Outpatient facility claims in HCCI’s analysis are for services provided at settings other than inpatient facilities or physicians’ offices. HCCI categorized outpatient facility claims as outpatient visits (emergency room (ER), outpatient surgery, observations) and outpatient services provided at other settings (laboratory/pathology, radiology, ancillary, and other categories). The categories varied in levels and rates of spending, prices, utilization, unit prices, and intensity. In 2011, the average facility price for an outpatient visit was $2,236, and the average facility price for outpatient services provided in other settings (“outpatient other”) was $185. Per 1,000 beneficiaries, outpatient visits totaled 326.
