Visits to emergency departments and physicians' offices have grown more complex and costly over time — at least based on the way providers are billing.
Data: Kaiser Family Foundation analysis of Merative MarketScan data; Note: Includes enrollees with private insurance coverage from large employers; Chart: Simran Parwani/Axios
Visits to emergency departments and physicians' offices have grown more complex and costly over time — at least based on the way providers are billing, per a"There is a trend towards visits being billed at higher levels over time," the authors wrote. "For consumers who bear the marginal costs of more expensive services — those with co-insurance or deductibles — this trend impacts out-of-pocket costs in addition to overall health system costs.
Moderately complex claims accounted for 54% of emergency department claims and 67% of all outpatient office claims for UTIs in 2004. Higher complexity claims made up 26% and 14% in those settings, respectively. Moderate complexity UTI claims accounted for only 31% of emergency department claims and 57% of outpatient office claims in 2004The number of higher complexity claims in those settings jumped to 66% and 37%, respectively, by 2021.
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