Minnesota

Abstract

Minnesota’s active legislative efforts aimed to increase healthcare price transparency and cost containment demonstrate the state’s commitment to improve its health care system. A leader in price transparency, the state has an active AllPayer Claims Database (APCD), which has been expanded to study cost, quality, and utilization. The state mandates that the Minnesota Hospital Association provide a hospital-specific performance and charge database for the 50 most common inpatient diagnosis-related groups. Minnesota also earns top grades for protecting patients from surprise and balance billing. In both emergency and non-emergency situations, a network provider is prohibited from billing an enrollee for any amount in excess of the allowable amount the health carrier has contracted for with the provider as total payment for the health care service. In recent terms, the state has introduced legislation that would require health plan companies to develop and implement a right to shop/shared savings incentive program.