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Fewer Americans see doctors in their office, CDC data show

Published January 25, 2019 on healthcaredive.com.

Dive Brief:

  • Americans made an estimated 883.7 million visits to physician offices in 2016, down from 990.8 million in 2015, according to new data from the Centers for Disease Control and Prevention.
  • That translates to about 278 office-based visits per 100 people, compared with 313 the prior year. More women than men visited a doctor, while infants and older adults outpaced rates for those aged 1 to 64.
  • Private insurance was the chief source of payment for 54% of all office-based physician visits, followed by Medicare (26%), Medicaid (15%) and no insurance (3%).

Dive Insight:

The new figures come as value-based payment is shifting more care in outpatient settings, but options like telehealth and retail clinics are eating into some traditional office-based encounters.

A recent study in JAMA found annual telehealth visits among commercially insured consumers jumped 52% a year from 2005 to 2014 and a whopping 261% from 2015 to 2017. Many of those are encounters that would otherwise likely have occurred in a physician’s office, urgent care or emergency room.

Patients who use telehealth services tend to be younger, disproportionately female and looking for easy, timesaving ways to connect with doctors or other healthcare professionals.

Regardless of how people access care, they want providers who are readily available and convenient to use. According to NRC Health’s 2019 Healthcare Consumer Trends Report, patients’ positive feelings about their provider didn’t override concerns about support staff, wait times and billing and insurance, even when they held their provider in high regard. Of more than 223,000 surveyed, 51% said access and convenience are their key reasons for choosing a provider.

According to the CDC, 86% of adults and 96% of children had a usual place they received healthcare in 2016, in most cases a doctor’s office.

Chronic conditions were the No. 1 reason people visited the doctor’s office, accounting for 37% of all encounters. Next were “new problems” (27%), preventive care (23%), injuries (7%) and pre- or postoperative care (6%).

Nearly half (48%) of all office-based visits involved an examination or screening. Other services provided included laboratory tests (29%), education and counseling (22%), imaging (14%) and procedures (14%). Comparatively, children outpaced adults for preventive visits, while adults accounted for more visits involving imaging services.

When it comes to payment, private insurance was the primary source for 63% of children and 71% of people aged 18 to 64. However, roughly a third (32%) of children relied on Medicaid. Among adults over 64, Medicare was the primary payment source (82%), with only 14% listing private health insurance.

The report is based on the National Center for Health Statistics’ National Ambulatory Medical Care Survey and covers doctors providing direct patient care in office-based practices. It excludes doctors working in community health centers.