Enlyte Quarterly Medical Price Index - Q2
Michele Hibbert
SVP of Regulatory Compliance Management
As reported by the Bureau of Labor and Statistics (BLS) for April 2024, the consumer price index in the United States increased 3.4% over the preceding 12 months. The medical care index rose 0.4% in April 2024 after rising 0.5% in March 2024. The index for hospital services increased 0.6% over the month and the index for physician’s services increased 0.1% which would be compared to Enlyte’s data in this report.
We analyzed our medical bill review professional services charge data for trends and are providing the "Enlyte Medical Price Index" (MPI) specific to P&C claims. This information is based on our own observations of charges and trends from professional service medical bills. These observances are anchored in 2020 to include data from the period Q1 2020 through the end of Q4 2023 by coverage type. New for this report is our starting point, or anchor of 2020. In addition, we are providing national changes per unit index in year-over-year and year-to-date views. This will enable us to demonstrate real-time changes in shorter increments.
Workers' Compensation Medical Price Index
Medical Price Index at the National Level
Since Q1 2020, physician charges per unit (or per procedure performed) increased by 11% in Enlyte’s MPI for workers' compensation coverage through Q1 2023. For physician charge services during the same time frame the BLS Consumer Price Index (CPI) increased 7%.
A new view of data demonstrates national year over year changes that shows slowing of price increases in the Enlyte MPI data from 2022 to 2023. The Enlyte MPI demonstrates 5% increases between 2020 to 2021 and 2021 to 2022, however the increase from 2022 to 2023 is 2%.
Charge per unit year to date measurements demonstrate that from 2023 to year-to-date we are seeing flat or negligible changes in workers' compensation coverage at the national level.
Medical Price at the State Level
In workers' compensation claims, the high-volume states of New York, California, Florida, and Texas provide noteworthy trends related to charges of medical services. Anchoring the data in 2020 demonstrates Texas and California have the largest increases with 11%. New York demonstrated a 3% increase in charge per unit spurred on by the increase in fee schedule changes and Florida has seen a 3% decrease.
Charge per unit year to date measurements for each state demonstrate that from 2023 to year-to-date Enlyte’s WC MPI is remaining flat or negligible changes for California, Florida, New York, and Texas.
Auto First-Party
Medical Price Index at the National Level
Taking a national view of provider charge data from Q1 2020 through Q4 2023 we observed a 5% increase in physician charges for first-party claims. When we compare first-party medical charges to the BLS CPI, we see a similar charge trend of 7%; however the BLS CPI is 2% higher than the Enlyte first-party MPI at the end of 2023.
A new view of data demonstrates changes at the national level that shows slowing of price increases in the Enlyte first-party MPI data from after 2021. The MPI demonstrates a 4% increase between 2020 to 2021 and remains the same through Q4 2023.
Charge per unit year to date measurements demonstrate from 2023 to year to date, Enlyte’s first-party MPI is remaining flat or negligible changes so far at the national level.
Medical Price Index at the State Level
In first-party claims, the large volume states of New York, Michigan, New Jersey, and Florida provide noteworthy changes in charge severity, particularly in New York. Michigan’s changes are less noteworthy over the shortened timeframe anchor of 2020 due to the introduction of the fee schedule which has controlled charges over time. Since Q1 2020, physician charge per unit has increased 19% in New York, driven by a fee schedule change and provider billing. Michigan, New Jersey, and Florida remained flat.
Reviewing year to date Enlyte first-party MPI demonstrates a 2% increase in New York, 2% decrease in Michigan while Florida and New Jersey remain unchanged.
Third-Party Medical Price Index
Medical Price at the National Level
Third-party claims are often “latent” when carriers receive them and may represent charges from more than a year earlier than observed in first-party claims that are more real-time. Third-party claims can also be submitted on non-standardized forms, without appropriate billing codes and often in descriptions rather than actual invoices. Data capture practices and charge submissions can be important drivers of charge observations in the third-party claim.
Since Q1 2020, physician charge per unit has increased in the third-party Enlyte MPI claim data by 17%.
Since Q1 2020, the Bureau of Labor Statistics Physician Consumer Price Index has increased 7%, creating a noteworthy difference in cost between first-party claims, third-party claims and the BLS CPI.
A new view of data demonstrates changes of continuing price increases in the Enlyte first-party MPI data after 2020. The Enlyte MPI demonstrates a 3% increase between 2020 to 2021, a 4% increase from 2021 to 2022 and a 5% increase from 2022 to 2023.
Reviewing year to date Enlyte first-party MPI demonstrates a 4% increase nationally, while the BLS CPI for Physician Services remains flat. Charges in first-party claims are the only coverage area where we are noting marked increase year to date.
Medical Price Index at the State Level
Since Q1 2020, physician charge per unit in the Enlyte first-party MPI has increased 13-14% in California, Georgia, and Texas, while Florida experienced a 4% increase.
Reviewing year to date Enlyte first-party MPI demonstrates a 3% increase in California and Texas, 2% increase in Georgia and 1% increase in Florida. The changes in price increase are not slowing down from the anchor date of 2020 and continuing to rise.
