125 / 537
Employer Group ABC
Incurred:
Apr 2014 thru Dec 2015
Paid:
Apr 2014 thru Mar 2016
51
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Page
5.4.4 Procedure groups
Table 5.4.4 shows the top 10 procedures, ranked according to medical claim expenses. For purposes of health plan
analysis, previous period to current period percentage changes may be more important than absolute dollars.
Changes in membership must be considered when any such analysis is performed. Many employers are considering
contracting with free-standing lab/x-ray facilities to better manage the growth in these areas.
Table 5.4.4 Total Plan Paid ($K) by Procedure Groups
% of Total
Plan Paid
Apr 2015 - Dec
2015
% Change in
Plan Paid
7.4%
-15.7%
5.3%
-16.7%
5.1%
-18.2%
3.7%
-12.9%
3.5%
-16.5%
3.4%
56.0%
3.2%
-26.9%
3.2%
-23.5%
2.8%
10.8%
2.7%
-24.4%
Procedure
Group
Apr 2014 - Dec 2014
Apr 2015 - Dec 2015
% Change in
Plan Paid
Plan Paid
% of Total
Plan Paid
Plan Paid
% of Total
Plan Paid
Subtotal
$25,051,738
39.9%
$21,638,335
40.3%
-13.6%
All Others
$37,660,360
60.1%
$32,087,051
59.7%
-14.8%
Total
$62,712,098
100.0%
$53,725,386
100.0%
-14.3%