According to an Observatory, surgeons, ophthalmologists, gynecologists and ENT sector 2 are the liberal doctors who make the most fee overruns.
The total amount of excess fees for physicians still on the rise! According to theCitizen observatory of out-of-pocket expenses in health (1), in 2014, more than 2.8 billion euros were billed to patients over and above the health insurance rates, an increase of 6.6% compared to 2012. A setback for the Healthcare Access Contract (CAS) set up in 2013, which was supposed to contain the evolution of fee overruns.
Concretely, even if certain tariff excesses have been curbed, more and more doctors are applying fee overruns. And with 2.5 billion euros (+ 7.7%), it is the specialists who remain the main beneficiaries of these overruns. Explanations.
Surgeons: + 10% since 2013
According to my data presented this Thursday morning, there are four specialties particularly affected by excess fees. There are more doctors in sector 2 than in sector 1: surgery, gynecology / obstetrics, ophthalmology and otolaryngology (ENT). And in 2014, it is the surgeons who remain the physicians whose remuneration is most linked to excess fees, both in percentage of practitioners concerned and in the amount of overruns invoiced.
Between 2012 and 2014, the excess fees for sector 2 surgeons rose from 595 to 651 million euros, an increase of 10%.
This increase results both from the increase in the number of practitioners in sector 2 (5,600, or + 4%), the number of procedures they performed (13 million, or + 7%) and the average amount overrun per act (€ 49.90, i.e. + 2%).
Ophthalmologists: excess acts are increasing
Another specialty in the viewfinder of the Observatory, ophthalmologists of sector 2 whose fee overruns increased by 8% between 2012 and 2014, from 361 to 389 million euros.
The average overrun per act, however, fell by 4%, from € 19.70 to € 18.90. But this decrease was offset by the significant increase in the number of procedures performed (20.5 million in 2014 against 18.3 million in 2012, an increase of 12%).
Gynecologists and ENT: the increase was contained
Finally, with 300 million euros in 2014, the increase in excess fees for obstetrician gynecologists in sector 2 has been contained at 2% since 2012. The excess per act has declined, from € 31.20 to € 29.70 € (- 5%), and the number of acts increased by 7%, to 10.1 million in 2014.
In ENTs, the amount of excess per procedure is almost stable, going from € 20.50 to € 20.70 (+ 1%). However, the total amount of overruns invoiced increased by 4%, to 96 million euros, again due to the increase in the number of acts (+ 3%).
(1) The Observatory brings together the Interassociative Collective on Health (CISS), the magazine 60 million consumers and the company Santéclair
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