Urgent care claim lines jump over 1000% from 2007-16

Private insurance claim lines for urgent care services grew 1,725 percent from 2007-16, a growth rate more than seven times the rate for emergency room claim lines (229 percent) in the same time period, according to FAIR Health.

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For the report, FAIR Health gathered data from its database of over 25 billion privately billed healthcare claims.

“In a time when healthcare spending accounts for almost 18 percent of the nation’s gross domestic product, and the healthcare ecosystem is undergoing rapid evolution, we hope that these new tools will inform decision making by all healthcare stakeholders, including payers, providers, government officials, policy makers and others,” said FAIR Health President Robin Gelburd.

Here are six findings from the report.

1. In retail clinics and urgent care centers in 2016, acute respiratory infections were the No. 1 diagnostic category.

2. For telehealth services, mental health-related diagnoses ranked No. 1.

3. The median billed charge for a 30-minute new patient office visit in 2016 ranged from $109 in a retail clinic, to $242 in an urgent care center to $294 in an office visit.

4. In 2016, for every adult age group, more claims were submitted for women than men across all care locations.

5. From 2007-16, claims for ambulatory surgery centers jumped 127 percent in rural areas and 95 percent in urban areas.

6. The median billed charge for evaluation and management services in a hospital increased 28 percent from 2012-16. In the same time period, allowed amounts for E&Ms in a hospital setting, which reflects the maximum amount an insurer will pay for a service, grew 26 percent.

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