Performance Hub

Cost & Utilization Measures

STATEWIDE RATES

Cost is defined as the actual amount paid to the health care provider by the health plan and/or the patient. These charts look at the overall statewide cost per patient per month. Statewide cost includes all costs for patients who were attributed to a primary care provider, without adjustments for high-cost outliers. High-cost outliers are costs over $125,000 for any patient. These charts also show cost and comparison across different health care settings.

MEDICAL GROUP VARIATION

Total Cost of Care

There is a substantial difference in costs between medical groups. These charts evaluate the variation of risk-adjusted total cost, relative resource use, and price across medical groups. Total cost is driven by both the amount of resources used and the price of each resource. To better understand the reasons for cost variation, MNCM’s analysis separates total cost into these two components.

Total Cost of Care by Medical Group

Price vs Total Cost of Care

Use vs Total Cost of Care

Utilization

To further understand variation in resource use, MNCM’s analysis also includes variation across medical groups in the utilization of common categories of medical services, such as inpatient hospital admissions or radiology services.

REGIONAL ANALYSIS

Variation in total cost of care can be seen between regions in Minnesota. These charts evaluate risk-adjusted total cost, relative resource use, and price across the regions. This regional analysis is based on where patients live, not where they obtained services.