Transcript Key Facts About Minnesota Health Care Markets For more information: www.health.state.mn.us/healtheconomics/ Health Care Cost Trends in Minnesota.

Key Facts About Minnesota Health
Care Markets
For more information:
www.health.state.mn.us/healtheconomics/
Health Care Cost Trends in
Minnesota
Minnesota Health Care Spending by Source
of Funds, 2005
Total Spending $29.4 Billion
Private Health
Insurance
43.5%
Other Public
Spending
7.0%
Medicare
14.6%
Medical
Assistance
17.8%
Out-of-Pocket
14.0%
Source: MDH Health Economics Program
Other Private
3.0%
Shares of Minnesota Health Spending by
Source of Funds, 2001-2005
2001
2002
2003
2004
2005
39.7%
40.4%
39.6%
39.8%
39.4%
Medicare
14.6%
14.3%
13.8%
14.2%
14.6%
Medicaid
18.2%
18.9%
18.7%
18.6%
17.8%
7.0%
7.2%
7.1%
7.1%
7.0%
60.3%
59.6%
60.4%
60.2%
60.6%
Private Health Insurance
41.0%
41.2%
42.6%
42.7%
43.5%
Out of Pocket
15.2%
14.7%
14.5%
14.4%
14.0%
Other Private
4.0%
3.7%
3.3%
3.1%
3.0%
100.0%
100.0%
100.0%
100.0%
100.0%
Public Spending
Other Public Spending
Private Spending
Total
Note: Detail may not sum to 100% due to rounding.
Source: MDH Health Economics Program
Public Spending for Health Care in
Minnesota: Federal, State, and Local
Shares, 2005
Total Public Spending in 2005: $11.6 Billion
State
30.2%
Federal
68.3%
Local
1.5%
Source: MDH Health Economics Program
Minnesota Health Care Spending by Type
of Service, 2005
Total Spending $29.4 Billion
Other Spending
15.2%
Hospital Care
29.3%
Prescription Drugs
11.9%
Long Term Care
(including Home
Care)
15.4%
Physician Services
21.7%
Source: MDH Health Economics Program
Other Professional
Services
3.1%
Dental Services
3.5%
Shares of Minnesota Health Care Spending
by Type of Service, 2001 to 2005
Type of Service
Inpatient Hospital
2001
2002
2003
2004
2005
20.1%
19.9%
19.8%
19.6%
19.7%
Outpatient Hospital
7.5%
8.0%
8.4%
8.8%
9.6%
Physician Services
22.6%
22.7%
22.5%
21.2%
21.7%
Long Term Care (including Home
Care)
16.8%
16.8%
16.0%
15.9%
15.4%
Prescription Drugs
10.7%
11.4%
12.1%
12.5%
11.9%
Dental
3.4%
3.4%
3.6%
3.5%
3.5%
Other Professional Services
2.7%
2.7%
2.8%
3.0%
3.1%
16.2%
15.1%
14.9%
15.4%
15.2%
100.0%
100.0%
100.0%
100.0%
100.0%
Other Spending
Total
Source: MDH Health Economics Program
Health Care Spending Per Capita and as a
Share of the Economy, Minnesota and U.S.
2001
2002
2003
2004
2005
Per Capita Health Care Spending:
Minnesota
$4,232
$4,662
$5,128
$5,372
$5,742
U.S.
$4,825
$5,202
$5,577
$5,922
$6,276
Minnesota
11.1%
11.8%
12.5%
12.3%
12.7%
U.S.
13.6%
14.3%
14.8%
14.8%
15.0%
Health Care Spending as a Share
of the Economy:
Sources: MDH Health Economics Program, Centers for Medicare and Medicaid Services (spending for
health services and supplies)
Private Health Insurance Premium and Spending
Trends, 1995 to 2005
% change from previous year
Per Minnesota Resident With Private Health Insurance
16.0%
16%
12.1%
12%
8%
15.5%
12.9%
12.2%
10.1%
9.8%
8.8%
7.9%
7.3%
8.9%
9.0%
7.4%
6.8%
4.5%
4.3%
4%
11.2%
10.5%
2.1%
0.9%
1.0%
0.5%
0%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Premiums
Expenses
Source: MDH Health Economics Program. Fully-insured market only.
Percent change from previous year
Key Minnesota Health Care Cost and
Economic Indicators, 1995 to 2005
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
1995
1996
Health care cost
1997
1998
1999
2000
Per capita income
2001
2002
Inflation
2003
2004
2005
Workers' wages
Notes: health care cost is MN privately insured spending on health care services per person, and does
not include enrollee out of pocket spending for deductibles, copayments/coinsurance, and services
not covered by insurance..
Sources: Health care cost data from Minnesota Department of Health, Health Economics Program; per capita
personal income from U.S. Department of Commerce, Bureau of Economic Analysis; inflation data from
U.S. Bureau of Labor Statistics (consumer price index); workers’ wages from MN Department of Employment
and Economic Development
Total Cost Per Person and Health Plan/Enrollee
Shares, 1997 to 2005
Minnesota Fully-Insured Private Market
$4,000
$3,500
$489
$433
$3,000
$382
$340
$2,500
$2,000
$1,500
$1,000
$152
$197
$184
$221
$1,517
$1,637
$1,781
$2,011
1997
1998
1999
2000
$297
$2,217
2001
$2,560
$2,829
$3,039
$3,247
2003
2004
2005
$500
$0
Health Plan Cost
Source: MDH Health Economics Program.
2002
Enrollee Cost
Health Care Cost Drivers: Spending Growth and
Shares of Total Growth by Service, 2003 to 2005
Minnesota Fully-Insured Private Market
30%
24.2%
25%
20.9%
18.6%
20%
13.8%
15%
10%
13.1%
9.2%
7.1%
12.7%
10.7%
8.5%
8.2%
5.9%
5%
3.9%
0%
l
al
tal
ic a
pit
d
To
s
e
o
th
rm
the
tien
O
a
tp
Ou
l
l
s
n
al
ic a
ug
pita
pit
cia
r
d
i
s
s
d
e
s
o
y
ho
on
th
rm
Ph
nt
ip ti
ien
the
r
t
t ie
c
O
a
a
s
tp
Inp
Pre
Ou
mi
Ad
n.
Growth Rate
l
gs
ian
pita
s
d ru
s ic
o
y
n
h
h
t
P
tio
en
cr ip
ati
s
p
e
In
Pr
mi
Ad
n.
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.
Premium Increases in Minnesota’s Small
Group Market, 1999 to 2006
Percent Change in Premium Per Member
25%
19.6%
20%
16.5%
14.0%
15%
11.2%
9.4%
10%
7.0%
5%
4.5%
5.1%
2005
2006
0%
1999
2000
2001
2002
2003
2004
Sources: Minnesota Department of Health and Minnesota Health Coverage Reinsurance Association
Premium Increases in Minnesota's
Individual Market, 1999 to 2006
Percent Change in Premium Per Member
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
17.2%
16.4%
9.4%
7.9%
6.7%
5.4%
4.6%
2.7%
1999
2000
2001
2002
2003
2004
2005
Source: Minnesota Health Coverage Reinsurance Association and Minnesota Department of
Health
2006
Health Insurance Coverage in
Minnesota
Distribution of Minnesota Population by Primary
Source of Insurance Coverage, 2005
Total Population 5.1 Million
Uninsured
7.4%
Private Health Insurance: 67.5%
Fully insured
27.3%
Self-insured
40.2%
MA, GAMC,
MNCare
11.0%
Medicare
13.5%
MCHA
0.6%
Source: MDH Health Economics Program
Private Health Insurance: Enrollment in Fully
Insured and Self-Insured Plans, 1997 to 2005
Percent of Privately Insured Minnesotans with Fully-Insured vs
Self-Insured Plans
70%
60%
50%
40%
30%
20%
10%
0%
1997
1998
1999
2000
Fully Insured
Source: MDH Health Economics Program
2001
2002
2003
Self-Insured
2004
2005
Private Health Insurance: Enrollment in Large
Group, Small Group, and Individual Coverage,
2004
Individual
6.3%
Small Group
12.9%
Large Group
80.8%
Source: MDH Health Economics Program
Percent of Minnesota Businesses Offering
Health Insurance, by Firm Size, 2006
100%
91.9%*
80%
97.0%*
71.2%*
58.4%
60%
42.3%*
40%
20%
0%
Fewer than 10
10 to 49
50 to 199
200 or more
*Indicates a statistically significant difference (95% level) from the rate for all firm sizes
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
All firm sizes
Percent of Minnesota Businesses Offering
Health Insurance, by Region, 2006
100%
80%
65.2%*
58.4%
60%
48.4%*
49.5%*
Northwest
Northeast
53.3%
40%
20%
0%
South
Twin Cities
*Indicates a statistically significant difference (95% level) from the statewide rate
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
Statewide
Percent of Employees Working for a Firm
That Offers Health Insurance, by Firm Size,
2006
99.4%*
100%
91.9%
88.6%
75.6%*
80%
60%
44.5%*
40%
20%
0%
Fewer than 10
10 to 49
50 to 199
200 or more
*Indicates a statistically significant difference (95% level) from the rate for all firm sizes
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
All firm sizes
Percent of Employees Working for a Firm
That Offers Health Insurance, by Region,
2006
100%
88.2%
85.4%
Northeast
South
80.8%*
90.4%
88.6%
Twin Cities
Statewide
80%
60%
40%
20%
0%
Northwest
*Indicates a statistically significant difference (95% level) from the statewide rate
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
Eligibility and Take-up Rates of Employer
Coverage by Firm Size, 2006
100%
81.7%* 79.6%*
80%
75.8% 74.4%
73.8% 75.1%
74.3%
77.7%
74.7% 76.6%
60%
40%
20%
0%
Fewer than 10
10 to 49
50 to 199
200 or more
% of employees eligible
% of eligible employees who enroll
*Indicates a statistically significant difference (95% level) from the rate for all firm sizes
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
All firm sizes
Eligibility and Take-up Rates of Employer
Coverage by Region, 2006
100%
80%
74.8% 78.1%
76.9% 79.7%
76.0% 76.8%
73.7%
75.5%
74.7%76.6%
60%
40%
20%
0%
Northwest
Northeast
South
Twin Cities
% of employees eligible
% of eligible employees who enroll
*Differences across regions are not statistically significant.
Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey
Statewide
Average Employer Contribution to
Premium for Single Coverage, by Firm Size,
2002
100%
85.9%
81.5%
85.2%
82.4%
83.0%
50 to 199
200 or more
All Firm Sizes
80%
60%
40%
20%
0%
Fewer than 10
10 to 49
Number of Employees in Firm
Differences in the employer contribution across firm sizes are not statistically significant.
Source: Minnesota Employer Health Insurance Survey, 2002
Average Employer Contribution to
Premium for Family Coverage, by Firm
Size, 2002
80%
70.2%
69.7%
61.9%
64.6%
67.0%
60%
40%
20%
0%
Fewer than 10
10 to 49
50 to 199
200 or more
Number of Employees in Firm
Differences in the employer contribution across firm sizes are not statistically significant.
Source: Minnesota Employer Health Insurance Survey, 2002
All Firm Sizes
Trends in Minnesota Small Group Health
Insurance Enrollment, 1994 to 2006
600,000
500,000
400,000
300,000
200,000
100,000
0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Note: Fully Insured market only.
Source: MDH, Health Economics Program; estimates based on data from various sources.
Per Person Annual Deductibles in the
Small Group Market, 2002 to 2005
(by share of total enrollment)
2002
2005
Range: $100 to $2,500
Range $100 to $5,000
Median: $500
Median: $500
No Deductible
65.6%
52.1%
Less than $500
16.1%
16.5%
$500 to $999
11.9%
16.9%
$1,000 to $1,999
6.2%
10.3%
$2,000 or More
0.2%
4.2%
100.0%
100.0%
Source: MDH, Health Economics Program
*Median calculation excludes enrollees with no deductible
Family Level Annual Deductibles in the
Small Group Market, 2002 to 2005
(by share of total enrollment)
2002
2005
Range: $200 to $5,000
Range: $200 to $10,000
Median: $1,000
Median: $1,000
No Deductible
65.6%
52.1%
Less than $500
0.9%
2.0%
$500 to $999
14.8%
14.4%
$1,000 to $1,999
12.0%
16.9%
6.8%
14.6%
100.0%
100.0%
$2,000 or More
Source: MDH, Health Economics Program
*Median calculation excludes enrollees with no deductible
Trends in Minnesota Individual Market
Enrollment, 1994 to 2006
300,000
250,000
200,000
150,000
100,000
50,000
0
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Source: MDH, Health Economics Program; estimates based on data from various sources.
Per Person Annual Deductibles in the
Individual Market, 2002 to 2005
(by share of total enrollment)
2002
2005
Range $50 to $10,000
Range $50 to $10,000
Median $1,000
Median $1,500
None
2.4%
2.4%
Less than $500
4.7%
2.9%
$500 to $999
23.9%
13.6%
$1,000 to $1,999
37.4%
40.4%
$2,000 to $2,999
19.4%
25.9%
$3,000 to $3,999
1.0%
3.5%
$4,000 to $5,999
6.6%
8.8%
$6,000 or More
1.2%
2.2%
Per Illness
3.4%
0.4%
100.0%
100.0%
Source: MDH, Health Economics Program
*Median calculation excludes enrollees with no deductible
Family Level Annual Deductibles in the
Individual Market, 2002 to 2005
(by share of total enrollment)
2002
2005
Range: $100 to $20,000
Range: $100 to $30,000
Median: $2,000
Median: $4,000
None
2.4%
2%
Less than $1,000
1.4%
3%
$1,000 to $2,999
21.9%
20%
$3,000 to $4,999
7.1%
38%
$5,000 to $6,999
2.7%
21%
$7,000 to $10,999
0.7%
4%
$12,000 or more
0.4%
10%
59.9%
0%
3.4%
0%
100%
100%
Dependent on Family Size
Per Illness
Source: MDH, Health Economics Program
*Median calculation excludes enrollees with no deductible
Uninsurance in Minnesota
Uninsurance Rate Trends in Minnesota
8%
7%
7.4%*
6.3%
6%
5.4%*
5.7%
5%
4%
3%
2%
1%
0%
1995
1999
2001
*Indicates statistically significant difference (95% level) from prior survey year.
Source: 1995, 1999, 2001, 2004 Minnesota Health Access Surveys
2004
Sources of Insurance Coverage in
Minnesota, 2001 and 2004
100%
5.7%
7.4%*
21.2%
25.1%*
90%
80%
4.7%
70%
4.6%
60%
50%
40%
62.9%*
68.4%
30%
20%
10%
0%
2001
Group
2004
Individual
Public
Uninsured
* Indicates statistically different at 95% level from 2001.
Source: Minnesota Health Access Surveys, 2001 and 2004 (preliminary). Estimates that rely solely on household
survey data differ slightly from annual estimates that include both survey and administrative data.
Sources of Health Insurance Coverage in
Minnesota by Age, 2004
100%
5.4%*
18.9%*
80%
20.4%*
5.0%
13.0%*
12.9%*
14.3%*
6.8%
3.5%*
11.6%*
16.2%*
4.6%
4.0%
0.3%*
25.1%
8.7%*
4.6%
6.0%
60%
7.4%
97.8%*
40%
69.2%*
70.1%*
77.0%*
71.6%*
62.9%
60.8%
20%
0.3%*
1.7%*
0%
0 to 17
18 to 24 25 to 34 35 to 54 55 to 64
65+
Group
Uninsured
Individual
Public
* Indicates statistically significant difference from rate for all ages.
Source: 2004 Minnesota Health Access Survey
All Ages
Sources of Health Insurance Coverage in
Minnesota by Income, 2004
100%
20.5%*
14.1%*
1.9%*
10.1%*
3.7%*
4.7%*
8.6%
18.4%*
80%
23.9%
7.4%
25.1%
5.2%
46.9%*
60%
4.6%
5.7%
61.2%*
84.3%*
40%
5.6%
71.7%*
62.9%
61.8%
20%
3.1%*
33.5%*
15.2%*
0%
Up to 100%
101 to 200%
201 to 300%
301 to 400%
More than
400%
Income as % of Federal Poverty Guidelines
Group
Individual
Public
* Indicates statistically significant difference from rate for all incomes.
Source: 2004 Minnesota Health Access Survey
Uninsured
All Incomes
Sources of Health Insurance Coverage in
Minnesota by Race/Ethnicity, 2004
100%
5.9%
7.4%
9.8%
12.8%*
21.0%*
23.8%
80%
34.2%*
25.0%
4.8%
45.2%*
60%
25.1%
4.6%
6.5%
37.9%*
28.8%
1.1%*
40%
0.6%*
65.5%
1.5%*
62.9%
58.7%
20%
40.5%*
41.0%*
35.5%*
0%
White
Black
Group
Asian
Individual
American Indian
Public
Hispanic
Uninsured
* Indicates statistically significant difference from rate for all race/ethnicities.
Source: 2004 Minnesota Health Access Survey
All
Race/Ethnicities
Uninsurance Rates by Economic
Development Region, 2001 and 2004
EDR1 Northwest
EDR2 Headwaters
EDR3 Arrowhead
EDR4 West Central
EDR5 North Central
EDR6 Mid-Minnesota
EDR7 Upper MN Valley
EDR8 East Central
EDR9 Central
EDR10 Southwest
EDR11 South Central
EDR12 Southeast
EDR13 Twin Cities
Statewide
8.0%
6.0%
10.9%
10.7%^
8.5%
6.5%
10.0%
7.3%
9.2%^
11.2%
7.3%
7.3%
9.4%
5.5%
4.3%
9.3%*
5.0%
5.2%^
9.1%
5.1%
5.0%
3.4%^
6.0%
5.4%^
5.7%
5.7%
0%
2%
4%
6%
2001
*Indicates statistically significant difference (95% level) from 2001.
^Indicates statistically different at 95% level from state rate within year.
Source: Minnesota Health Access Surveys, 2001 and 2004
7.4%*
7.4%*
8%
2004
10%
12%
Income Distribution of Minnesota’s
Uninsured Population, 2001 and 2004
Family Income as % of
Federal Poverty Guidelines
Distribution of
Uninsured
Comparison:
State Population
2001
2004
2001
2004
0-100%
17.1%
26.3%*
6.9%^
9.5%*^
101-200%
35.4%
31.5%
15.3%^
16.6%*^
201-300%
22.9%
20.6%
19.6%^
17.7%*
301-400%
11.1%
11.9%
17.2%^
18.9%*^
401%+
13.5%
9.8%*
40.9%^
37.3%*^
100.0%
100.0%
100.0%
100.0%
*Indicates statistically different at 95% level from 2001.
^ Indicates statistically significant difference between uninsured and total population at 95% level within year.
Source: 2001 and 2004 Minnesota Health Access Surveys
Employment Characteristics of Minnesota’s
Uninsured Population, 2001 and 2004
Comparison:
State Population
Distribution of
Uninsured
2001
Employed
2004
2001
2004
72.6%
69.9%
75.0%
72.3%*
20.9%
22.6%
4.9%^
8.4%*^
0 to 10 hours
1.3%
1.2%
1.4%
1.4%
11 to 20 hours
7.9%
7.2%
5.0%^
5.6%
21 to 30 hours
15.0%
16.7%
6.7%^
7.0%^
31 to 40 hours
47.7%
45.9%
48.4%
50.0%
More than 40 hours
28.1%
29.0%
38.4%^
36.0%*^
100.0%
100.0%
100.0%
100.0%
Of Those Who Are Employed:
Temporary/Seasonal Job
Number of Hours Worked Per Week
For uninsured children, refers to parent
* Indicates statistically different at 95% level from 2001.
^ Indicates statistically significant difference between uninsured and total population at 95% level within year.
Source: 2001 and 2004 Minnesota Health Access Surveys
Employment Characteristics of Minnesota’s
Uninsured Population, 2001 and 2004: Size of
Employer
Distribution of
Uninsured
2001
2004
Comparison:
State Population
2001
2004
Size of Employer
Self employed
13.4%
9.3%*
6.5%^
5.2%*^
Fewer than 10 employees
26.8%
26.8%
13.1%^
13.4%^
11 to 50 employees
16.5%
19.6%
14.4%
13.4%^
51 to 100 employees
10.1%
15.0%
8.0%
10.6%*^
101 to 500 employees
14.0%
12.8%
16.6%
17.6%^
More than 500 employees
19.2%
16.7%
41.4%^
39.7%^
100.0%
100.0%
100.0%
100.0%
For uninsured children, refers to parent
* Indicates statistically different at 95% level from 2001.
^ Indicates statistically significant difference between uninsured and total population at 95% level within year.
Source: 2001 and 2004 Minnesota Health Access Surveys
Racial/Ethnic Distribution of Minnesota’s
Uninsured Population, 2001 and 2004
Distribution of Uninsured
Comparison: State Population
2001
2004
2001
2004
White
75.7%
70.1%*
90.7%^
88.7%*^
Black
12.0%
7.6%*
4.2%^
4.4%^
American Indian
5.1%
5.6%
1.7%^
2.0%^
Asian
3.9%
4.8%
3.2%
3.6%
Other
1.0%
0.2%*
0.4%
0.1%*
Hispanic
9.0%
15.1%*
2.9%^
3.3%^
See note
See note
See note
See note
Distribution adds to more than 100% since individuals were allowed to choose more than one race/ethnicity.
* Indicates statistically different at 95% level from 2001.
^ Indicates statistically significant difference between uninsured and total population at 95% level within year.
Source: 2001 and 2004 Minnesota Health Access Surveys
Access to Employer Coverage: Offer, Eligibility,
and Take-up Rates, 2001 and 2004
Non-Elderly Minnesotans' Access to Employer-Based Insurance
100%
84.1%
97.7% 95.7%*
95.3% 95.0%
Eligibility Rate 2
Take-up Rate 3
80.3%*
80%
60%
40%
20%
0%
Employer Offer 1
2001
2004
1: Person works for or has a family member who works for an employer that offers health insurance.
2: Percent of those with a connection to an employer that offers coverage who are eligible for health insurance coverage offered
by that employer.
3: Percent of those eligible for employer coverage who enroll.
*Indicates statistically different at 95% level from 2001.
Source: 2001 and 2004 Minnesota Health Access Surveys
Minnesota’s Uninsured: Potential Access
to Coverage, 2001 and 2004
70%
59.1%*
60%
50.9%
50%
40.0%
40%
38.5%
32.0%
30%
23.6%
25.9%*
20.1%
20%
10%
0%
1
Employer Offer
Employer Eligible
2
2001
Potentially Public
Eligible
3
Not Eligible for Employer
or Public Coverage
2004
1. Employer offer: percent of uninsured who work for or have a family member who works for an employer offering coverage.
2. Employer eligible: percent of uninsured who are eligible for coverage through an employer.
3. Potentially public eligible: based on family structure, income, and eligibility for employer coverage.
Note: The employer eligible, potentially public eligible, and not eligible for employer or public coverage categories add to more than 100
percent because some of the uninsured are potentially eligible for either employer or public coverage.
* Indicates statistically different from 2001 at 95% level.
Source: 2001 and 2004 Minnesota Health Access Surveys
Public Insurance Programs
Medicare Enrollment and Spending,
Minnesota and U.S.
Enrollment
Fiscal yr
Minnesota
U.S.
Expenditures
($ millions)
Minnesota
U.S.
Estimated spending per
enrollee
Minnesota
U.S.
1994
623,733
36,935,366
$2,116
$162,481
$3,392
$4,399
1995
630,521
37,535,024
$2,381
$180,088
$3,776
$4,798
1996
635,748
38,064,130
$2,265
$194,393
$3,563
$5,107
1997
639,293
38,444,739
$2,415
$207,156
$3,778
$5,388
1998
643,877
38,824,855
$2,442
$209,509
$3,792
$5,396
1999
648,272
39,140,386
$2,430
$208,648
$3,748
$5,331
2000
654,405
39,619,986
$2,509
$215,689
$3,834
$5,444
2001
660,399
40,025,724
$2,760
$237,269
$4,179
$5,928
2002
667,407
40,488,878
$2,937
$251,117
$4,400
$6,202
2003
676,156
41,086,981
$3,184
$274,054
$4,709
$6,670
2004
686,155
41,728,804
$3,486
$300,089
$5,080
$7,191
Sources: Enrollment data from Centers for Medicare and Medicaid Services as of July 1 each year.
Spending estimates by federal fiscal year from the U.S. Census Bureau, Consolidated Federal Funds
Report; specific estimates for MN developed by MDH using an adjustment for border crossing.
Minnesota’s Medicare Enrollment as
Percent of Population, by Region
Medicare Enrollment as % of Population, 2004
20%
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
19.0%
17.4%
19.0%
18.5%
15.5%
13.6%
13.4%
11.0%
Northwest Northeast
West
Central
Central Southwest Southeast
Twin
Cities
Total
Sources: Centers for Medicare and Medicaid Services, enrollment by county as of July 1, 2004; U.S.
Census Bureau, population by county as of July 1, 2004
% of Medicare enrollees in an HMO
Medicare Managed Care Enrollment
Trends, Minnesota and U.S.
25%
20%
15%
10%
5%
0%
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Minnesota
U.S.
Source: Centers for Medicare and Medicaid Services, Medicare Managed Care Contract Reports for
December of each year and total enrollment as of July 1 each year.
Medical Assistance Enrollment and
Spending History
Growth in:
State
FY
Avg. Monthly
Enrollment
Spending
($ millions)
Avg. Monthly
Spending
per Enrollee
Enrollment
Total
Spending
Spending
per
Enrollee
1996
428,467
$2,805
$546
-1.1%
8.2%
9.5%
1997
414,585
$2,797
$562
-3.2%
-0.3%
3.1%
1998
387,891
$2,917
$627
-6.4%
4.3%
11.5%
1999
370,054
$2,997
$675
-4.6%
2.7%
7.7%
2000
367,737
$3,233
$733
-0.6%
7.9%
8.5%
2001
378,884
$3,582
$788
3.0%
10.8%
7.5%
2002
403,668
$4,136
$854
6.5%
15.5%
8.4%
2003
442,595
$4,761
$896
9.6%
15.1%
5.0%
2004
463,650
$4,991
$897
4.9%
4.8%
-0.1%
2005
482,861
$5,193
$896
4.0%
4.0%
0.0%
2006
498,406
$5,435
$909
3.2%
4.7%
1.4%
Source: Minnesota Department of Human Services
Medical Assistance Enrollment and
Spending Growth
% change from previous year
20%
15%
10%
5%
0%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
-5%
-10%
Enrollment
Total Spending
Source: Minnesota Department of Human Services.
Spending per Enrollee
Medical Assistance Enrollment and
Spending by Eligibility Category, 2005
10.9%
26.5%
19.5%
49.7%
69.6%
23.9%
Enrollment
Families with children
Spending
Disabled/Blind
Elderly
Source: Minnesota Department of Human Services, data for state fiscal year 2005
MinnesotaCare Enrollment and Spending
History
Growth in:
State
FY
Avg. Monthly
Enrollment
Spending
($ millions)
Avg. Monthly
Spending
per Enrollee
Enrollment
Total
Spending
Spending
per
Enrollee
1996
88,277
$80
$75
14.0%
41.7%
24.3%
1997
93,136
$98
$88
5.5%
23.2%
16.8%
1998
97,854
$108
$92
5.1%
10.5%
5.2%
1999
106,552
$164
$129
8.9%
51.7%
39.3%
2000
108,999
$187
$143
2.3%
13.8%
11.2%
2001
122,247
$240
$164
12.2%
28.3%
14.4%
2002
138,022
$351
$212
12.9%
46.3%
29.6%
2003
151,205
$435
$240
9.6%
23.8%
13.0%
2004
148,505
$487
$273
-1.8%
11.9%
14.0%
2005
141,822
$409
$240
-4.5%
-16.1%
-12.1%
2006
128,733
$438
$284
-9.2%
7.3%
18.2%
Source: Minnesota Department of Human Services
% change from previous year
MinnesotaCare Enrollment and Spending
Growth
80%
70%
60%
50%
40%
30%
20%
10%
0%
-10%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
-20%
-30%
Enrollment
Total Spending
Source: Minnesota Department of Human Services.
Spending per Enrollee
MinnesotaCare Enrollment by Eligibility
Category, 2006
Parents
31%
Adults without
children
23%
Children
45%
Source: Minnesota Department of Human Services, data for July 2006.
General Assistance Medical Care (GAMC)
Enrollment and Spending History
Growth in:
State
FY
Avg. Monthly
Enrollment
Spending
($ millions)
Avg. Monthly
Spending
per Enrollee
Enrollment
Total
Spending
Spending
per
Enrollee
1996
43,533
$153
$292
-18.1%
1.4%
23.9%
1997
38,428
$145
$314
-11.7%
-5.1%
7.5%
1998
31,113
$121
$324
-19.0%
-16.7%
2.9%
1999
26,794
$132
$411
-13.9%
9.5%
27.2%
2000
23,347
$128
$456
-12.9%
-3.4%
10.8%
2001
24,592
$135
$457
5.3%
5.5%
0.1%
2002
29,886
$182
$508
21.5%
35.3%
11.3%
2003
37,340
$248
$553
24.9%
36.1%
8.9%
2004
34,957
$246
$586
-6.4%
-1.0%
5.8%
2005
36,797
$237
$536
5.3%
-3.7%
-8.5%
2006
39,201
$289
$614
6.5%
22.1%
14.6%
Source: Minnesota Department of Human Services
GAMC Enrollment and Spending Growth
% change from previous year
40%
30%
20%
10%
0%
-10%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
-20%
-30%
Enrollment
Total Spending
Source: Minnesota Department of Human Services.
Spending per Enrollee
MCHA Enrollment and Spending History
Growth in:
Calendar
Year
Enrollment
as of 12/31
Claims
($ millions)
Avg. Monthly
Claims per
Enrollee
Enrollment
Total
Claims
Claims per
Enrollee
1994
33,477
$93
$224
-5.2%
6.4%
6.9%
1995
30,470
$95
$247
-9.0%
2.3%
10.0%
1996
27,552
$88
$252
-9.6%
-7.3%
2.2%
1997
26,314
$91
$281
-4.5%
3.6%
11.6%
1998
24,954
$90
$294
-5.2%
-0.5%
4.6%
1999
25,433
$102
$336
1.9%
12.3%
14.3%
2000
25,938
$112
$364
2.0%
10.3%
8.2%
2001
27,428
$125
$389
5.7%
11.2%
7.0%
2002
31,088
$141
$402
13.3%
13.3%
3.4%
2003
33,705
$175
$450
8.4%
23.9%
11.9%
2004
33,063
$205
$512
-1.9%
17.1%
13.6%
Source: Minnesota Comprehensive Health Association. Claims per enrollee estimated by MDH using average
of year-end enrollment figures.
MCHA Enrollment and Spending Growth
% change from previous year
30%
25%
20%
15%
10%
5%
0%
-5%
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004
-10%
-15%
Enrollment
Claims
Claims per enrollee
Source: Minnesota Comprehensive Health Association. Claims per enrollee estimated by MDH using average
of year-end enrollment figures.
MCHA Claims, Premiums, and Losses
Calendar
Year
Claims
($ millions)
Premiums
($ millions)
Losses
($ millions)
Premiums as
% of Claims
1994
$93
$54
$44
58.6%
1995
$95
$52
$49
55.3%
1996
$88
$49
$43
55.8%
1997
$91
$47
$48
52.2%
1998
$90
$48
$47
52.8%
1999
$102
$52
$57
51.1%
2000
$112
$59
$59
52.4%
2001
$125
$65
$66
52.2%
2002
$141
$77
$72
54.7%
2003
$175
$93
$90
53.4%
2004
$205
$107
$110
52.3%
Source: Minnesota Comprehensive Health Association.
Key Statistics on Minnesota Health
Plans
Health Plan Market Shares: Total FullyInsured Private Market, 2005
(Premium Volume: $5.24 billion)
40%
36.5%
35%
30%
27.5%
25%
21.0%
20%
15%
10%
7.2%
5%
2.4%
1.4%
1.2%
1.0%
0.6%
0.6%
0.5%
Assurant
United
Healthcare
Federated
Mutual
Mutual of
Omaha
State Farm
Mutual Auto
Bankers Life
& Casualty
0%
Blue Cross
Blue Shield
Medica
HealthPartners
Preferred
One
Note: Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of
Minnesota includes BCBSM and Blue Plus. Fully insured market only, market share based on premium volume.
Source: MDH Health Economics Program, analysis of MCHA Premium Database for 2005.
Other (214
companies)
Health Plan Market Shares: Small Group
Market, 2006
Total Premium Volume in 2006: $1.5 Billion
50%
45%
44.3%
40%
35%
30.7%
30%
25%
20%
17.5%
15%
10%
3.3%
5%
3.1%
0.5%
0.4%
0.3%
Time Ins. Co.
(formerly
Fortis)
Principal Life
Ins. Co.
Other (3
companies)
0%
Blue Cross
Blue Shield of
MN
Medica
HealthPartners PreferredOne
Federated
Mutual Ins. Co.
Note: Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of Minnesota includes
BCBSM and Blue Plus. Market shares based on premium volume; fully insured market only.
Source: Minnesota Department of Commerce, "Report of 2006 Loss Ratio Experience in the Individual and Small Employer Health Plan
Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations," June 2007.
Loss Ratio Experience in the Small Group
Market, 1997 to 2006
Total Market
Blue Cross
Medica
HealthPartners
100%
90%
80%
70%
Statutory minimum for large
companies
60%
50%
40%
30%
20%
10%
0%
1997
1998
1999
2000
2001
2002
Companies with common ownership have been combined for purposes of this analysis.
Source: Minnesota Department of Commerce loss ratio reports.
2003
2004
2005
2006
Health Plan Market Shares: Individual
Market, 2006
Total Premium Volume in 2006: $520 Million
70%
64.4%
60%
50%
40%
30%
20%
12.6%
11.6%
10%
5.9%
1.6%
1.5%
1.4%
0.9%
American
Family Mutual
Ins. Co.
World Ins. Co.
State Farm
Mutual
Automobile Ins.
Co.
Other (5
companies)
0%
Blue Cross
Blue Shield of
MN
Time Ins. Co. HealthPartners
(formerly
Fortis)
Medica
Note: Companies with common ownership were treated as one entity. For example, Time Ins. Co. includes Time Ins. Co. and John
Alden Life Ins. Co.. Market shares based on premium volume; fully insured market only.
Source: Minnesota Department of Commerce, "Report of 2006 Loss Ratio Experience in the Individual and Small Employer Health Plan
Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations ," June 2007.
Loss Ratio Experience in the Individual
Market, 1997 to 2006
Total Market
Blue Cross
Time Ins. Co. (formerly Fortis)
HealthPartners
110%
100%
90%
80%
70%
60%
Statutory minimum
for large companies
50%
40%
30%
20%
10%
0%
1997
1998
1999
2000
2001
2002
Companies with common ownership have been combined for purposes of this analysis.
Source: Minnesota Department of Commerce loss ratio reports.
2003
2004
2005
2006
Summary of HMO Financial Trends, 2002 to 2006
In Millions of Dollars
2002
Net Income
Total Revenue
Net Income as % of Revenue
2003
2004
$65.4
$128.9
$133.3
$63.5
$33.2
$4,213.8
$4,514.6
$4,506.8
$4,643.9
$5,028.5
1.6%
2.9%
3.0%
1.4%
0.7%
Minnesota products only. Definition of “total revenue” varies across years.
Source: MDH Health Economics Program analysis of HMO annual reports
2005
2006
Minnesota HMO Profitability by Product
Line, 2002 to 2006
Net Income as % of Revenue
20%
15%
10%
5%
0%
-5%
-10%
2002
2003
2004
2005
2006
Commercial
PMAP,
PGAMC,
MNCare
Medicare
MSHO
All Other
Total
0.7%
0.8%
1.0%
0.1%
-0.6%
1.3%
3.5%
4.6%
1.3%
-4.6%
3.0%
7.4%
3.9%
4.0%
4.4%
6.9%
7.7%
5.3%
6.5%
10.0%
9.3%
10.1%
15.1%
6.7%
8.8%
1.6%
2.9%
3.0%
1.4%
0.7%
Source: MDH Health Economics Program analysis of HMO annual reports
Minnesota Hospitals
Hospital Capacity in Minnesota, 2005
Number of
Hospitals
Available
Beds*
Occupancy
Rate Based
on Available
Beds
136
11,650
60.5%
Licensed
Beds**
Occupancy
Rate Based
on Licensed
Beds
Available
Beds Per
1,000
Population
16,392
43.0%
2.3
*Available beds is defined as “the number of acute care beds that are immediately available for use or
could be brought online within a short period of time.”
**Licensed beds is defined as “the number of beds licensed by the Department of Health, pursuant to
Minnesota Statutes, sections 144.50 to 144.58.”
Source: MDH, Health Care Cost Information System
Regional Hospital Capacity in Minnesota,
2005
Number
of
Hospitals
Available
Beds*
Occupancy
Rate Based
on
Available
Beds
Central
20
1,119
52.2%
1,390
42.0%
1.6
Metropolitan
26
5,700
72.4%
8,328
49.6%
2.1
Northeast
17
1,188
51.8%
1,465
42.0%
3.7
Northwest
13
447
38.7%
576
30.0%
2.3
South Central
15
553
42.8%
784
30.2%
1.9
Southeast
12
1,658
60.4%
2,613
38.3%
3.5
Southwest
24
627
26.8%
773
21.7%
2.8
West Central
9
358
40.5%
463
31.3%
1.9
136
11,650
60.5%
16,392
43.0%
2.3
Region
Total
Licensed
Beds**
Occupancy
Rate Based
on
Licensed
Beds
Available
Beds Per
1,000
Population
*Available beds is defined as “the number of acute care beds that are immediately available for use or could be brought
online within a short period of time.”
**Licensed beds is defined as “the number of beds licensed by the Department of Health, pursuant to Minnesota Statutes,
sections 144.50 to 144.58.”
Source: MDH, Health Care Cost Information System
Minnesota Hospital Visits and Admissions,
1995 - 2005
700,000
9,000,000
8,000,000
600,000
7,000,000
Admissions
6,000,000
400,000
5,000,000
300,000
4,000,000
3,000,000
200,000
2,000,000
100,000
1,000,000
0
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Inpatient Admissions
Source: MDH, Health Care Cost Information System
Outpatient Visits
Outpatient visits
500,000
Average Length of Stay (ALOS) in
Minnesota Hospitals, 1995 – 2005
Average length of stay (days)
6
5
4.8
4.7
4.6
4.5
4.5
4.5
4.4
4.3
4.3
4.2
4.2
1998
1999
2000
2001
2002
2003
2004
2005
4
3
2
1
0
1995
1996
1997
Source: MDH, Health Care Cost Information System
Trend in Outpatient Surgeries at Minnesota
Hospitals, 1995 - 2005
350,000
300,000
250,000
200,000
150,000
100,000
50,000
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: MDH, Health Care Cost Information System
Trend in Emergency Room Visits at
Minnesota Hospitals, 1995 - 2005
1,800,000
1,600,000
1,400,000
1,200,000
1,000,000
800,000
600,000
400,000
200,000
0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: MDH, Health Care Cost Information System
Net Income of Minnesota Hospitals, 1995 to
2005
$800
$706
$700
Millions of dollars
$616
$600
$500
$454
$403
$400
$351
$351
$370
$400
$347
$309
$300
$268
$200
$100
$0
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: MDH, Health Care Cost Information System
Minnesota Hospitals' Net Income as a
Percent of Revenue, 1995-2005
8%
7.3%
7%
6.6%
6.6%
6.5%
6.9%
6.1%
6%
5.4%
5.7%
5%
5.1%
5.3%
4.4%
4%
3%
2%
1%
0%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: MDH, Health Care Cost Information System
Sources of Patient Revenue for Minnesota
Hospitals, 2005
Payer
Percent of Total
Patient Revenue
Medicare
30.4%
State Programs (MA/GAMC/MNCare)
11.0%
Private Insurance
49.9%
Self-Pay
4.7%
Other
3.9%
Total
Source: MDH, Health Care Cost Information System
100.0%
Uncompensated Care Costs in Minnesota
Hospitals, 1996 to 2005
$250
$191
$200
$ Millions
$151
$150
$100
$81
$82
1996
1997
$98
$106
1998
1999
$123
$124
$125
$129
2000
2001
2002
2003
$50
$0
*Uncompensated care figures are adjusted by a cost to charge ratio.
Source: MDH, Health Care Cost Information System.
2004
2005
Uncompensated Care Trends in Minnesota
and the U.S., 1996 to 2005
Uncompensated Care as Percent of Hospital Operating Expenses
7%
6.1%
6%
6.0%
6.0%
6.2%
6.0%
5.6%
5.4%
5.5%
5.6%
5.6%
5%
4%
3%
2%
1.7%
1.6%
1.9%
2.0%
1.9%
1.8%
1.7%
1.6%
1.8%
2.0%
1%
0%
1996
1997
1998
1999
2000
Minnesota
2001
2002
2003
U.S.
*Uncompensated care figures are adjusted by a cost to charge ratio.
Source: MDH, Health Care Cost Information System; American Hospital Association
2004
2005
Uncompensated Care Trends for Rural and
Urban Minnesota Hospitals, 1996 to 2005
2.5%
2.0%
Uncompensated Care as Percent of Hospital Operating Expenses
2.0%
2.0%
1.9%
1.8%
1.9%
1.8%
1.8%
1.8%
1.7%
1.5%
1.5%
1.3%
1.7%
1.6%
1.6%
1.6%
2002
2003
1.8%
1.7%
1.9%
1.5%
1.3%
1.0%
0.5%
0.0%
1996
1997
1998
1999
Rural
2000
2001
Urban
*Uncompensated care figures are adjusted by a cost to charge ratio.
Source: MDH, Health Care Cost Information System.
2004
2005
Minnesota’s Largest Providers of Hospital
Uncompensated Care, 2005
Uncompensated Care as Percent of Hospital Operating Expenses
8%
7.5%
2.0%,
statewide
average
7%
6%
5%
4%
3.4%
2.6%
3%
2%
1.3%
1%
1.5%
1.8%
1.7%
1.0%
1.6%
1.3%
1.7%
0%
Hennepin
County
Medical
Center
Regions
Hospital
Fairview- Saint Marys
North
Abbott Saint Marys United
University Hospital Memorial Northwestern Medical
Hospital
Medical
Medical
Hospital
Center
Center
Center
*Uncompensated care figures are adjusted by a cost to charge ratio.
Source: MDH, Health Care Cost Information System.
St. Cloud Methodist
Other
Hospital Hospital Park Hospitals
Nicollet
(126
Health
Hospitals)
Services
Services Available in Minnesota Hospitals,
2005
Number of Hospitals
Services Available
Services Not available
Surgery
Inpatient Surgery
128
8
Outpatient Surgery
134
2
18
118
6
130
Outpatient Psychiatric Services
56
80
Detoxification Services
25
111
Computer Tomography (CT) Scanning Services
131
5
Magnetic Resonance Imaging (MRI) Services
128
8
Positron Emission Tomography (PET) Services
13
123
Single Photon Emission Computerized Tomography
(SPECT) Services
29
107
Renal Dialysis Services
41
95
Cardiac Catheterization Services
23
113
Open-Heart Surgery Services
Organ Transplant Services
Mental Health/Chemical Dependency Services
Diagnostic Radiology
Other Services
Source: MDH, Health Care Cost Information System
Physician Services
Estimated Number of Physicians Practicing
in Minnesota, 2005
Number of Physicians:
12,799
Primary Care Physicians
6,125
Specialty Physicians
6,674
Physicians per 100,000 Population:
249
Primary Care Physicians
119
Specialty Physicians
130
Source: MDH, Office of Rural Health & Primary Care
Estimated Number of Physicians Practicing in
Metro and Non-Metro Counties, 2005
Metro
Number of Physicians:
Non-Metro
Total
10,894
1,905
12,799
Primary Care Physicians
4,895
1,230
6,125
Specialty Physicians
5,999
675
6,674
293
135
249
Primary Care Physicians
132
87
119
Specialty Physicians
161
48
130
Physicians per 100,000 Population:
Metropolitan counties include the 21 Minnesota counties that are classified as part of a metropolitan statistical area.
Source: MDH, Office of Rural Health & Primary Care