Onpoint Hospital Cost Report
This report was authored at the request of the State of Maine (SOM) Office of Employee Health & Benefits, which was seeking a comparative analysis of cost variation among Maine Hospitals. The request was for a single composite measure of variation in hospital cost (inpatient and outpatient) based on payments to Maine acute care hospitals. The following analysis by Onpoint Health Data was based on the most current statewide commercial claims data available (i.e., calendar year [CY] 2010) and was adjusted for patient mix by applying diagnosis-related groups (DRGs) to inpatient claims and 3MTM abulatory patient groups (APGs) to outpatient claims. This report serves as an update to analyses done with CY2008 and CY2009 claims data.
Small Maine hospitals (designated as “Level 1”) were evaluated independently of large Maine hospitals (“Level 2”) on services similar to those performed by their peers. Level 1 hospitals were compared only on a set of services common to all Maine hospitals (“Level 1 Services”). Level 2 hospitals were compared both on these common Level 1 Services and on services provided only at larger Maine hospitals (“Level 2 Services”). While this study was based on commercial claims data, the methodology also indirectly adjusted for hospital differences in Medicare/Medicaid patient mix.1
“Hospital Cost Comparison for Hospital Tiered Benefit: Report on Maine Hospital Payment Variation Using 2010 Statewide Commercial Claims Data,” Prepared by Onpoint Health Data, January 2012