Utilization in the Commercial Market: New Data from Q2

Staff portrait of Kathy Hempstead

Katherine Hempstead, PhD, MA, director and senior program officer, leads RWJF's work on health insurance coverage.

Kathy Hempstead discusses the latest National Association of Insurance Commissioners (NAIC) data on utilization of health care services by the commercially insured comparing the second quarter of 2013 to the second quarter of 2014.

Major findings include:

  • Utilization of health care increased in the individual market, but declined slightly in the group market.
  • Use of ambulatory care increased about 5 percent for the individual market, and declined less than 2 percent for the group market.
  • Hospital admissions and patient days increased nearly 20 percent in the individual market, but declined about 5 percent in the group market.
  • While utilization in the group market exceeds that in the individual market in all categories, the ratio of individual to group utilization increased between Q2 2013 and Q2 2014.

These trends in part reflect compositional changes in the populations enrolled in both the individual and group segments of the commercial market. However, these may also show the impact of multiple changes in benefit design and care management which are designed to reduce utilization among all populations.