Issues Related to Health Care Delivery Capacity in Minnesota

1
Issues Related to Health Care Delivery Capacity
in Minnesota

• Scott Leitz, Director
• Office of Health Policy
• MN Department of Health
• July 13, 2006

2
Overview

• Context
• Population growth and shifts
• Impacts on Capacity
• Some data
• Current Regulatory Environment
• Ongoing Policy Issues and MDH study

3
Factors Affecting Future Need for Capacity

• Population growth
• MN population expected to grow by 1 million
  people (20) between 2000 and 2020
• Changing demographics (aging)
• Changes in use rates of health care services
  (caused by factors other than aging population)

4
Projected Minnesota Population Growth,by Age
Group
Source Minnesota State Demographic Center
5
How Does Use of Health Care Services Vary by
Age? Hospital Example
Hospitalization Rates by Age
Sources National Center for Health Statistics
(2000 National Hospital Discharge Survey) U.S.
Bureau of the Census
6
Projected Growth in Inpatient Hospital Days by
Region, 2000 to 2020
28
26
Statewide Growth Rate 37
26
53
40
9
19
34
7
Projected Occupancy Rates as of 2003 Available
Beds, by Region, 2020
41
58
Statewide Occupancy Rate 75
35
76
94
29
46
85
8
Health Care Capital Expenditures in Minnesota
9
2005 Health Care Capital Expenditures in
Minnesota, by type of project
10
New MRIs in Minnesota since 1993
11
Minnesotas Current Regulatory Environment
Briefly

• Minnesota currently operates under a moratorium
  on hospital construction
• Since 1984
• Requests for exceptions are guided by a hospital
  public interest review process administered by
  MDH
• The new law and the new new law
• Legislature remains the ultimate decision-maker
  on whether to grant an exception
• Inpatient and outpatient capacity investment is
  monitored through the capital expenditure
  reporting requirement under M.S. 62J.17

12
A Few Policy Considerations

• The role of competition in a less than perfectly
  competitive market
• The imperfection of assessing future need
• How should need for new facilities/equipment be
  determined?
• v.s. convenience? And who makes determination?
• Once need is established, what is best process
  for deciding who delivers services?
• The Maple Grove question
• Are there alternative models beyond CON or no
  CON that should be examined? Are there lessons
  from other industries?

13
MDH Study

• 2006 Legislature required the MDH to
• The commissioner of health shall study and report
  to the legislature by February 15, 2007, on the
  need for a new process for approving the
  construction of medical facilities or the
  addition of services at existing medical
  facilities

14
Contact Information

• Scott Leitz, Director of Health Policy
• Minnesota Department of Health
• 651-201-3565
• Scott.leitz_at_state.mn.us