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Resource Use (Cost/Utilization) Measurement and Reporting in Minnesota

        In order to maintain current measures of providers’ health care utilization, Minnesota law requires all licensed health care providers to collect and provide descriptive and financial aggregate data on patients.  Included in the data providers are required to collect is information regarding the number of patients served, revenue by type of payer, and other sources of revenue.1  In addition, the law requires the total cost, expenditures, and services of all hospitals and health centers should be reported to the public in a way that is easily understandable by the Commissioner of Health.2  Minnesota also requires cost reporting by nursing home facilities receiving Medicare or Medicaid payments.  The reporting must include statistical data, financial statements, and other accounting information.3  In order to gain further knowledge on health care costs within the state, Minnesota law requires state agencies that administer health programs to submit additional health information to the Commissioner if requested, in order to set spending limits and monitor actual amounts spent.4

        Minnesota also encourages health care performance measurement.  The law creates a Center for Health Care Purchasing Improvement within the Department of Health to assist the state in purchasing high quality health care services in order to make cost and quality more transparent, create more accountability for health care outcomes, and identify barriers to efficient, effective quality health care.5  Furthermore, the law authorizes a pilot program that compares data from different providers to observe the barriers and opportunities of having health care quality and cost effectiveness.6  Since Minnesota has taken steps toward the implementation of health care homes, the law requires an evaluation of health care homes, including along their performance and quality, preventative care measures, payment arrangements, and estimated cost savings from implementing the health care home model.7  Similarly, the state of Minnesota has instituted payment reforms that reward high quality, low cost providers and create incentives for those enrolled in state health care programs to receive care from such providers.8

 

Footnotes

  • 1. M.S.A. §62J.41; MN ADC 4651.0110
  • 2. M.S.A. §144.701
  • 3. MN ADC 9549.0041
  • 4. M.S.A. §62J.40
  • 5. M.S.A. §62J.63
  • 6. M.S.A. §62J.322
  • 7. M.S.A. §256B.0752
  • 8. M.S.A. §256B.0753; M.S.A. §256B.0754

 

Resource Use (Cost/Utilization) Measurement and Reporting in Minnesota

Subtopic Statute/Regulation Description
Resource Use (Cost/Utilization) Measurement and Reporting M.S.A. § 144.698 Reporting requirements If a hospital or outpatient surgical center has not filed its financial information with a voluntary, nonprofit reporting...
M.S.A. § 144.701 Rate disclosure The Commissioner of Health must ensure that total costs, total revenues, overall utilization, and total services for each hospital...
M.S.A. § 62J.052 Provider cost disclosure Each pharmacy must provide the following information to a patient upon request: The pharmacy’s usual and...
M.S.A. §144.701 Rate Disclosure The total cost, expenditures, and services of all hospitals and health centers should be reported to the public in a way that is...
M.S.A. §256B.0752 Health care home reporting requirements An annual report of the implementation and administration of the health care homes must be submitted to the...
M.S.A. §256B.0753 Payment restructuring; care coordination payments The Commissioner of Human Services must establish a payment system that gives per person...
M.S.A. §256B.0754 Payment reform The Commissioner of Human Services must establish quality incentive payments for all those enrolled in state health care programs....
M.S.A. §62J.322 Provider Information Pilot Study A pilot program that compares data from different providers to observe the barriers and opportunities of having...
M.S.A. §62J.40 Cost containment data from state agencies and other governmental units State agencies that administer health programs may be required to submit...
M.S.A. §62J.41 Data from Providers Providers are required to collect and provide patient specific information as well as descriptive and financial aggregate data on...
M.S.A. §62J.63 Center for Health Care Purchasing Improvement   The law creates a Center for Health Care Purchasing Improvement within the Department of Health...
M.S.A. §62U.02 Payment restructuring; quality incentive payments All health care services offered by providers or by medical homes must be assessed based on quality...
MN ADC 4651.0110 Health Care provider Reporting All licensed health care providers in the state must provide the Commissioner of Health with an annual financial and...
MN ADC 4651.0120 Reporting Requirements The required financial and statistical report to be filed by licensed doctors must include information about the health care...
MN ADC 9549.0041 General Reporting Requirements As a condition for payment under a medical assistance program such as Medicaid, a nursing home facility must submit an...