decisionhealth Newsletters, Part B News - 2010 Issue 9 (September)
Benchmark of the Week: State-level E/M utilization per enrollee, 2008
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Article Overview
This article reviews state-level outpatient evaluation and management utilization using CMS claims and beneficiary enrollment data from 2008. It is aimed at readers interested in Medicare utilization benchmarking, geographic variation, and outpatient E/M service patterns across states, with a focus on broad utilization comparisons rather than coding policy.
Why This Topic Matters
It helps coders, analysts, and healthcare administrators understand how Medicare outpatient E/M service use varied across states and why comparative utilization benchmarks can matter for reporting and operational review.
What You Will Learn
- How state-level outpatient E/M utilization was benchmarked using CMS claims and enrollment data
- How utilization was normalized per Medicare enrollee to compare states
- What broad patterns of variation were observed across selected high- and low-utilization states
- What contextual factors may be considered when interpreting geographic variation in utilization
Who Should Read This
- Medical coders
- Coding auditors
- Healthcare analysts
- Practice managers
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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