New Office Visits

CMS 1500 Professional Services

Did you know?

  • CMS reports that in this “baby boomer” time, there are approximately 314,000 Medicare newly enrolled beneficiaries each month.
  • Despite this, New Office Visit activity has declined by about 7.1% over the 2018-2019 period (based on data from RTMD, which now serves healthcare organizations in a Medicare beneficiary area consisting of 48 states and the District of Columbia).
  • Over the same time period, the average time spent with the patient has remained constant. This affects the capacity of a provider to focus on volume and may reflect the utilization of other non-acute providers (i.e., retail clinics).

Why should I care?

  • New Office Visits have always been a critical access point into the U.S. healthcare system and present an opportunity to serve.
  • This encounter offers acute care facilities a strategic value around how we organize our infrastructure in terms of access, quality, and costs.
  • Examining trends in New Office Visits can help raise important questions about how a hospital tailors its existing services:
  • Are New Office Visits becoming more time and resource intensive, resulting in the inability to see more patients?
  • Are patients seeking care in different settings, such as urgent care, extended hour facilities, or retail clinics?
  • Are payment policies for testing, especially those for co-pays, driving patients to alternative settings?
  • Are immunization, lifestyle, and technological advances impacting utilization?

What should I do?

RTMD advises each facility to:

  • Research trends in New Office Visits in your market by volume, type (time spent), content (principal diagnosis), and reimbursement.
  • Review your market for new providers that represent non-traditional physician settings, such as urgent care facilities.
  • Study outmigration and referrals for New Office Visits.
  • Examine your new patient and Medicare patient policies. If volume is down, determine if this is because your physicians are not accepting new Medicare patients.

Let us show you how we can help you make more informed decisions with our RealTime Medicare FFS claims data.

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