Managed care decreases demand for some services

Providers who assume outpatient services increase across the board as managed care increases should reconsider that assumption before using it as the basis for any business decisions, according to the Evanston, IL-based Sachs Group. The recently released sixth edition of Outpatient Estimates, which forecasts ambulatory utilization through 2002, shows that while the need for many outpatient services increases as a result of managed care, demand actually decreases for others.

Less use of EDs, more cardiac services

For example, Sachs estimates the national demand for emergency department visits could decrease 55% by 2002, while cardiac rehabilitation services could increase 38%. Forecasted increases in outpatient procedures reflect managed care’s emphasis on preventive care as well as the initiative to provide services in the most cost-effective site. Other areas of increase include mammography and sigmoidoscopies.

The data take into account local market variations including demographics and insurance coverage. For example, bone density scans are forecasted to decrease 2% nationally, but increase 6% in the Chicago market.

For a copy of the report, which is built from more than 136 million claims and comprises 342 different procedure groups, contact: Sachs Group, 1800 Sherman Ave., Evanston, IL 60201. Telephone: (847) 475-7526.

AHCPR releases new data file

The Agency for Health Care Policy and Research has updated it Medical Expenditure Panel Survey Web site ( with a new public use MEPS data file. Now available for downloading is the full-year, person-level population characteristics and utilization data for 1996. Variables in this release include demographics, employment, health status, health insurance, and health care utilization.

The MEPS Web site also has several other recent releases that can be downloaded, including Health Insurance Coverage In America — 1996, Job-Based Health Insurance 1987 and 1996, Nursing Homes — Structure and Selected Characteristics, 1996, and Children’s Health, 1996: Health Insurance, Access to Care, and Health Status.

Data profile the uninsured in large metro areas

The Washington, DC-based Employee Benefit Research Institute (EBRI) recently released a data resource that profiles uninsured Americans in 22 metropolitan areas with populations of two million or more. EBRI used merged data from the Census Bureau’s March 1995, March 1996, and March 1997 Current Population Surveys for the tabulations.

Findings include:

o Midwestern and Northeastern metropolitan areas tend to have lower uninsured rates than Western and Southern areas. The Detroit area had the lowest uninsured rate — 9.3% of its non-elderly population — and Houston had the highest — 30.1%.

o Midwestern and Northeastern metropolitan areas tended to have higher rates of private health insurance coverage compared with Western and Southern metropolitan areas. The Cincinnati area had the highest rate of private health insurance — 83.5% — and San Diego had the lowest — 58.7%.

Fact sheets on each geographic area as well as a state-by-state basis are available on the EBRI Web site at