By: Kelly Gooch Among the commercially insured, national emergency room use remained unchanged from 2009 to 2016, but ER price hikes and greater use of high-severity codes resulted in more ER spending, according to updated data from the Health Care Cost Institute. The data on ER spending, price and utilization reflects five facility fee current procedural terminology codes, which indicate the...
By: Shelby Livingston Even though emergency department use has stayed the same, ED spending per member nearly doubled from 2009 to 2016 as the severity of ED visits and the prices associated with those visits increased, new data from the Health Care Cost Institute shows. The not-for-profit HCCI analyzed employer-sponsored insurance claims for the five procedure codes used to bill for ED...
HCCI recently expanded its reporting on emergency room (ER) spending trends to include the most recent data available (2016). We characterize trends in spending, price, and utilization for the five Current Procedural Terminology (CPT) codes designed to capture the level of severity and complexity of every ER visit. While average prices for all five ER CPT codes were higher in 2016 than in 2009, th...
ABSTRACT Objective: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. Data Sources: Commercial health insurance claims data, 2009–2013. Study Design: Retrospective analyses using two‐stage residual inclusion instru...
By Thomas Beaton Employer-sponsored health plans that include high cost sharing expectations can help control spending for plan sponsors, but could create longer-term health risks for employee beneficiaries. Striking the right balance between lowering costs and enabling healthy decision-making can be a challenge for employers and payers looking to design cost-effective plans. How can plan sp...
