88-89 / 537
Employer Group ABC
Incurred:
Apr 2014 thru Dec 2015
Paid:
Apr 2014 thru Mar 2016
23
|
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 changes in utilization. Also displayed is the average cost from the Verscend Normative Database, and the population’s cost
rank relative to the Norm.
Table 3.1.3 Cost drivers: Change in unit price and change in utilization breakout for diagnostic tests
25,
26
Testing
Category
Subcategory
Current PMPM
Change in PMPM
Change in
utilization per
1,000
Change in Unit
pricing
Norm value of
PMPM
Percent
Rank(Norm
value = 50%)
Cardiology
All
$5.05
-26.2%
-19.0%
-24.9%
$3.58
-
Ultrasound/Doppler
$2.56
-15.6%
-15.8%
0.2%
$1.76
-
Cardiography
$2.17
-30.3%
-19.5%
-13.5%
$1.38
-
Electrophysiology
$0.32
-53.7%
-28.1%
-35.5%
$0.44
-
Imaging
All
$38.67
-24.5%
-22.6%
-7.5%
$22.56
-
CT
$13.25
-15.9%
-14.0%
-2.3%
$6.56
-
MRI
$9.77
-27.1%
-24.9%
-3.0%
$5.77
-
Radiology Diagnostic (incl.
Cardiology)
$4.68
-36.9%
-24.1%
-16.9%
$2.17
-
US
$3.96
-22.0%
-20.6%
-1.8%
$3.34
-
Plain film
$3.72
-21.6%
-23.9%
3.1%
$2.98
-
Not classified
$3.28
-31.3%
-25.4%
-8.0%
$1.74
-
Lab
All
$19.51
-21.0%
-21.0%
-0.0%
$14.63
-
Pathology
All
$4.95
-19.9%
-22.3%
3.2%
$3.39
-
Sleep study
All
$1.11
-42.2%
-40.6%
-2.7%
$1.04
-
Vascular
All
$1.12
-11.7%
-23.7%
15.8%
$0.71
-
25
Note:
Table 3.1.3 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
26
Norm or Verscend Norm in this report refers to the values from Verscend's Commercial Normative database.