Transcript Section 1: Minnesota Health Care Spending and Cost Drivers • Minnesota health care spending by source of funds • Minnesota health care spending by.

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Section 1: Minnesota Health Care Spending
and Cost Drivers
• Minnesota health care spending by source of
funds
• Minnesota health care spending by type of service
• Minnesota/U.S. health care spending
comparisons
• Minnesota private market trends: premiums,
spending, and cost drivers
A summary of the charts and graphs contained within is provided at Chartbook Summaries - Section 1.
Direct links are listed on each page. Please contact the Health Economics Program at 651-201-3550 or
[email protected] if additional assistance is needed for accessing this information.
MINNESOTA HEALTH CARE SPENDING
BY SOURCE OF FUNDS
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Minnesota Health Care Spending by Source of
Funds, 2012
Total Spending $39.8 Billion
Other Public
Spending**
6.0%
Private Health
Insurance
38.9%
Medicare
19.1%
Out-of-Pocket
12.4%
Other Private*
2.5%
Medical
Assistance
21.0%
*Other major private payers include private workers’ compensation and auto medical insurance.
**Major components of other public spending are MinnesotaCare, government workers’ compensation and
Veterans Administration.
Source: MDH Health Economics Program
Summary of graph
4
Minnesota Health Spending by Source of
Funds, 2008 to 2012, in Millions of Dollars
Public Spending, Total
2008
2009
2010
2011
2012
$14,901
$16,054
$16,785
$17,571
$18,398
Medicare
$6,165
$6,564
$6,887
$7,158
$7,626
Medicaid
$6,543
$7,006
$7,322
$8,047
$8,374
Other Public Spending
$2,193
$2,484
$2,575
$2,366
$2,398
Private Spending, Total
Private Health Insurance
Out-of-Pocket
Other Private
Total
$20,598
$20,909
$20,769
$20,729
$21,425
$14,884
$15,155
$15,149
$15,015
$15,491
$4,775
$4,779
$4,657
$4,749
$4,932
$939
$975
$963
$966
$1,002
$35,500
$36,963
$37,554
Note: Detail may not sum to total due to rounding. Revisions to historic time series may lead to slight variation
from previously published estimates.
Source: MDH Health Economics Program
$38,301
$39,823
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Shares of Minnesota Health Spending by
Source of Funds, 2008 to 2012
2008
2009
2010
2011
2012
42.0%
43.4%
44.7%
45.9%
46.2%
Medicare
17.4%
17.8%
18.3%
18.7%
19.1%
Medicaid
18.4%
19.0%
19.5%
21.0%
21.0%
Other Public Spending
6.2%
6.7%
6.9%
6.2%
6.0%
58.0%
56.6%
55.3%
54.1%
53.8%
Private Health Insurance
41.9%
41.0%
40.3%
39.2%
38.9%
Out-of-Pocket
13.5%
12.9%
12.4%
12.4%
12.4%
Other Private
2.6%
2.6%
2.6%
2.5%
2.5%
100.0%
100.0%
100.0%
100.0%
100.0%
Public Spending
Private Spending
Total
Note: Detail may not sum to 100% due to rounding. Revisions to historic time series may lead to slight
variation from previously published estimates.
Source: MDH Health Economics Program
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Public Spending for Health Care in Minnesota:
Federal, State, and Local Shares, 2012
Total Public Spending $18.7 Billion
State, 26.5%
Federal, 72.4%
Local, 1.0%
Source: MDH Health Economics Program
Summary of graph
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Public Programs’ Share of Population vs. Share
of Health Care Spending, 2012
60%
50%
46.2%
40%
31.0%
30%
20%
10%
0%
Public Enrollment as % of Population
Source: MDH Health Economics Program
Summary of graph
Public Spending as % of Total Spending
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Minnesota Health Care Spending per Person
by Payment Source, 2012
$15,000
$11,420
$10,000
$10,746
$9,120
$4,561
$5,000
$4,333
$917
$0
Medicare*
#
MA
MNCare
MCHA*
Private health Out-of-pocket
insurance*
*Excludes Medicare Supplement insurance.
# Excludes portion of expenses paid by Medicare Advantage enrollee premiums
MA is Medical Assistance, GAMC is General Assistance Medical Care, MCHA is Minnesota Comprehensive Health
Association. Individuals with dual coverage are included in each of the respective coverage options.
Source: MDH Health Economics Program
Summary of graph
9
Shares of Health Care Spending Paid for by
Businesses, Government, and Individuals, 2012
Individuals
26.4%
Government
46.9%
Businesses
26.7%
Health care spending by local and state government employers included in the business spending for
health care.
Source: MDH Health Economics Program
Summary of graph
MINNESOTA HEALTH CARE SPENDING
BY TYPE OF SERVICE
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Minnesota Health Care Spending by Type of
Service, 2012 Total Spending $39.8 Billion
Chemical/Mental
Non-medical,
Health, 2.5%
5.7%
Long Term Care*,
15.1%
Other Medical,
8.2%
Hospital Care,
34.9%
Prescription
Drugs, 8.6%
Dental Services,
3.2%
*Includes home health care
Source: MDH Health Economics Program
Summary of graph
Physician
Services, 19.2%
Other
Professional
Services, 3.4%
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Minnesota Health Care Spending by Type of
Service, 2008 to 2012, in Millions of Dollars
Type of Service
2008
2009
2010
2011
2012
Inpatient Hospital
$7,340
$7,588
$7,577
$7,570
$7,910
Outpatient Hospital
$4,274
$4,585
$5,035
$5,388
$5,970
Physician Services
$7,207
$7,225
$7,342
$7,323
$7,648
Long Term Care (incl. Home Care)
$5,403
$5,644
$5,740
$5,937
$6,016
Prescription Drugs
$3,469
$3,687
$3,451
$3,280
$3,423
Dental
$1,385
$1,290
$1,246
$1,263
$1,290
Other Professional Services
$1,151
$1,218
$1,105
$1,245
$1,359
Chemical/Mental Health
$824
$918
$947
$966
$1,007
Other Medical Spending
$2,720
$2,901
$3,084
$3,263
$3,263
Other non-Medical Spending
$1,726
$1,906
$2,027
$2,067
$1,938
$35,500
$36,963
$37,554
$38,301
$39,823
4.8%
4.1%
1.6%
2.0%
4.0%
Total
Growth from previous year
Note: Revisions to historic time series may lead to slight variation from previously published estimates.
Source: MDH Health Economics Program
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Shares of Minnesota Health Care Spending by
Type of Service, 2008 to 2012
Type of Service
2008
2009
2010
2011
2012
Inpatient Hospital
20.7%
20.5%
20.2%
19.8%
19.9%
Outpatient Hospital
12.0%
12.4%
13.4%
14.1%
15.0%
Physician Services
20.3%
19.5%
19.6%
19.1%
19.2%
Long Term Care (incl. Home
Care)
15.2%
15.3%
15.3%
15.5%
15.1%
Prescription Drugs
9.8%
10.0%
9.2%
8.6%
8.6%
Dental
3.9%
3.5%
3.3%
3.3%
3.2%
Other Professional Services
3.2%
3.3%
2.9%
3.3%
3.4%
Chemical/Mental Health
2.3%
2.5%
2.5%
2.5%
2.5%
Other Medical Spending
7.7%
7.8%
8.2%
8.5%
8.2%
Other Non-Medical Spending
4.9%
5.2%
5.4%
5.4%
4.9%
100.0%
100.0%
100.0%
100.0%
100.0%
Total
Note: Revisions to historic time series may lead to slight variation from previously published estimates.
Source: MDH Health Economics Program
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Factors Accounting for Health Care Spending
Growth in Minnesota, 2002 to 2012
100%
80%
60%
40%
20%
0%
2002
2003
2004
2005
2006
2007
2008
2009
2010
-20%
-40%
Population growth
Inflation
Other factors
Note: Revisions to historic time series may lead to slight variation from previously published estimates.
Source: MDH Health Economics Program
Summary of graph
2011
2012
MINNESOTA/U.S. HEALTH CARE
SPENDING COMPARISONS
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Minnesota and U.S. Health Care Spending:
Where It Came From, 2012
38.9%
Private Health Insurance
34.8%
12.4%
12.5%
Out-of-Pocket
2.5%
4.1%
Other Private
21.0%
Medical Assistance
16.7%
19.1%
21.7%
Medicare
6.0%
Other Public Spending
10.1%
0%
5%
10%
15%
20%
Minnesota
25%
US
Sources: MDH Health Economics Program and Centers for Medicare & Medicaid Services (estimated
spending for health consumption expenditures).
Summary of graph
30%
35%
40%
45%
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Minnesota and U.S. Health Care Spending:
Where it Went, 2012
34.9%
33.5%
Hospital Care
19.2%
21.5%
Physician Services
15.1%
Long Term Care (incl. Home Care)
Minnesota
8.8%
U.S.
8.6%
10.0%
Prescription Drugs
3.2%
4.2%
Dental Services
3.4%
2.9%
Other Professional Services
15.6%
Other Spending
19.2%
0%
5%
10%
15%
20%
25%
Note: Some spending included in hospital services in the national estimate is defined as long term care spending
in the Minnesota estimates.
Sources: MDH Health Economics Program and Centers for Medicare & Medicaid Services (estimated
spending for health consumption expenditures).
Summary of graph
30%
35%
40%
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Health Care Spending Per Capita and as a
Share of the Economy, Minnesota and U.S.
2008
2009
2010
2011
2012
Minnesota
$6,713
$6,973
$7,071
$7,163
$7,403
U.S.
$7,421
$7,689
$7,919
$8,136
$8,389
Minnesota
13.5%
14.3%
14.0%
13.7%
13.5%
U.S.
15.3%
16.4%
16.4%
16.3%
16.2%
Per Capita Health Care Spending:
Health Care Spending as a Share of
the Economy:
Note: Revisions to historic time series may lead to slight variation from previously published estimates.
Sources: MDH Health Economics Program, Centers for Medicare & Medicaid Services (spending for
health consumption expenditures).
MINNESOTA PRIVATE MARKET TRENDS:
PREMIUMS, SPENDING, AND COST
DRIVERS
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Growth in Private Health Insurance Premiums
and Health Care Spending, Per Enrollee
% change from previous year
15%
10.7%
10%
7.1%
5%
7.3% 7.1%
5.9% 5.9%
5.8%
4.4%
3.4%
7.0%
6.2%
4.3%
4.2%
2.1%
1.3%
0.8%
2.9%
0.2%
0.6%
0%
2004
2005
2006
2007
2008
2009
2010
-1.2%
2011
-5%
Premiums
Expenses
Fully-insured market only.
Source: MDH Health Economics Program, analysis of annual medical-only reports from health plan companies.
Revisions to historic time series may lead to slight variation from previously published estimates.
Summary of graph
2012
2013
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Difference Between Per Person Premiums and
Spending as a Percent of Revenue
Premiums - Spending as % of
Premiums
10%
8.1%
8%
5.7%
6%
4.5%
4%
4.4%
3.8%
3.5%
2.4%
2%
2.2%
1.2%
-0.1%
0%
2004
2005
2006
2007
2008
2009
2010
2011
-2%
Fully-insured market only. A positive number indicates that premiums were higher than spending, and a negative
number indicates that spending was higher than premiums.
Source: MDH Health Economics Program, analysis of annual medical-only reports from health plan companies.
Revisions to historic time series may lead to slight variation from previously published estimates.
Summary of graph
2012
2013
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Key Minnesota Health Care Cost and
Economic Indicators, 2004 to 2013
15%
Per Capita Personal Income
Mpls-StP CPI
Avg. Weekly Wage
Health Care Cost PMPM
10%
5%
0%
2004
2005
2006
2007
2008
2009
2010
2011
2012
-5%
Health care cost is Minnesota fully-insured private health insurance spending per person and does not include enrollee out of
pocket spending for deductibles, copayments/coinsurance, and services not covered by insurance.
Sources: MDH Health Economics Program, analysis of annual medical-only reports from health plan companies; per capita
personal income from U.S. Department of Commerce, Bureau of Economic Analysis; inflation data from U.S. Department of
Labor, Bureau of Labor and Statistics, Consumer Price Index – All Urban Consumers (CPI-U), Minneapolis-St. Paul, data as
of July 2015; average weekly workers’ wages from Minnesota Department of Employment and Economic Development as of
July 2015.
Summary of graph
2013
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Total Cost Per Person and Health Plan &
Enrollee Shares
$877
$4,135
$854
$4,019
$818
$775
$3,855
2008
$3,902
2007
$740
$681
$548
2006
$3,873
2005
$3,647
2004
$3,500
$3,124
$486
$2,952
$2,000
$3,352
$3,000
$435
$4,000
$622
$5,000
2009
2010
2011
2012
2013
$1,000
$0
Health Plan Cost
Enrollee Cost
Fully-insured market only.
Source: MDH Health Economics Program, analysis of annual medical-only reports from health plan companies.
Revisions to historic time series may lead to slight variation from previously published estimates.
Summary of graph
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Health Care Cost Drivers: Spending and
Shares of Growth by Service, 2011 to 2013
30%
26.2%
25%
20.0%
20%
17.7%
15%
12.4% 12.5%
10%
5%
10.7%
9.6%
3.6%
4.2%
3.3%
4.1%
3.8%
1.2%
0%
Growth Rate
Share of Spending Growth
Note: Growth rates calculated as annual growth per enrollee over the 2-year period. “Other medical”
includes skilled nursing facilities, home health care, emergency services, services of health professionals
other than physicians and dentists, durable medical goods, and chemical dependency/mental health.
Source: MDH Health Economics Program, analysis of annual medical-only reports from health plan
companies.
Summary of graph
25
Additional Information from the Health
Economics Program Available Online
• Health Economics Program Home Page
(www.health.state.mn.us/healtheconomics)
• Publications
(www.health.state.mn.us/divs/hpsc/hep/publications/index.html)
• Health Care Market Statistics (Chartbook Updates)
(www.health.state.mn.us/divs/hpsc/hep/chartbook/index.html)
• Interactive Health Insurance Statistics
https://pqc.health.state.mn.us/mnha/Welcome.action
A summary of the charts and graphs contained within is provided at Chartbook Summaries - Section 1.
Direct links are listed on each page. Please contact the Health Economics Program at 651-201-3550 or
[email protected] if additional assistance is needed for accessing this information.