CLAIMS DATA SET (MN APCD) Annual Meeting National Association of - PowerPoint PPT Presentation

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