121 / 537
Employer Group ABC
Incurred:
Apr 2014 thru Dec 2015
Paid:
Apr 2014 thru Mar 2016
47
|
Page
5.3 Disease Fingerprint
Table 5.3.1 presents utilization patterns of members with chronic conditions, ranked by number of members, for total
office visits, emergency room visits and hospital admissions.
Table 5.3.1 Chronic Conditions Utilization Summary
Chronic Condition
# of
Members
Members
per 1000
Office Visits
per 1000
ER Visits
per 1000
Admissions
per 1000
PMPY
Hypertension
1,951
123.0
7,046.4
288.2
112.6
$7,716.09
Hyperlipidemia
1,683
106.1
7,006.9
217.9
75.8
$6,389.88
Diabetes
943
59.4
8,075.9
346.0
155.9
$11,083.29
Osteoarthritis
631
39.8
10,722.9
395.1
202.1
$13,046.46
Asthma
477
30.1
7,830.3
477.5
126.7
$7,566.68
Coronary Artery Disease
(incl. MI)
354
22.3
8,670.9
530.1
261.1
$14,806.04
Congenital Anomalies
214
13.5
8,620.9
370.8
192.9
$14,514.58
Chronic Obstructive
Pulmonary Disease
147
9.3
10,742.2
644.6
349.8
$15,573.03
Cerebrovascular Disease
137
8.6
9,929.8
895.3
429.4
$21,608.24
Chronic Liver and Biliary
Disease
117
7.4
9,936.9
746.4
357.7
$19,147.11
Rheumatoid Arthritis
105
6.6
10,912.0
303.1
157.0
$13,216.27
Atrial Fibrillation
90
5.7
10,281.3
669.1
411.3
$17,858.53
Inflammatory Bowel
Diseases
85
5.4
8,878.4
711.2
381.8
$22,252.10
Chronic Renal Failure
80
5.0
10,235.3
698.8
416.5
$29,044.80
Osteoporosis
73
4.6
12,288.8
531.1
232.9
$16,817.56
Coagulopathy
71
4.5
11,822.4
977.1
657.3
$42,403.50
Bipolar Disorder
63
4.0
14,809.0
1,257.6
340.8
$12,658.16
Immune Disorders
48
3.0
17,235.2
764.8
778.0
$65,683.52
Congestive Heart Failure
45
2.8
12,726.5
1,304.9
941.7
$36,197.78
Demyelinating Diseases
43
2.7
8,663.4
117.1
14.6
$19,604.92
Ulcerative Colitis
39
2.5
8,098.3
468.2
260.1
$12,175.16
Cirrhosis
23
1.4
7,422.7
587.6
556.7
$19,886.19
Major Organ Transplant
16
1.0
9,383.9
568.7
540.3
$44,475.55
HIV/Aids
9
0.6
6,702.7
270.3
162.2
$16,539.76
Schizophrenia
8
0.5
16,714.3
214.3
142.9
$6,125.36
Parkinson's Disease
5
0.3
9,391.3
208.7
0.0
$13,942.84
Chronic Pancreatitis
4
0.3
10,392.9
750.0
428.6
$16,246.32
Cystic Fibrosis
2
0.1
8,571.4
571.4
571.4
$83,587.28
Gaucher's Disease
1
0.1
4,000.0
800.0
800.0
$9,653.48
Sickle Cell Anemia
1
0.1
8,000.0
4,000.0
0.0
$11,553.44
Note:
1.
In this table a member can have multiple chronic conditions.
2.
The results displayed in this table are based on claims incurred.