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Slowdown in office visits raises care concerns

Usually, health care costs rise when the economy recovers from a recession, even during a relatively slow recovery such as the present one. The deep recession that began in late 2007 officially ended in June 2009, but health care costs have remained relatively flat, according to the Kaiser Family Foundation. (See In the second quarter of 2009, 156 million nonelderly patients with private insurance made physician office visits. In the second quarter of 2011, that number fell to 129 million, a decline of 17 percent.

Kaiser notes that factors other than the recession and pace of recovery might be in play. For instance, the share of workers with at least a $1,000 deductible grew from 18 percent in 2008 to 31 percent in 2011.

Insurers profited last year because they raised premiums in expectation of rising utilization. Yet the long-term effects for clinician executives charged with managing the care of populations are somewhat murky. “In some cases people may be foregoing unnecessary care, meaning that health costs are reduced with little or no effect on health,” says the Kaiser survey. “In other cases people are likely cutting back on necessary care, potentially endangering patients’ longer term health and leading to higher costs over time.”

Quarterly trends in U.S. office visits, 2000–2011

Quarterly trends in U.S. office visits, 2000–2011

Note: These seasonally adjusted estimates have a 95 percent confidence interval of 4 percent. Produced by the Stanford University Program on Prevention Outcomes and Practices with the assistance of the IMS Institute for Healthcare Informatics.

Source: “The Economy and Medical Care,” Kaiser Family Foundation, Nov. 15, 2011.

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