MN Community Measurement announced Wednesday it has published new information online about how much medical groups in Minnesota are paid to provide more than 100 common healthcare services.
The nonprofit organization, founded by Minnesota's health plans and the Minnesota Medical Association, already provides information on the quality of healthcare through its Web site. Officials said they worked with health plans and provider organizations to develop the new set of cost-of-care measures upon request by Minnesota 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, the organization's president.
The new cost-of-care measures report the average amount health plans in Minnesota pay physicians and other healthcare providers to perform 103 healthcare services, including flu shots, colonoscopies and Caesarean sections. The measures do not include payments to hospitals and other healthcare facilities for services provided in those settings.
Four health plans in Minnesota provided the data for the report: Blue Cross Blue Shield of Minnesota, HealthPartners, Medica and PreferredOne. The measures include amounts the health plans paid in 2008 for people who received their insurance coverage through their employers, but not for people enrolled in a government program such as Medicare or MinnesotaCare.
The data doesn't give consumers information about how much they will have to pay in copayments for the services. Consumers must consult with their health plans for that information.
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.
"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," Chase said. "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."
According to Chase, providers are paid ibased 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 underfunded 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," he said, "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."