84-85 / 537
Employer Group ABC
Incurred:
Apr 2014 thru Dec 2015
Paid:
Apr 2014 thru Mar 2016
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Page
The table below breaks down the cost driver for each category analyzed in the prior chart. This allows you to understand whether the changes in cost are
driven by a change in pricing or a change in utilization. Also displayed is the average cost from the Verscend Normative Database, and the population’s cost
rank relative to the Norm.
Table 3.1.2 Cost drivers: Change in unit price and change in utilization breakout for specialty procedures and consultations
22,
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Specialty Procedures/
Consultations
Current PMPM
Change in PMPM
Change in
Utilization per
1,000
Change in Unit
Pricing
Norm
value of PMPM
Percent Rank
(Norm
value = 50%)
GI
$20.73
14.0%
-17.9%
38.9%
$15.63
-
Misc
$14.40
-30.0%
-19.2%
-13.4%
$8.45
-
Anesthesia
$13.33
-27.7%
-22.5%
-6.7%
$9.35
-
Durable Medical
Equipment
$9.38
-25.9%
-25.2%
-1.0%
$4.51
-
Cardiology
$9.13
-14.8%
-4.3%
-11.0%
$5.61
-
Physical Therapy
$8.28
-15.2%
-16.3%
1.3%
$4.70
-
Heme/onc
$5.80
-34.9%
-13.3%
-24.9%
$3.52
-
Radiology Therapy (incl.
Rad Oncology)
$5.28
27.9%
29.1%
-0.9%
$3.70
-
Pulmonary
$4.15
-3.1%
-27.4%
33.4%
$2.08
-
Gen Surg
$4.14
-30.4%
-19.6%
-13.4%
$4.18
-
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Note:
Table 3.1.2 is based on select categories of Verscend Procedure Groups which utilize CPT4 Procedure Codes.
Source: Medical Intelligence : Claims Module / Trend / Medical / drill by Plan Type / Zoom Fwd / drill by Procedure Group
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Norm or Verscend Norm in this report refers to the values from Verscend's Commercial Normative database.