MN Community Measurement has published new information about how much Minnesota's medical groups are paid to provide more than 100 common healthcare services.
The program worked with health plans and provider organizations to develop the measure based on a request from Gov. Tim Pawlenty's Health Cabinet.
"This has been a great example of how we can work together as a community to give people information they can use about the cost of care," said Jim Chase, president of MN Community Measurement.
The new cost-of-care measure reports the average amount that health plans in Minnesota pay physicians and other healthcare providers to perform 103 healthcare services, including flu shots, colonoscopies and Caesarean sections. The measure does not include payments to hospitals and other facilities for services provided in those settings.
The data reveals a wide range of payments for some services. For example, physicians are paid between $325 and $1,354 for their services in conducting colonoscopies and between $29 and $236 for conducting group psychotherapy sessions.
Four health plans in Minnesota provided the data for the measure: Blue Cross Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne.
The measure includes amounts the health plans paid in 2008 for people who received their insurance coverage through their employers, but not for those enrolled in a government program such as Medicare or MinnesotaCare. Co-payment information is not included, either.
"Rising healthcare costs have to be addressed if we're going to achieve a sustainable healthcare system that we can afford now and 10 years from now," said Chase. "There are many factors that go into rising healthcare costs, including the number of services we use and the price we pay for them. This payment information is only a small part of it, but we think it is useful for consumers to see that there is a range in what healthcare providers are paid. They can use this information, along with quality information, their relationships with their caregivers, convenience and other factors to assess the overall value of the care they are receiving."
Providers are paid based on negotiations between medical groups and health plans. Many factors influence the amount, including the size of the medical group, the cost of doing business in that region of the state, the number of uninsured or under-funded patients seen by the medical group, the amount of medical education and training provided by the group, the degree to which the group has invested in new technology or additional staff to improve patient care and the types of patients the medical group sees.
"It's complex," said Chase, "but we think it's important for this information to be available not just to the health plans and the healthcare providers, but to consumers as well."
Photo obtained under Creative Commons licese - Ed.