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
4.9%Increase
Cost of Care in MiHIA Region
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2.3%Increase
Consumer Price Index
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The Cost of Care Trend for 2019 shows a 4.9% increase in total cost of care expenditures in the MiHIA region between 2018 and 2019 while the population trend continues to decrease by 0.24%. MiHIA's cost of care is greater than the 2019 CPI of 2.3% and greater than the CPI for all medical commodities of 2.5%.
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
Both adults and children in the MiHIA Region are insured at a lower rate than the Michigan state value.
However, significant gains have been made in the past few years.
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 then dropped
Health Care payments
Uninsured Payments
Uninsured payments per capita increased $124 from 2018 to 2019 and increased by $6 million overall in the MiHIA Region.
Employer Paid Coverage & Individual Market Insurance Payments
The per capita payment for employer paid coverage and individual market insurance rose $237 from 2018 to 2019 for an overall increase of $87 million in the MiHIA Region.
Region: MiHIA
Medicare Payments
The per capita payment for medicare payments rose $702 from 2018 to 2019 for an overall increase of $129 million in the MiHIA Region.
Medicaid Payments
The per capita payment for medicaid insurance rose $255 from 2018 to 2019 for an overall increase of $40 million in the MiHIA Region. The total population of medicaid patients decreased in this time period.
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, asthma, and diabetes have all 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)
The Adult Medicaid Population with Mental Illness in the MiHIA Region increased by 5.0% between 2017 and 2018, with the CMH for Central Michigan having the largest population size among all CMHs.
AuSable CMH had the greatest percent change in costs associated with mental illness, with a 130.1% increase. Costs increased from $1324.20 in 2017 to $3046.54 in 2018.
Prepaid Inpatient Health Plan Cases
Mid-State Health Network's total number of PIHP cases are decreasing, while the cost per case ($13,040) is increasing, although still less than the Michigan state average cost
Prepaid Inpatient Health Plan: Mid-State Health Network
In the Mid-State Health Network, Total PIHP Admissions for Substance Use Disorders numbered 11,921 in FY 2018, an increase of almost 1200. 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 is decreasing slightly, while out-of-pocket costs have seen fluctuations
Average Monthly Marketplace Premium
The average monthly marketplace premium after application of an advanced premium tax credit is decreasing.
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. This significant discount to monthly premiums allows a greater number of people to be able to afford health 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 |
| 2019 | +4.9% |  |
| 2018 | +4.6% |  |
| 2017 | -2.1% |  |
| 2016 | -5.9% |  |
| 2015 | +4.4% |  |
| 2014 | +3.0% |  |