Physician Office Visits

The Agency for Healthcare Research & Quality releases a series of Statistical Briefs based on the Medical Expenditure Panel Survey.  The latest one describes physician visits in 2016.  (AHRQ Statistical Brief)   About 35% of all visits were to primary care physicians, with another 9% to pediatricians, 6% to ob/gyn, 7.4% to eye doctors, 5.5% to orthopedists and 4.6% to psychiatrists.  The average expense for a physician visit was $265 across all specialties, but the median expense was only $116; which reflects a lower average visit cost for the most common specialties.  Average cost for a primary care visit was $186, and it was $169 for a pediatrician and $159 for a psychiatrist.  On the other end, an average bill for a trip to the orthopedist was $419 and to a cardiologist $335.  55% of all physician visits had no copayment.  This also varied across specialties, with 66% of pediatrician visits not having cost-sharing and 63% of ob/gyn appointments.  But only 44% of opthalmologist and 41% of dermatologist visits had no cost-sharing.  Median out-of-pocket payment for those visits with some cost-sharing was $30, with a range of $25 for pediatrician and primary care doctors to $40 for orthopedists, dermatologists and eye doctors.  Mean or average out-of-pocket payments were higher than median ones.  For example the average cost-sharing on a pediatric visit was $40 and for ophthalmologists it was $125.  Across payer types, as you might expect, Medicaid enrollees paid the least out-of-pocket, followed by Medicare beneficiaries, with commercial insureds having the greatest cost-sharing, and total expense for a visit followed a similar pattern.  There was some variation among specialties depending on payer type as well.  One take-away would be that there is less cost-sharing for doctor visits than one might expect, but this is probably overly influenced by the high number of people on Medicaid who have no cost-sharing in most cases.