Healthcare professionals and the impact of COVID-19: a comparative study of revenue and utilization
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Brief (FAIR Health, Inc.)
- Contributor(s):
- FAIR Health, Inc., issuing body.
- Publication:
- New York, NY : FAIR Health, Inc., June 10, 2020
- Language(s):
- English
- Format:
- Text
- Subject(s):
- COVID-19 -- economics Facilities and Services Utilization -- statistics & numerical data Health Personnel -- economics Pandemics -- economics United States
- Genre(s):
- Technical Report
- Abstract:
- This brief reports on FAIR Health's in-depth study of the impact of the COVID-19 pandemic on healthcare professionals' utilization and revenue, an impact that has not previously been assessed in depth. It also looks at how the impact varies by specialty. To study these issues, FAIR Health drew on its repository of private claims data to analyze, on a monthly basis, changes in utilization and estimated allowed amounts1 for professionals in the first four months of 2020 as compared to 2019. The changes nationwide are compared to the changes in the Northeast, where the pandemic hit hardest in March and April.2 The second part of the study focuses on seven specialties: cardiology, dermatology, oral surgery, gastroenterology, orthopedics, pediatric primary care and adult primary care. For each specialty, FAIR Health analyzed changes in utilization and estimated allowed amounts in the first four months of 2020 as compared to 2019, as well as changes in the five most common procedures in the first four months of 2020. Among the findings: (1) Nationally, from March 2019 to March 2020, utilization of professional services decreased 65 percent and professional revenue based on total estimated allowed amounts decreased 45 percent. From April 2019 to April 2020, utilization fell 68 percent and revenue 48 percent. (2) In the Northeast, from March 2019 to March 2020, utilization of professional services fell 60 percent and revenue based on total estimated allowed amounts declined 55 percent. In April, utilization fell 80 percent and revenue 79 percent. (3) Of specialties studied, oral surgery had the largest decreases in March 2020 utilization (80 percent), March 2020 revenue based on total estimated allowed amounts (84 percent), April 2020 utilization (81 percent) and April 2020 revenue (92 percent). Gastroenterology had the second largest decreases in all four categories. (4) Of specialties studied, pediatric primary care had the smallest decreases in March 2020 utilization (52 percent), March 2020 revenue based on total estimated allowed amounts (32 percent), April 2020 utilization (58 percent) and April 2020 revenue (35 percent). (5) Across many specialties from January to April 2020, office or other outpatient evaluation and management (E&M) visits became more common relative to other procedures, both by utilization and total estimated allowed amounts. This may have been due in part to the fact that many of these E&M services could be rendered via telehealth, whereas certain other procedures that became less common required in-person visits. (6) A routine electrocardiogram with at least 12 leads, with interpretation and report (CPT3 93000), fell out of the top five cardiology procedures by total estimated allowed amounts in March and April 2020. (7) A tangential biopsy of skin, single lesion (CPT 11102), fell from the top five dermatology procedures by both utilization and total estimated allowed amounts in April 2020. (8) In oral surgery, a procedure specifically for telehealth--telephone E&M by a physician or other qualified healthcare professional, 11-20 minutes (CPT 99442)--climbed from number 131 in utilization in January 2020 to number 1 in April 2020. (9) In January 2020, the top five gastroenterology procedures by utilization included an endoscopy (CPT 43239, esophagogastroduodenoscopy) and a colonoscopy (CPT 45380) procedure, but by April 2020 both had dropped out of the top five. (10) Total knee replacement (CPT 27447) and total hip replacement (CPT 27130) ranked high in the orthopedic top five procedures by total estimated allowed amounts in January 2020. They fell out of the top five by April 2020. (11) From January to April 2020, a test for streptococcus (CPT 87880) fell out of the pediatric primary care top five by utilization. (12) From January to April 2020, a vaccination procedure (CPT 90471) dropped out of the adult primary care top five by utilization. (13) There was little change from March-April 2019 to March-April 2020 in preventive care visits for pediatric patients 0-4 years of age, whether from the standpoint of utilization or of revenue based on total estimated allowed amounts. Decreases in these months were much greater for preventive care visits for older pediatric patients (5-17 years of age) and adults (18 and older).
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (32 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101774928 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101774928