FAIR Health releases study of revenue and utilization during COVID-19

National nonprofit FAIR Health released its latest COVID-19 study, evaluating changes in utilization and revenue during the pandemic. The study uses FAIR Health’s database of over 31 billion private health care claims to analyze changes in utilization and estimated in-network reimbursement amounts in January – April of 2020 compared to 2019.

 

 

The brief states that from March 2019 to March 2020 utilization of professional services declined by 65% nationwide. During this same period, professional revenue decreased 45%. Both measurements fell further in an April 2019 to April 2020 comparison where utilization fell 68% and revenue decreased 48%.

The brief reasons that the lower percentage reductions in revenue compared to utilization may be because there was a greater decline in less expensive procedures, while some urgent and more expensive procedures still occurred during this time.

FAIR Health also evaluated the impact of these measurements in the Northeast which was considered the epicenter of the COVID-19 pandemic in the United States. From March 2019 to March 2020, this region experienced a 60% decrease in professional service utilization and a revenue decrease of 55%. For April, utilization dropped 80% and revenue dropped 79%.

 

Image: FAIR Health

 

The study also focused on impacts on 7 specialties: cardiology, dermatology, oral surgery, gastroenterology, orthopedics, pediatric primary care, and adult primary care. Of these specialties, oral surgery faced the biggest declines in utilization (80% in March, 81% in April) and revenue (84% in March, 92% in April).

The top 5 procedures for oral surgery also changed from January to April of 2020. Top procedures such as the removal of an impacted tooth or the use general anesthesia fell considerably, while telephone evaluations and other outpatient visits (which could be used with telehealth) moved into the top 5.

 

Image: FAIR Health

 

Pediatric primary care had the smallest declines, but the April comparison still shows a 58% decrease in utilization and a 35% decline in revenue.

The full report is available here. FAIR Health has released two other COVID-related studies examining costs of inpatient services for COVID patients, and the impact of the pandemic on hospitals and health systems.