospital setting.

SOURCE FAIR Health