Enlyte Quarterly Medical Price Index - Q3

As reported by the Bureau of Labor and Statistics (BLS) for October 2024, the consumer price index in the United States increased 2.4% over the preceding 12 months which is 1.0% less than reported in April 2024. This increase represents the smallest 12-month increase since February 2021. The medical care index rose 0.4% again in October 2024 after declining in the two previous months. The index for hospital services saw a decrease of 0.6% which follows a 0.6% increase in the previous month. The BLS index for physicians' services increased 0.9% in September which will be used for comparison in this report and in contrast, the prescription drugs index declined 0.5% over the month.

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 Q2 2024 by coverage type. We are providing national changes per unit index year over year and a year-to-date view. This current information will enable us to demonstrate near 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 10%, a 1 % decline since Q4 2023 in Enlyte’s MPI for workers’ compensation coverage through Q2 2024. For physician charge services during the same period the BLS Consumer Price Index (CPI) increased 8%.

Reviewing changes in the data year over year at a national level demonstrates slowing of price increases in the Enlyte MPI data from 2023 to 2024. The Enlyte MPI demonstrates 5% increases between 2020 to 2021 and 7% increase between 2021 to 2022, however the increase from 2022 to 2023 is 2% with a decline in 2024 of 1%.

Charge per unit year-to-date measurements demonstrate that year to date Enlyte’s wokers’ comp MPI is remaining flat or negligible changes in workers’ compensation coverage at the national level. There is no change from the previous report on year-to-date metrics.

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 increases in Texas of 7% and California 12%; and decreases of 5% in New York and 7% in Florida.

Charge per unit year-to-date measurements for each state demonstrate that year to date Enlyte’s workers’ comp MPI in selected states have demonstrated noteworthy changes. California has increased 1%, Florida has decreased 5%, New York has decreased 3%, and Texas has increased 4%. This is a stark change from the first quarter of 2024 where minor changes were observed and as the year matures, we are likely to see comparable results in these states.

Auto First-Party

Medical Price Index at the National Level

Since Q1 2020, physician charges per unit (or per procedure performed) increased by 4%, a 1% decline since Q4 2023 in Enlyte’s MPI for auto first-party coverage through Q2 2024. For physician charge services during the same period the BLS Consumer Price Index (CPI) increased 8%.

Reviewing changes in the data year over year at a national level demonstrates slowing of price increases in the Enlyte MPI data from 2022 to 2024. The Enlyte MPI demonstrates 3% increases between 2020 to 2021 and 1% increase between 2021 to 2022, 2022 to 2024 are negligible or flat.

Charge per unit year-to-date measurements demonstrate from 2024 year to date, Enlyte’s 1st 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 high-volume states of New York, Michigan, New Jersey, and Florida provide insightful views in provider charges. Of note in New York, provider charges have increased since Q1 2020 of 16%, 3% less than Q4 2023. Michigan, New Jersey, and New York have essentially remained flat, however, New Jersey and Michigan are demonstrating provider charge changes in Q2 2024. 

The noteworthy changes in Michigan year to date demonstrate a 3% decrease and in New Jersey a 7% increase year to date for the MPI. Florida and New York are essentially unchanged through Q2 2024. Enlyte believes the changes in New Jersey can be attributed to billing outside of the fee schedule due to the age of the PIP fee schedule.

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. Enlyte has also observed third-party claims 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 19%, a 2% increase since 2023.

Reviewing changes in the data year over year at a national level demonstrates continued increases in the Enlyte MPI data for 3rd party coverage from 2023 to 2024 of 6%, the most significant year-over-year change. The Enlyte MPI demonstrates 3% increases between 2020 to 2021, 4% increase between 2021 to 2022, and between 2022 to 2023 a 4% increase.

Reviewing year to date Enlyte third-party MPI demonstrates both third-party and BLS are flat nationally. Enlyte believes this observation may indicate a smaller increase in 2024 once the full year is observed for third-party claims.

Medical Price Index at the State Level

Since Q1 2020, physician charge per unit in the Enlyte third-party MPI has increased 15-17% in California, Georgia, and Texas while Florida remains at a 4% increase.

Reviewing year to date Enlyte third-party MPI demonstrates a 3% increase in California and Georgia, while Florida and Texas are flat so far in 2024. The changes in price increase are not slowing down from the anchor date of 2020 and continuing to rise.