第三方汽车成本驱动因素:医疗通胀等

Third party auto claim costs have been on the rise over the past few years due to many factors including social inflation, “核”定居点, 不断增加的医疗费用等等. Medical bill review auditing in third party claim review can identify trends in provider billing and costs. 来帮助理解这些成本驱动因素, Enlyte analyzed its third party medical bill review charge data from the beginning with claims created in our bill review system from 2017 through the end of 2021. 下面，我们概述了Enlyte对这些数据趋势的观察: 

国家层面的医疗通胀

The graph above shows third party charge observations per unit, respectively, at the national level. This information is depicted in a medical price index for third party medical bill data anchored with claims created in 2017 to the end of 2021.

首先，我们研究了全国的医疗通胀趋势. From the first quarter of 2017 until the end of 2021, physician charge per unit increased 9%. It is interesting to note that first party medical bill increases were noted to be at a 4% increase.

进行比较, 在同一时期, the Bureau of Labor Statistics Physician Services Consumer Price Index increased 6%.

州一级的医疗膨胀

The graphs above demonstrate third party auto casualty charged observations in California, 佛罗里达和德克萨斯.

To take a closer look at how medical inflation is affecting third party claims, 我们看了一些高容量的状态, 包括佛罗里达, 德克萨斯州和加利福尼亚州. 以下是我们的发现:

• 自2017年第一季度起, Florida experienced a 4% increase in charge per unit while California and Texas saw charge per unit increase 9%.
• Allowed per unit measures are calculated however are not a tangible metric for claims allowed amount. Aside from pricing medical specials/bills many factors go into the final settlement of the 3rd party claim. Data to support allowed amounts would need to be identified by represented claims vs. non-represented claims and the non-represented claims would appear more like first party payments.

按服务组分类的医疗通货膨胀

以上图表显示了按单位收取的第三者交通意外伤亡费, 按服务组分类，包括评价和管理, 疼痛管理，物理医学和康复.

帮助更好地了解第三方医疗费用趋势, 我们还按服务群体调查了医疗通胀. Both evaluation and management and pain management services saw significant increases in charged: 

• 2017年第一季度至2021年第二季度, 评价和管理服务的单位收费增加了19%.
• 另外, 每单位疼痛管理服务的收费增加了32%, 而单后审核审计单位增加了16%.
• Charge per unit for physical medicine and rehabilitation services remained relatively steady over the same time period.
• 上涨是由市场利率和通常和习惯收费推动的.

按服务组划分的医疗严重程度

The charts above demonstrate charged per claimant for some of the most frequently observed service groups in third party claims.

另外, Enlyte’s medical bill review data also highlighted a few other service groups that are commonly analyzed for trends in medical severity: 

• 而捏脊手法疗法, 急诊科服务, radiology and physical medicine services have experienced little change in charge per claimant through the majority of the pandemic, physical medicine and chiropractic manipulative therapy experienced an uptick starting in Q3 2021, 分别增加了33%和21%.
• Surgery services saw a 76% increase in charge per claimant since January 2019.

按伤害分类的医疗严重程度

The charts above demonstrate claimant injury distribution as well as charge per claimant for specific injury classifications. 请注意这个具体的细分, we looked at claims created data starting from January 2019 through January 2022.

查看Enlyte为第三方提供的医疗账单审核数据, 我们确定了几个值得关注的关键成本趋势. It is important to note that except for a 6% increase in the number of claimants diagnosed with soft-tissue injuries, 自2019年1月以来，损伤类型分布保持一致.

• 自2019年1月起, soft tissue injury charges per claimant increased 20% and ICD10’M’ (diseases of the musculoskeletal system) charge per claimant has increased 22%. M codes are not typically injury codes but can be related as symptoms to the loss. 

索赔频率

The chart above demonstrates third party auto casualty claim frequency we have collected in medical bill auditing compared to the U.S. 交通部里程驱动报告.

To put these trends in more context, we also analyze third party claim frequency. 这是大流行的结果, 驾驶习惯已经改变, and we observed two clear downturns: miles driven corresponding with the start of the pandemic and the emergence of the Delta variant. 行驶里程的下降导致索赔频率降低, 哪一个是第三方索赔, 到2022年1月尚未恢复到大流行前的水平.

关于我们的数据

This report is generated based on Enlyte’s third party auto casualty Medical Price Index, which consists of medical bill review data audited for the third party claim. The data in this report is compiled from claims created Q1 2017 through the end of Q4 2021. Our data represents the most comprehensive and largest data set available for this market segment in medical bill review.