Utilization, Revenue Cratered for Healthcare Specialties in March, April

We know that people stopped going to the doctor when COVID-19 hit in March. FAIR Health, a not-for-profit with a large database that includes 150 million insured Americans and claims from 60 insurers and third-party administrators, put some numbers to that generalization in a report today.

Overall, the report shows that utilization of professional services declined by 65% in March 2020 compared with March 2019 and revenue (which FAIR Health calculates based on estimates of in-network fees) for the month flew 45%. In April, the drop-off was even steeper: a 68% decrease in utilization compared with April 2019 and a 48% decline in revenue.

The FAIR Health researchers also looked at seven specialties. Oral surgery had the largest declines in utilization and revenue while pediatric primary care had smallest. Cardiology, dermatology, gastroenterology and orthopedics all saw utilization and revenue declines in March  and April of well over 50% compared with those months a year ago. Pediatric and adult primary care also saw steep declines but not as steep as the declines for those four specialties

FAIR Health’s data showed little change in preventive care for newborns and children through the age of four. There has been some concern that other kinds of infectious diseases might take off if children stopped getting vaccinated. The FAIR Health claims data show some drop off in vaccinations - 14% decline in March compared with March 2019  and 10% decline in April compared with April 2019 – but decrease wasn’t as precipitous as many feared.

The report notes that evaluation and management (E&M) visits became more common relative to other procedures, both by utilization and revenue estimates. The report attributes the change to telehealth and the decline in procedures that require in-person care.