Section 1: Minnesota Health Care Spending and Cost Drivers
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1 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 1 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 or health.hep@state.mn.us if additional assistance is needed for accessing this information.
2 MINNESOTA HEALTH CARE SPENDING BY SOURCE OF FUNDS
3 Minnesota Health Care Spending by Source of Funds, 2012 Total Spending $39.8 Billion 3 Private Health Insurance 38.9% Other Public Spending** 6.0% 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
4 Minnesota Health Spending by Source of Funds, 2008 to 2012, in Millions of Dollars Public Spending, Total $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 $20,598 $20,909 $20,769 $20,729 $21,425 Private Health Insurance $14,884 $15,155 $15,149 $15,015 $15,491 Out-of-Pocket $4,775 $4,779 $4,657 $4,749 $4,932 Other Private $939 $975 $963 $966 $1,002 Total $35,500 $36,963 $37,554 $38,301 $39,823 4 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
5 Shares of Minnesota Health Spending by Source of Funds, 2008 to Public Spending 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% Private Spending 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% Total 100.0% 100.0% 100.0% 100.0% 100.0% 5 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
6 Public Spending for Health Care in Minnesota: Federal, State, and Local Shares, 2012 Total Public Spending $18.7 Billion 6 State, 26.5% Federal, 72.4% Local, 1.0% Source: MDH Health Economics Program
7 Public Programs Share of Population vs. Share of Health Care Spending, % 7 50% 46.2% 40% 30% 31.0% 20% 10% 0% Public Enrollment as % of Population Public Spending as % of Total Spending Source: MDH Health Economics Program
8 Minnesota Health Care Spending per Person by Payment Source, 2012 $15,000 8 $10,000 $9,120 $11,420 $10,746 $5,000 $4,561 $4,333 $917 $0 # Medicare* MA MNCare MCHA* Private health 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 Out-of-pocket
9 Shares of Health Care Spending Paid for by Businesses, Government, and Individuals, 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
10 MINNESOTA HEALTH CARE SPENDING BY TYPE OF SERVICE
11 Minnesota Health Care Spending by Type of Service, 2012 Total Spending $39.8 Billion Non-medical, 5.7% Chemical/Mental Health, 2.5% 11 Long Term Care*, 15.1% Other Medical, 8.2% Hospital Care, 34.9% Prescription Drugs, 8.6% *Includes home health care Source: MDH Health Economics Program Physician Services, 19.2% Dental Services, 3.2% Other Professional Services, 3.4%
12 Minnesota Health Care Spending by Type of Service, 2008 to 2012, in Millions of Dollars Type of Service 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 Total $35,500 $36,963 $37,554 $38,301 $39,823 Growth from previous year 4.8% 4.1% 1.6% 2.0% 4.0% 12 Note: Revisions to historic time series may lead to slight variation from previously published estimates. Source: MDH Health Economics Program
13 Shares of Minnesota Health Care Spending by Type of Service, 2008 to Type of Service 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% Total 100.0% 100.0% 100.0% 100.0% 100.0% Note: Revisions to historic time series may lead to slight variation from previously published estimates. Source: MDH Health Economics Program
14 Factors Accounting for Health Care Spending Growth in Minnesota, 2002 to % 14 80% 60% 40% 20% 0% % -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
15 MINNESOTA/U.S. HEALTH CARE SPENDING COMPARISONS
16 Minnesota and U.S. Health Care Spending: Where It Came From, Private Health Insurance 38.9% 34.8% Out-of-Pocket 12.4% 12.5% Other Private 2.5% 4.1% Medical Assistance 16.7% 21.0% Medicare 19.1% 21.7% Other Public Spending 6.0% 10.1% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Minnesota Sources: MDH Health Economics Program and Centers for Medicare & Medicaid Services (estimated spending for health consumption expenditures). US
17 Minnesota and U.S. Health Care Spending: Where it Went, Hospital Care 34.9% 33.5% Physician Services 19.2% 21.5% Long Term Care (incl. Home Care) 8.8% 15.1% Minnesota U.S. Prescription Drugs 8.6% 10.0% Dental Services Other Professional Services 3.2% 4.2% 3.4% 2.9% Other Spending 15.6% 19.2% 0% 5% 10% 15% 20% 25% 30% 35% 40% 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).
18 Health Care Spending Per Capita and as a Share of the Economy, Minnesota and U.S. Per Capita Health Care Spending: Minnesota $6,713 $6,973 $7,071 $7,163 $7,403 U.S. $7,421 $7,689 $7,919 $8,136 $8,389 Health Care Spending as a Share of the Economy: Minnesota 13.5% 14.3% 14.0% 13.7% 13.5% U.S. 15.3% 16.4% 16.4% 16.3% 16.2% 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).
19 MINNESOTA PRIVATE MARKET TRENDS: PREMIUMS, SPENDING, AND COST DRIVERS
20 Growth in Private Health Insurance Premiums and Health Care Spending, Per Enrollee 15% 20 % change from previous year 10% 5% 0% 10.7% 7.1% 7.3% 7.1% 7.0% 5.9% 5.9% 5.8% 6.2% 4.4% 4.2% 4.3% 3.4% 2.9% 2.1% 1.3% 0.8% 0.2% 0.6% -1.2% % 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.
21 Difference Between Per Person Premiums and Spending as a Percent of Revenue 10% 21 Premiums - Spending as % of Premiums 8% 6% 4% 2% 0% -2% 8.1% 5.7% 4.5% 4.4% 3.8% 3.5% 2.4% 2.2% 1.2% -0.1% 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.
22 Key Minnesota Health Care Cost and Economic Indicators, 2004 to % Per Capita Personal Income Mpls-StP CPI Avg. Weekly Wage Health Care Cost PMPM 22 10% 5% 0% % 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.
23 Total Cost Per Person and Health Plan & Enrollee Shares $5, $4,000 $3,000 $435 $486 $548 $622 $681 $740 $775 $818 $854 $877 $2,000 $1,000 $2,952 $3,124 $3,352 $3,500 $3,647 $3,873 $3,902 $3,855 $4,019 $4,135 $ 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.
24 Health Care Cost Drivers: Spending and Shares of Growth by Service, 2011 to % 25% 26.2% 24 20% 20.0% 17.7% 15% 10% 9.6% 12.4% 12.5% 10.7% 5% 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.
25 25 Additional Information from the Health Economics Program Available Online Health Economics Program Home Page ( Publications ( Health Care Market Statistics (Chartbook Updates) ( Interactive Health Insurance Statistics 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 or health.hep@state.mn.us if additional assistance is needed for accessing this information.
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