USE OF THE MINNESOTA ALL PAYER CLAIMS DATA SET (MN APCD) Annual Meeting National Association of Health Data Organizations October 30, 2015 Stefan Gildemeister Director, Health Economics Program
2 Overview • Purposes the MN APCD has been built for • Applications of the MN APCD today • Examples • Next Steps • Longer term priorities
3 MN APCD Use: A Backward Bending Supply Curve • Economics 101: Labor supply grows with wage, until it contracts Other Research Applications • MN APCD: Transparency and broader research applications Price Transparency
4 Current Uses of the MN APCD, 2014 to 2016 Access Utilization Quality Health Care Cost SIM/Risk Disease Adj. Burden Evaluation Health Care Homes & Readm. MDH/Health Economics Program, Uses of the MN APCD, August 2015; http://www.health.state.mn.us/healthreform/allpayer/use_of_apcd_fact_sheet.pdf
5 Pain Management Services in MN: CRNAs Number of Procedures (11,600) Performed by CRNAs (253) 0.6% 100% 1.9% 6.0% 90% 26.1% 80% 26.9% 70% 25.7% 60% 50% 40% 21.3% 64.6% 30% 20% 22.1% 10% 4.7% 0% Percent of CRNAs Percent of Procedures 101+ Procedures 21 to 100 Procedures 6 to 20 Procedures 2 to 5 Procedures 1 Procedure MDH/Health Economics Program (2014), Chronic Pain Procedures in Minnesota, 2010-2012, Report to the MN Legislature, Jan. 2015
6 Potentially Preventable Health Care Events, 2012 1,400 Health Care Spending, in Mill $ 1,200 Emergency Room Visits 1,000 800 600 Hospital 400 Admissions Hospital 200 0 0 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000 Number of Health Care Events Source : MDH/Health Economics Program (2015), Potentially Preventable Health Care Events in Minnesota, 2012; July 2015.
7 Commercial Market Cost Drivers, 2011 to 2013 $800 Price $700 Volume 23.6% $600 Service Mix 7.8% $500 $400 Millions ($) 4.3% $300 31.7% 68.6% $200 80.8% 46.9% 64.0% $100 91.2% 53.8% $0 -0.7% -72.0% -$100 Total Inpatient Hospital Outpatient Hospital Professional -$200 Services Source: Mathematica Policy Research analysis of Minnesota commercial all-payer claims data; forthcoming in MDH/Health Economics Program (2015), Minnesota Health Care Spending and Projection: 2013.
8 Multi-morbidity of Chronic Disease and Health Care Spending, 2012 70% $90,000 $78,700 65.0% $80,000 60% Number of MN Residents w/Coverage $73,900 $70,000 $68,000 Annual Health Care Spending 50% $62,300 $60,000 $55,700 40% $50,000 $49,800 $44,600 $40,000 30% $38,600 $32,700 $30,000 $27,500 20% 15.0% $22,300 $20,000 $9,800 $17,600 $13,600 10% 7.0% 5.0% 3.0% 1.0% 1.0% 1.0% 0.0% 0.0% 0.5% 0.0% 0.0% 0.0% 0.0% 0.0% $10,000 $5,700 $1,600 0% $0 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15+ Percent w/Chronic Disease Annual Spending Source : MDH/Health Economics preliminary analysis of Minnesota All Payers Claims Data (MN APCD), Sept. 2015, forthcoming in: Minnesota Chronic Disease Atlas, 2012.
9 The Most Important Graph in Health Policy? Minnesota Health Spending is Concentrated Among the Highest Spenders (Minnesota Residents with Insurance Coverage, 2012) 100% 90% Cumulative Percent of Total Spending Top 2% of spenders account for 24% of Top 2% of spenders account for 24% of 80% spending spending 76.0% 70% 60% Top 5% of spenders account for 49% of Top 5% of spenders account for 49% of spending 51.1% 50% 40% 32.9% 30% 20% 17.1% 9.7% 10% 5.5% 3.0% 95 95 98 1.5% 0.0% 0.6% 0.1% 0% 0 10 20 30 40 50 60 70 80 90 100 Cumulative Percent Population Ordered by Health Care Spending Source : MDH/Health Economics preliminary analysis of Minnesota All Payers Claims Data (MN APCD), August 2014; chart adapted from NIHCM Foundation analysis.
10 Pediatric Health Care Use in MN, 2013 to 2014 ( Systematic Coefficient of Variation, MN Counties) Source : MDH/Health Economics preliminary analysis of Minnesota All Payers Claims Data (MN APCD), Sept. 2015, forthcoming: Pediatric Health Care Use in Minnesota, 2013 to 2014.
11 Other Ongoing Research • Low-value health care services • Prescription drug spending • Retail • Medical • Assessing State Innovation Model implementation in MN • Cost • Utilization • Epidemiological work • Traumatic brain injury • Readmissions for diabetes • Opioid Rx use • Antibiotic usage • Assessing Data Quality
12 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 • Minnesota APCD http://www.health.state.mn.us/healthreform/allpayer Contact the Health Economics Program at: 651-201-3550 or health.hep@state.mn.us
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