Insurer think tank: radiologists not the villains

In 2011, group plans and writers of individual health insurance had to start complying with the preventive services provisions in the Patient Protection and Affordable Care Act of 2010 (PPACA). The PPACA provisions require plans to cover some preventive health services, such as checkups, without imposing co-payments, deductibles or other cost-sharing provisions on the patients.

Perhaps as a result, use of mental health and substance abuse inpatient services jumped 10 percent, to 4.1 per 1,000 insureds. Per-capita spending on those services climbed 17 percent, to $31.

Use of primary care provider preventive visits increased 4.7 percent, to 336 per 1,000 insureds. Per-capita spending on primary care preventive services rose 8.3 percent, to $40. Per-capita spending on preventive care visits with specialists increased 4.7 percent, to $17.

Spending on specialist office visits other than preventive visits grew at a 7.8 percent clip in 2011 after purring along at 9.8 percent in 2010.

In the past, patients and patient advocates have complained bitterly about anesthesiologists, pathologists, radiologists and other hospital-based specialists who surprise patients who are using in-network hospitals with out-of-network specialty care bills.

HCCI found that per-capita spending on anesthesia increased 5.6 percent in 2011, which was a little higher than the overall 2011 professional procedures increase average of 4.5 percent. Per-capita spending on pathology increased 6.6 percent.

Per-capita spending on radiology actually fell 2.4 percent, to $140.

See also:

• Health Benefit Costs to Jump Another 7%
• Segal: Health Plans Beat Cost Expectations
• Kaiser-HRET: PPACA is Here