Report shows specialists drove increase in office visits

The IMS Institute for Healthcare Informatics report shows that after 4 years of decline, the number of patients visiting physicians’ offices increased by 2.7% in 2013.

While the increase is positive, the number is still 8% lower than office visits in 2008. The report also showed that inpatient hospital admission after an emergency visit declined by 14.6%, “perhaps as a response to policies that discourage ER usage,” the report states. Hospital visits overall were up by 13 million visits.

The increase in office visits was attributed primarily to a 4.9% increase in traffic to specialty offices. A slight decline was seen in primary care office visits.

Seniors led the increase in office visits, up 6.7% in 2013, compared to an increase of only 1.5% in 2012, according to the report. Visits by adults aged 26 to 64 followed, increasing visits to specialists by 5.9% in 2013, vs. a 0.5% decline in 2012.

Primary care visits by adults, defined in the report as including family practice, internal medicine, pediatrics, osteopathic medicine and general practice, declined by 2.1% and visits by children under 18 declined by 1.1%. That small increase represents a significant rise over a 2012 decrease of 6.7%, according to the report.

Despite gains in office visits, the report showed that insurance has been shifting toward higher deductible plans over the last 10 years. About 20% of patients carried high deductible health plans and health savings accounts, which were introduced in 2006 and selected more often by young, healthy workers. According to the report, many employers are encouraging employees to select high deductible plans, and 17% of employers offered no other options. Around 57% of patients hold PPO plans, a number that has remained mostly unchanged over the last 10 years. About 23% of privately insured patients participated in HMO and other plans, down from 45% in 2004.

Money spent on prescription medications grew by 3.2%, but only by 1.0% per capita. The average copay for 78.6% of all medications dispensed in retail locations was less than $10. Sixty percent of those purchasers were commercially insured, but the report stated that out-of-pocket costs to patients varied “widely by payment type” and that Medicare Part D prescriptions had very low costs, with 86% sold for under $10 and only 6% priced higher than $30.

Of all dispensed medications, 86% were filled with generic drugs, an increase of $5.8 billion. Oncology drugs accounted for the highest amount spent at $27.9 billion, an increase of 9.2% over 2012. Spending increased by 10% for treatments for diabetes, autoimmune diseases and multiple sclerosis, while spending in mental health, respiratory, lipid control and antihypertensive drugs fell by over 5%. Because these drugs were still prescribed in significant amounts, the report attributed the drop in spending to patent expirations and fewer new medications in those categories.