The total cost of medical care in Minnesota showed only “moderate” growth in 2016, although “affordability continues to be a major concern.” These are among the key findings of the 2017 Cost and Utilization Report published by Minnesota Community Measurement (MNCM).
The report provides data on the cost of medical care and insights on some of the key drivers of rising prices.
The study found that the total cost of medical care increased 3.4 percent from 2015 to 2016 for commercially insured patients. The increase was significantly lower than the 5.6 percent jump recorded in the previous year and is moderate by historical standards, according to MNCM.
Among some of the key findings highlighted by MNCM are the following:
- Among the 122 medical groups examined in the report, the average total cost of care in 2016 was $490 per patient per month; however, the range was from $386 to $977 on a risk-adjusted basis (that is, the averages take into account that some medical groups have a larger share of patients needing more care).
- The cost for common medical procedures varies substantially across medical groups. One example cited by MNCM is the charge for reading an eye chart. While the average payment in 2016 was $6, it ranged from $4 to $46 depending on the medical group.
- The use of hospital emergency rooms has a three-fold difference in use across the state, even after adjusting for patient illness.
“Emergency room utilization had the highest correlation to total cost…Outstate utilization of the ER was 20 percent higher than the metro region, led by Mayo’s Rochester campus that had a 61 percent higher observed rate than expected,” wrote reporter Brett Boese in an article in the Rochester Post Bulletin.
The Post Bulletin reported that residents of southeastern Minnesota have substantially higher medical costs in general. “Residents of the Southeast Region pay an average of $601 per month, which is 22 percent higher than the Metro Region and 19 percent higher than the state average of $490.
“The (MNCM) report says Mayo Clinic and its regional facilities account for eight of Minnesota’s nine most expensive sites. The most expensive health care facility in the state is Mayo’s Rochester campus, which cost patients a risk-adjusted monthly average of $977 — almost exactly twice the state average,” according to the Post Bulletin.
“Better understanding of how much variation we have in our medical care system and what factors contribute to the variation is a starting point for strategies to make health care more affordable,” said MNCM President Julie Sonier in a statement accompanying the release of the study. “The measures in this report provide unique insight for comparing and taking actions to manage and reduce health care costs.”
The report uses data from 2016 health insurance claims of more than 1.5 million commercially-insured patients (i.e. those with private health insurance, both individual and employer-sponsored) enrolled with four Minnesota health plans: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne.