On January 3, 2017, MinnPost published an article titled, “Minnesota health and medical experts cite greatest concerns — and hopes — for 2017.” In the article, several health and medical experts including Jim Chase, MN Community Measurement President, were asked to answer the following question: With a new administration taking over the White House, what is your greatest concern for your particular corner of the health/medical field in the coming year? What is your greatest hope?
“2017 will be a time of great opportunity to improve our health system. We can adopt a more efficient enrollment and purchasing system for people with high risks and those who need subsidies. We can expand payment methods that focus on patient outcomes and encourage less waste on treatments with marginal benefits. We can agree on better performance metrics across payers so we reduce the administrative burden on doctors while expanding transparency about their results. We can do more to reduce health disparities by race and income by providing more information that helps address both the social and care difference that cause these disparities. The greatest risk is people waiting to see what happens in Washington and not taking the actions we know have worked to give Minnesotans better care: focusing on patient and community needs, testing new processes and partnerships to improve outcomes, and sharing information on results.” — Jim Chase, president of Minnesota Community Measurement
[As seen in the Mankato Free Press] By Brian Arola, firstname.lastname@example.org, Oct 12, 2016
MANKATO — Medical care costs for insured patients in Minnesota rose by more than 5 percent last year, according to new data analysis.
The 5.6 increase in medical costs statewide is the biggest since the MN Community Measurement nonprofit started releasing cost of care data for medical groups two years ago.
The nonprofit measures costs by tallying insurance claims made by the more than 1.5 million patients enrolled in the four health plans available in Minnesota last year.
On top of being a larger increase than the 3.2 percent one highlighted in last year’s report, the uptick also far outpaces income increases for Minnesotans over the same time period.
Jim Chase, president of MN Community Measurement, said that’s a concern for families trying to keep up with medical costs.
“That’s worrisome when you think of how much pressure there is on families,” he said.
Higher costs in Greater Minnesota, where there are fewer options available to patients, are also a problem, he said.
The cost of care for insured patients at the medical groups included in the report ranged from $365 to $914 per month. Area medical facilities fell in the middle of the two marks. Mayo Clinic Health System in Mankato came in at $534 per month, a 2.9 percent increase from the previous year. Mayo facilities in St. James, Waseca and New Prague all came in lower per month — New Prague, at $461 per patient, being the lowest.
In a statement, Mayo Clinic Health System spokesman Micah Dorfner said measuring costs for care at destination centers such as Mayo Clinic can be complicated. While the clinic supports efforts to transparently measure costs for care, distinctions should be made in the data to reflect the difference between complex care and community care. As a health system, Dorfner said steps are being taken to mitigate costs.
“Mayo Clinic Health System continues to take significant steps to manage cost of care, including improving access, reducing costs and increasing transparency,” he said.
Mankato Clinic saw a larger increase in cost of care than the Mankato Mayo over the past year — 11.7 percent — but still had a lower overall cost at $490.
The increase from year to year could be explained by a variety of factors, said Randy Farrow, CEO of Mankato Clinic. Pharmacy costs, an unusual number of major medical procedures in a given year, or more visits associated with preventive care could all lead to higher costs for care, he said.
Of the factors the clinic can control, Farrow said it’s typical to have about a 2 to 3 percent increase in costs per year, mostly to make up for inflation and wage increases.
Pharmacy costs were one of the factors Farrow said the clinics don’t control — apart from their willingness to prescribe generic drugs — but they could still be attributed to the clinic in insurance claims. At a 9.3 percent increase, take-home pharmacy costs were the services with the largest increase from last year.
In an unintentional way, preventive care could also be a driver of increased costs. Farrow said if clinics are encouraging patients to be proactive with their health, it could lead to more visits to the clinic in a given year. More visits equal higher costs for care, although the short-term expense should be eclipsed by cost savings related to maintaining a healthier lifestyle in the following years.
Whatever the cause of the increases, Farrow said the transparent cost for care measures are good from both a patient and medical group perspective.
“It’s good to start having people see this data and be more transparent,” he said. “I think it’s going to make us all better and more competitive because we know price is an issue.”
The issue isn’t expected to go away next year either, Chase said. Premium hikes for individual insurance plans announced recently could foretell a similar increase in cost of care next year.
“I’m guessing we’ll see continued acceleration of health care costs, and that’s worrisome,” he said.
Follow Brian Arola @BrianArolaMFP.
Consumer Reports evaluates primary care physician groups on key performance measures
By Joel Keehn
March 29, 2016
Everyone needs a primary care doctor. That’s the person who knows you best, refers you to specialists, and follows up on care. But what do you look for when choosing a primary care doctor?
“For many people, the most important thing is that they like their doctor,” says John Santa, M.D., a medical consultant for Consumer Reports who has studied the qualities that make a good physician—and how to measure that—for more than two decades. “They want to feel that their doctor listens and understands them.”
Just as important, Santa says, is “whether your doctor is skilled at what he or she is paid to do—keep you healthy, help you recover from an illness or injury, or help you manage a chronic disease, like diabetes or high blood pressure.”
You might think it would be easy to find out how well physicians perform those essential functions. But it’s not, for several reasons.
To start, there’s the size of the doctor population: Almost a million practicing physicians are in the U.S. And roughly half are primary care doctors. Who is responsible for gathering information on them all?
At least as problematic: How is a doctor’s performance measured, anyway? After all, primary care doctors take on many tasks—from ordering cancer screening tests to treating infections, from managing chronic diseases such as heart disease to coordinating care with specialists. So which criteria exactly should they be judged on?
Once those questions get answered, how are physicians persuaded to share that information—or where can interested parties go to gather it? And how can the information be presented in a way that’s accepted by medical professionals as accurate and fair, and still be useful to patients?
White Minnesotans tend to receive better health care than people of color, a new report compiled by MN Community Measurement indicates.
Generally, white and Asian patients had the highest rates of optimal care, while American Indian and black patients usually had the lowest rates, according to the report. The analysis draws on data collected from Minnesota clinics and patients.
Jim Chase, president of MN Community Measurement, said the extent of the racial disparities varied widely by location.
“It’s not just that the results are different between whites and everybody else,” he said. “There are differences between different, new immigrant groups, and different results across different areas of the state.”
For example, the colon cancer screening rate for African-Americans is within 7 percentage points of the rate for whites, both in the east metro and northwest Minnesota.
“You contrast that to somewhere like southwest Minnesota and the gap is about 34 percentage points. It’s huge between African-Americans at the 35 percent rate (for colon cancer screening) and the white population at 69 (percent),” Chase said.
The report also assessed patient satisfaction, including whether patients felt respected and whether they would recommend their clinic to family and friends. Patients with better health outcomes typically rated their overall care experiences better as well.
By Michael Ollove, Stateline Chicago Sun Times
January 5, 2016
When walk-in health clinics started spreading rapidly in the mid-2000s, the nation’s biggest and most prestigious medical organizations voiced objections. They raised concerns about patient safety, gaps in patients’ medical records, conflicts of interest and disruptions of the relationship between patients and their doctors.
Doctors also worried that increased competition from the clinics would hurt their practices, which seldom could match the clinics’ convenient operating hours.
By Verna Gruessner, HealthPayer Intelligence
December 10, 2015
“Having a broader picture of the cost is critically important… Practices can compare themselves to others and take action to reduce overall costs.”
What’s the first step in addressing methods for reducing medical costs and strengthening healthcare delivery? Improving transparency behind healthcare spending as well as educating stakeholders in the financial aspects of the medical industry is one of the very first steps to take.
In pursuit of this goal, the Network for Regional Healthcare Improvement (NRHI) has brought a tremendous amount of energy to leading the Total Cost of Care project, which aims to identify the entire cost paid for healthcare services received at the individual level in a given period of time.
Mental health issues too often remain a hidden story, particularly in rural Minnesota, in which resources and health professionals are limited. For our children it becomes even more complex, but critically important that screenings are routinely done.
A recent state study revealed that only 40 percent of Minnesota teenagers are being screened for mental health conditions. The Minnesota Community Measurement and Minnesota Department of Health released the study, which considered two key health care issues: mental health condition screening for teenagers and obesity counseling for youths.
Despite moves by health insurers and the federal government toward providing publicly available information on physicians, most states fail when it comes to doctor transparency, a new report shows.
The Health Care Incentives Improvement Institute flunked 40 states and the District of Columbia with a grade of “F” while three other states received a “D,” which is also considered failing. This means nearly 90% of U.S. states aren’t providing easy access or any access to information to help consumers make informed choices when they pick a physician.
California joined Minnesota and Washington to earn an “A” grade for their quality reporting. Minnesota’s efforts are increasingly looked at as a model given statewide effort to compare doctor practices on several performance measures as well as a patient’s experience in the doctor’s office. The Minnesota HealthScores web site compares doctor practices on how well they get their patients’ preventive care and wellness screenings.
The other states with passing grades were Maine, which received a “B,” while “C” grades were awarded to Massachusetts, Oregon and Wisconsin.
The results are disappointing given the push by employers, insurers and consumer groups for more transparency, particularly as Americans face higher deductibles and related cost-sharing that force them to shop for better health care buys.
Health plans like Aetna, Anthem, Cigna and UnitedHealth Grouphave their own measurements health plan subscribers can access but consumers are often less trusting of insurance company rankings. The information from states earning passing grades from HCI3 ranking generally come directly from the doctor practice.
Only 40 percent of Minnesota youth received a mental health screening as part of their preventive checkups last year. Of those, 1 in 10 showed signs of depression or other mental health concerns, state officials said Thursday.
The results come from a first-ever analysis of Minnesota health clinics. The study shows clinics are doing well in counseling children on obesity but suggests they’re falling short on mental health evaluation.
Of the 98,000 3- to 17-year-olds in Minnesota who had a wellness exam last year, 29 percent were considered overweight or obese, slightly lower than the national average. Of those kids who were screened, 85 percent were counseled about nutrition and exercise by their provider the Minnesota Department of Health said.
While officials were encouraged by the nutrition counseling rate, they remain concerned about data indicating less than half the state’s clinics are screening adolescents for depression.
“When clinicians did screen for depression, they found 9.7 percent — or 4,300 of 43,400 young people screened — had indications of a mental health condition, such as depression, anxiety or attention disorders,” the department said, noting that “untreated depression in adolescence has been tied to an increase in social isolation, academic failure, teenage pregnancy, substance abuse, tobacco use and suicide.”
Fewer than half of adolescents taken to Minnesota clinics for well-child exams last year were screened for mental health or depression, according to a report released on Thursday.
But among the 43,400 youngsters who were screened, 4,300 — or 9.7 percent — had indications of a condition such as depression, anxiety or attention disorders, according to the report by the state Department of Health and MN Community Measurement, a nonprofit dedicated to publicly reporting health care information.
The screenings matter, said Sue Abderholden, executive director of the nonprofit National Alliance on Mental Illness Minnesota.
“One thing we forget is that mental illnesses are a young person’s illness,” Abderholden said. “Most people begin experiencing the symptoms before the age of 26 and half before the age of 14. With any illness, we know that identifying it early and treating it, that’s when you have the best outcome.”
Altru Health System patients and their health insurance providers pay more for their care on average compared with patients at regional competitors but pay close to the Minnesota statewide average, according to a recent report.
A 2015 MN Community Measurement report analyzing medical costs in the state and neighboring communities found Altru patients and their insurance plans pay an overall average cost of $502 per patient per month. That’s higher than patients of Fargo-based Sanford Health’s many Minnesota clinics and patients of rural clinics near Fosston and Crookston.
However, Altru patients and their plans pay an average amount compared with the overall average cost in Minnesota, which is $449 per patient per month, according to the organization’s Total Cost of Care report.