Monthly Archives: February 2012

US Physician office visits declined 17% from 2009-2011

Being insured is no guarantee unemployed will seek care

Research suggests they may be unable to cover co-pays and deductibles, or fear they cannot afford the expenses that result.

By Victoria Stagg Elliott, amednews staff. Posted Feb. 7, 2012.

Unemployed people who have private health insurance are less likely to put off care because of cost than those without insurance or on public plans. But they are much more likely than the employed to stay away from the doctor’s office.

“Even if you have insurance, you typically have to pay 20% or more of the price, and when you become unemployed, you become more cautious about spending money,” said Randall Ellis, PhD, professor of economics at Boston University and president of the American Society of Health Economists. “You put off preventive visits, and if you have the flu, you choose not to go in for treatment.”

About 29.3% of the unemployed had private insurance, according to a data brief issued Jan. 24 by the Centers for Disease Control and Prevention’s National Center for Health Statistics analyzing adults 18-64 who participated in the National Health Interview Survey for 2009-2010 (

Full article is here.

Puzzling fact is that outpatient office visits declined by 17%:

“Outpatient office visits declined 17% among patients with private insurance — from 156 million in the second quarter of 2009 to 129 million in the second quarter of 2011.”


Yet  total private insurance spending on physicians remained almost unchanged.

2009 2010 Change
Total $408.3 billion $415.8 billion 1.8%
Private insurance $209.0 billion $209.4 billion 0.2%

Source: National Health Expenditure Data, Centers for Medicare & Medicaid Services Office of the Actuary, January (

Also see:

Could be worth exploring…

ARF 2009-10 is available free

ARF=Area Resource File

2009-2010 ARF Can Now Be Downloaded at No Cost.

The 2009-2010 ARF data files and documentation can now be downloaded. Click the link below to learn how to download ARF documentation and data.

"The basic county-specific Area Resource File (ARF) is the nucleus of the overall ARF System. It is a database containing more than 6,000 variables for each of the nation's counties. ARF contains information on health facilities, health professions, measures of resource scarcity, health status, economic activity, health training programs, and socioeconomic and environmental characteristics. In addition, the basic file contains geographic codes and descriptors which enable it to be linked to many other files and to aggregate counties into various geographic groupings."

"You may also choose to search the ARF to see what data variables are available in the current file."

The table of contents below gives a sense of the county level information included.

A-1)        Header for ARF. 1
A-2)        State and County Codes. 1
A-3)        Census County Group Codes. 7
A-4)        County Typology Codes. 7
A-5)        Metropolitan/Micropolitan and Combined Statistical Areas. 10
A-6)        Rural/Urban Continuum Codes. 11
A-7)        Urban Influence Codes. 13
A-8)        BEA Economic Area Codes and Names and Component Economic 14                          Area Codes and Names.
A-9)        Federal Region Code and Census Region and Division Codes and Names. 14
A-10)     Veterans Administration Codes. 16
A-11)     Contiguous Counties. 17
A-12)     Health Service Area Codes. 18
A-13)     Area Health Education Center (AHEC) Codes and Names. 18
A-14)     HPSA Codes. 19
A-15)     SSA Beneficiary State and County Codes. 21
B-1)        Physicians. 22
B-2)        Dentists and Dental Hygienists. 31
B-3)        Optometrists. 36
B-4)        Pharmacists. 37
B-5)        Podiatrists. 38
B-6)        Veterinarians. 39
B-7)        Nurses. 40
B-8)        Physician Assistants. 43
B-9)        Chiropractors. 45
B-10)      Occupational Therapists. 46
B-11)      Physical Therapists. 46
B-12)      Psychology and Social Work Teachers. 47
B-13)      Psychologists. 47
B-14)      Sociologists. 48
B-15)      Social Workers. 48
B-16)     Audiologists   49
B-17)     Speech Language Pathologists  49
B-18)      Healthcare Practitioner Professionals. 50
B-19)      Decennial Census Occupation Data. 50
C-1)        Hospital Type. 54
C-2)        Hospital Services (or Facilities) 57
C-3)        Hospital Employment 57
C-4)        Nursing and Other Health Facilities. 58
C-5)        Health Maintenance Organizations. 60
C-6)        Preferred Provider Organizations (PPOs) 61
D-1)        Utilization Rate. 62
D-2)        Inpatient Days. 62
D-3)        Outpatient Visits. 62
D-4)        Surgical Operations and Operating Rooms. 62
E-1) Hospital Expenditures. 63
E-2) Medicare Advantage Adjusted Average Per Capita Cost (AAPCC) 63
F-1) Population Estimates. 68
F-2) Population Counts and Number of Families and Households. 72
F-3) Population Percents. 82
F-4) Labor Force. 84
F-5) Per Capita Incomes. 86
F-6) Income. 88
F-7) Persons and Families Below Poverty Level 90
F-8) Ratio of Income to Poverty Level 92
F-9) Median Family Income. 93
F-10)      Household Income. 93
F-11)      Medicaid Eligibles. 97
F-12)      Medicare Enrollment Data. 99
F-13)      Medicare Advantage/Managed Care Penetration. 100
F-14)      Medicare Prescription Drug Plan (PDP) Penetration. 103
F-15)      Health Insurance Estimates. 103
F-16)      Food Stamp/SNAP Recipient Estimates. 104
F-17)      Social Security Program.. 104
F-18)      Supplemental Security Income Program Recipients. 105
F-19)      5‑Year Infant Mortality Rates. 107
F-20)      Infant Mortality Data. 108
F-21)      Mortality Data. 108
F-22)      Total Deaths. 111
F-23)      Natality Data. 111
F-24)      Births in Hospitals. 113
F-25)      Total Births. 113
F-26)      Education. 114
F-27)      Census Housing Data. 114
F-28)      Veteran Population. 117
G-1)        Land Area and Density. 119
G-2)        Population Per Square Mile. 119
G-3)        Elevation. 119

FAIR Health claims data, N=125 million

Window to the marketplace

FAIR Health now delivers the industry's primary source of out-of-network benchmarks with unprecedented transparency

"What was referred to as a "black box" in February 2008 today has become an open window to the healthcare marketplace. The industry's privately owned database of usual-and-customary (UC) charge information is now a transparent, public information source called FAIR Health."

Data sources

"Currently, FAIR has approximately 80 different data sources nationwide, collectively contributing claims data for 125 million covered lives. Data is deidentified as to the payer source and the individual member's identity. By aggregating claims in this way, FAIR can meet HIPAA requirements and discourage the use of information for competitive advantages among participating payers.

Gelburd says the required fields that FAIR collects from the claims data supplied by contributors include CPT codes, standard charges, date and location of service. Additional fields include ICD-9 and ICD-10 codes, provider identifiers and negotiated, in-network charges. The optional fields are particularly useful from a research perspective."

I would welcome comments from anyone who has used this data.