By Katharine Grayson, Staff reporter- Minneapolis / St. Paul Business Journal
Dec 18, 2014, 2:30pm CST
Which health provider Minnesotans choose to visit can have a big impact on the total cost of their medical care, according to a study released Thursday by nonprofit MN Community Measurement.
The study analyzed 115 primary care providers using health insurance claims data covering 1.5 million patients. The organization found notable differences in cost between providers.
At the lowest end was Moorhead-based Seven Day Clinic, with a monthly cost of $269. At the high end was Rochester-based Mayo Clinic, at $826 per month. Those dollar figures combined payments from insurers and patients. (See the organization’s full list here.)
This is the first time MN Community Measurement analyzed the state’s care providers using the total cost of care metric, which takes into account a full range of procedures a patient undergoes, including surgeries and lab work. The organization adjusted for risk, so health providers who treated sicker patients weren’t penalized.
Seven clinics provided care at lower-than-average costs and most of them were independently owned medical groups.
There’s been a lot of debate nationwide about whether consolidation drives up the cost of care partly because larger systems can command higher prices from insurers. MN Community Measurement didn’t set out to answer the question of whether a provider’s size influenced cost, said organization President Jim Chase.
A quick look comparing market share and prices show there may be at least some correlation, however.
As of Dec. 31, Minneapolis-based Allina Health was the dominant care provider in the Twin Cities market, with about 33 percent of the market. Minneapolis-based Fairview Health Services ranked second, with about 20 percent, and HealthPartners Inc. third, with 17 percent. Those health systems ranked out the same way when it came to cost: Allina at $434, a number that also was about equal to the average cost of care in the state; Fairview, $408 (six percent below average) and Bloomington-based HealthPartners, $392 (10 percent below average).
That wasn’t true in all cases for the metro area, however. For instance, University of Minnesota Physicians, based in Minneapolis, was among the state’s most expensive providers, with a monthly cost of $567. Also, HealthPartners cost less than many other small providers.
Minnesota’s largest health system merger in recent years was HealthPartners’ acquisition of St. Louis Park-based Park Nicollet Health Services. The health providers are still listed separately in Minnesota Community Measurement’s report. However, HealthPartners was less expensive: $392 compared to Park Nicollet’s $424.
MN Community Measurement may look into whether size plays a role in pricing in the future, Chase said. Overall, he hopes the study will make pricing more transparent for consumers and businesses.