Read and download the detailed PDF version of all Cost of Care Summary Reports
MIHIA's annual Cost of Care report is a high level assessment that aims to measure the cost trends in the region. By analyzing and presenting the best data available, this report serves as a resource to measure the impact of regional efforts to contain health care costs.
Data Sources utilized include the Bureau of Labor Statistics, Centers for Medicare & Medicaid Services, Michigan Department of Community Health, Kaiser Family Foundation, and local health insurers in the region (e.g. Aetna, Blue Cross, HealthPlus of Michigan), unless otherwise noted.
WHAT IS COST OF CARE?
Cost of Care is comprised of actual costs of providing services related to the delivery of health care, including the costs of procedures and therapies. MiHIA’s Quadruple Aim Cost of Care strategic goal is that the Cost of Care inflation trend for the MiHIA region will not exceed the Consumer Price Index (CPI).
WHY DOES COST OF CARE MATTER?
Efficient and effective health systems and health care delivery across the region promotes growth throughout the community. This includes increased business growth through a stronger workforce, lower absenteeism, and decreased health care costs on employers, state and local budgets, and individuals. Furthermore, the quality of life for citizens in the region is improved with stronger support in the community to control healthcare costs and the enhanced ability to meet tough health reform challenges related to improving quality and cost of care.
WHAT IMPACTS COST OF CARE?
Some factors that impact cost of care include wasteful healthcare spending, such as unnecessary medical tests, high cost of prescription drugs, increases in obesity and chronic health conditions, consolidation of service providers, and an aging population, which will increase the cost of Medicare, Medicaid, and health care, and require increased levels of care, creating demand.
GOAL
MiHIA’s Quadruple Aim Cost of Care strategic goal is that the Cost of Care inflation trend for the MiHIA region will not exceed the Consumer Price Index (CPI).
GOAL HAS NOT BEEN MET
7.3%Increase
Cost of Care in MiHIA Region
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7.3%Increase
Consumer Price Index
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The Cost of Care Trend for 2021 shows a 7.3% increase in total cost of care expenditures in the MiHIA region between 2020 and 2021 while the population trend continues to decrease by 0.05%. MiHIA's cost of care is greater than the 2021 CPI of 7.2% and greater than the CPI for all medical commodities, which was 0.4%.
MiHIA Region Demographics
POPULATION
This indicator shows the total population in the region.
The population size of a region is used to describe and understand populations and is important in planning for the future of a community, particularly for schools, community centers, health care, and child care.
Access to Care
Health Insurance
Medical costs in the United States are extremely high, so people without health insurance may not be able to afford medical treatment or prescription drugs.
To stay healthy, children require regular checkups, dental and vision care, and medical attention for illness and injury. Children with health insurance are more likely to have better health throughout their childhood and adolescence.
Primary Care Provider Rate
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58 providers/ 100,000 population
This indicator shows the primary care provider rate per 100,000 population. Primary care providers include practicing physicians specializing in general practice medicine, family medicine, internal medicine, and pediatrics.
Data Source: County Health Rankings
The Labor Force Participation rate has been steadily declining, most likely due to an aging population
Adults without Health Insurance
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This indicator shows the percentage of adults aged 18-64 that do not have any kind of health insurance coverage.
Data Source: U.S. Census Bureau - Small Area Health Insurance Estimates
The medicare population is steadily increasing while the medicaid population rose exponentially in the last year
Healthcare Payments
Uninsured Payments
Analyzing the amount of healthcare payments for the uninsured population provides data for more accurate future planning in terms of insurance programs and health services. Uninsured people are less likely to receive medical care, including services for major health conditions and chronic diseases, and more likely to have poor health status.
Employer Paid Coverage & Individual Market Insurance Payments
Private insurance plans often provide more comprehensive benefits and easier access to care than public plans. However, private plans can be very expensive for employers as well as individuals. A high rate of private insurance coverage may indicate greater financial security.
Region: MiHIA
Medicare Payments
Medicare is a federal health insurance program created for individuals 65 years and older and also people with certain disabilities, irrespective of health status, income, or medical history. This data reflects the cost of medical services, including personal health care services and products.
Medicaid Payments
Medicaid is a federal and state program that provides health coverage for persons of all ages with limited income and resources. Medicaid accounts for one-fifth of health care expenditures and its structure provides flexibility to utilize funding to address health priorities.
Chronic Conditions
Medicare Population
Chronic Disease Prevalence
MiHIA Region
Rates of heart disease, asthma, and Hb1Ac compliance are steadily improving
Medicaid Population
Chronic Disease Prevalence
State of Michigan
Rates of heart disease and diabetes have decreased and asthma increased since the prior time period
*Data not available by county / MiHIA Region
Analysis of the differences in the average total cost per beneficiary by the number of claims-based conditions allows for an understanding of the exact financial burden of disease and provides data for more accurate future planning. Some of the claims-based conditions include: Acute Myocardial Infarction, Alzheimer’s Disease, Asthma, Atrial Fibrillation, Cancer, Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease (COPD), Depression, Diabetes, Heart Failure, Hyperlipidemia (high cholesterol), Hypertension, Ischemic Heart Disease, Obesity, Osteoporosis, Rheumatoid Arthritis/Osteoarthritis, Schizophrenia, and Stroke.
Average Total Cost Per Medicare Beneficiary With 0 Chronic Conditions in MiHIA Region
Average Total Cost Per Medicare Beneficiary With 1 Chronic Condition in MiHIA Region
Average Total Cost Per Medicare Beneficiary With 2 Chronic Conditions in MiHIA Region
Average Total Cost Per Medicare Beneficiary With 3 Chronic Conditions in MiHIA Region
Medicaid Behavioral Health
Behavioral Health services in Michigan are managed through Community Mental Health Service Programs (CMHSPs) and Prepaid Inpatient Health Plans (PIHPs)
Psychological distress and substance abuse can affect all aspects of our lives. It is important to recognize and address potential psychological issues before they become critical. Drug abuse and addiction have negative consequences at both the individual and societal level. Mental Health disorders are common across the United States, but only a fraction of those affected receive treatment.
A combination of behavioral therapy and treatment medications tailored to an individual's particular abusive pattern and other mental, emotional, or medical issues are suggested to help overcome addiction. Community Mental Health Services Programs in Michigan provide patients with resources and services to help overcome these issues.
Prepaid Inpatient Health Plan Cases
A Prepaid Inpatient Health Plan (PIHP) is an organization that is responsible for managing Medicaid services related to behavioral health and development disabilities. A PIHP also provides medical services to consumers under a contract with the state Medicaid agency with prepaid capitation payments, is responsible for arranging inpatient care; and does not have a comprehensive risk contract.
Prepaid Inpatient Health Plan: Mid-State Health Network
In the Mid-State Health Network, Total PIHP Admissions for Substance Use Disorders numbered 12,877 in FY 2019, an increase of almost 1000. While the Substance Use Disorder Admission rate is higher than the previous time period, it is still lower than the Michigan rate. The rate of Substance Use Admissions that Require Medication-Assisted Treatment is lower than the previous time period and slightly higher than the Michigan rate.
Cost of Care Summary
State public health funding per capita and the out of pocket cost have increased in 2021
Average Monthly Marketplace Premium
The premium tax credit is a refundable tax credit designed to help eligible individuals and families with low or moderate income afford health insurance purchased through the Health Insurance Marketplace, also known as the Exchange. The size of the premium tax credit is based on a sliding scale. Those who have a lower income get a larger credit to help cover the cost of their insurance.
Cost of Care in the MiHIA Region Has Increased Slightly
GOAL HAS NOT BEEN MET
MiHIA’s Quadruple Aim Cost of Care strategic goal is that the Cost of Care inflation trend for the MiHIA region will not exceed the Consumer Price Index (CPI).
| Cost of Care | ||
| Year | Percent Change | Trend |
| 2021 | +4.5% |  |
| 2020 | +2.8% |  |
| 2019 | +4.9% | |
| 2018 | +4.6% |  |
| 2017 | -2.1% |  |
| 2016 | -5.9% | |
| 2015 | +4.4% |  |
| 2014 | +3.0% |  |