NAHDO Annual Conference; October 2009 Patrick Miller, MPH; Research Associate Professor Jo Porter, MPH; Deputy Director NH Institute for Health Policy.

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Presentation transcript:

NAHDO Annual Conference; October 2009 Patrick Miller, MPH; Research Associate Professor Jo Porter, MPH; Deputy Director NH Institute for Health Policy and Practice 1 NAHDO Annual Conference October 2009

2 22 NH Hospital Acute Care Pricing Comparison Source NH Insurance Department, 2008 NAHDO Annual Conference October 2009

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5 Payer by HAA 2005 Payments PMPM 2005 Total Payments PMPM Payments PMPM 2008 Total Payments PMPM 2 Berlin Carrier A $316.25$324.57$322.97$ Carrier B $310.87$323.71$313.59$ Carrier C $649.72$668.37$368.72$ Other $238.69$260.63$345.71$ Totals $297.92$312.85$351.21$ Colebrook Carrier A $284.94$295.09$278.18$ Carrier B $263.96$278.17$413.95$ Carrier C $326.27$343.12$323.50$ Other $188.43$208.72$322.50$ Totals $256.71$271.84$324.21$ Concord Carrier A $209.24$222.14$309.09$ Carrier B $247.19$254.54$260.16$ Carrier C $194.07$204.87$269.68$ Other $199.20$214.96$244.24$ Totals $224.75$236.32$287.35$ NAHDO Annual Conference October 2009

66 Prevalence of Adult Coronary Artery Disease by Age, NH Medicaid (non-Dual) and NH CHIS Commercial Members, 2005 NAHDO Annual Conference October 2009

77 Percent of Children Age 3 to 6 Years with a Well-Child Visit During the Year, SFY2006 NAHDO Annual Conference October 2009

88 Outpatient Emergency Department Visit Rates per 1,000 Members by Age, SFY2006 NAHDO Annual Conference October 2009

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10 NAHDO Annual Conference October 2009

Total IP ADE Discharge, Rate, Total Paid, and Average Paid, for Maine and New Hampshire NAHDO Annual Conference October MaineIP Discharges Rate / 1,000 Discharges Total PaidAverage Paid $ 11,864,264 $ 15, $ 13,705,995 $ 17,800 Total1, $ 25,570,259 $ 16,856 % Increase3% 29% 16%12% New HampshireIP Discharges Rate / 1,000 Discharges Total PaidAverage Paid $ 5,712,414 $ 12, $ 6,719,104 $ 13,332 Total $ 12,431,518 $ 12,909 % Increase10% 12% 18%7%

Total Discharges and Payments by Payer Using APCD Data – 2006 and 2007 Combined, by CARRIER NAHDO Annual Conference October Carrier (Blinded) ME Discharges Rate / 1,000 Discharges ME Payments % Total Payments NH Discharges Rate / 1,000 Discharges NH Payments % Total Charges $273,288 1% $609,840 5% $1,320,522 0% 00$ 0 0.0% $55,807 0% $1,831,766 15% 41, $23,014,786 90% $5,736,175 46% $21,312 0% 00.00$ 0 0.0% $884,545 3% $4,253,737 34% Total1, $25,570, % $12,431, %

NAHDO Annual Conference October APCD Meeting May 6, Selected Chronic Diseases: Prevalence Rate - Trends Healthcare Review: New Hampshire Benchmarks ** ‘Smoking related’ refers to diagnoses identified by published research with high mortality risk for persons who smoke. Rates shown can not be linked directly to smokers.

NAHDO Annual Conference October APCD Meeting May 6, Percent of Members Receiving Preventive Services**: Trends Healthcare Review: New Hampshire Benchmarks ** Measures are calculated for a one-year time period. Results may not correspond to HEDIS-related measures that cover multi-year time periods.

NAHDO Annual Conference October APCD Meeting May 6, Healthcare Review: Company XYZ HealthCare Costs - Impact of High Cost Cases** on Overall Medical Costs - Trends patients $97K per case 0.5% members 15% payments 58 patients $129K per case 0.7% members 18% payments ** High Cost Cases = Patients with greater than $50,000 in claims for the year. $30.9M w/0 RX $ $35.5M 64 patients $107K per case 0.7% members 18% payments $37.4M

Claims-based web module Through CDC Assessment Initiative funding, NH is building a claims module for the NH Web-based Reporting and Query System (HealthWRQS). Will augment web modules that use other administrative data Hospital discharge, birth, death, cancer registry, BRFSS data Will develop a Community Health Profile To include most relevant indicators for each data set

NAHDO Annual Conference October

NAHDO Annual Conference October

NAHDO Annual Conference October

Questions and Discussion NAHDO Annual Conference October 2009