Health Care Market Reports

Overview

The Division of Health Care Finance collects and maintains a large amount of data from Medicaid, the Children's Health Insurance Program (CHIP), and the State Employee Health Plan (SEHP). In addition, in cooperation with the Kansas Insurance Department, DHCF maintains the Kansas Health Insurance Information System (KHIIS), which includes health care data from individual and small-group private insurance plans.

These datasets are being combined using a tool called the Data Analytic Interface (DAI), a multi-payer administrative claims database initiative sponsored by the Division of Health Care Finance and the Kansas Insurance Department. The DAI went into production in early 2010 with Medicaid and SEHP data. The KHIIS module is currently under implementation. With the DAI, DHCF is now able, among other things, to compare prices paid for health care services and utilization across different insurance plans, and across time.

These reports are developed and reviewed under the aegis of the Kansas Health Data Consortium a collaborative, multi-stakeholder advisory committee on data-driven policy with membership spanning across key sectors of the health and health care industry. The reports provide a summary and comparative data on health care cost, utilization, service patterns and trends, and other key descriptive snapshots of the health care market. Multiple data sources provide input to the Data Consortium process, as indicated within parentheses next to each category below in the format (date reviewed by the Consortium, data source). Some of the reports are developmental drafts and are not to be used for reporting purposes whenever identified as such.

Market Price Index Comparisons: Medicaid vs SEHP

  1. 2009 Medicaid SEHP Pricing Comparison for Provider Services by Type (PDF)
  2. Durable Medical Equipment Cost Comparisons (PDF)
  3. Pharmacy Cost and Utilization (PDF)

Insurance Mandates

  1. Mandates Overview (PDF)
  2. Mandates Summary (PDF)

Insurance Premiums & Market Characteristics

  1. KHIIS Premium Report (PDF)
  2. Private Insurance Market Statistics Graphs (PDF)
  3. Private Insurance Market Statistics Table (PDF)

Provider Payments

  1. 2006 Hospital Payments (PDF)
  2. 2006 Provider Specialties Payments (PDF)
  3. 2007 Hospital Payments (PDF)
  4. 2007 Provider Specialties Payments (PDF)
  5. Allowed to Charge Ratio by Drug Group (PDF)

Beneficiary Expenditures

  1. Average Patient Responsibility by Drug Group (PDF)
  2. Patient Responsibility as a Percent of Allowed (PDF)
  3. Percentage of Paid Claims by Line of Business and Age Group (PDF)
  4. Summary Table of 2007 Rx Drug Claim For KHIIS (PDF)
  5. Summary Table of 2007 Rx Drug Claim For Medicaid (PDF)
  6. Summary Table of 2007 Rx Drug Claim For SEHP (PDF)

Membership & Demographics

  1. KHIIS Geomaps (PDF)
  2. KHIIS Member Claim by County Report (PDF)

Medical Trends & Utilization

  1. Change from Previous Year (PDF)
  2. Net Paid Amount (PDF)
  3. Net Paid per Consumer (PDF)
  4. Outpatient Rehabilitative Therapy Services Table (PDF)
  5. Paid Claims by Diagnostic Category and Line of Business (PDF)
  6. Paid Claims by Line of Business (PDF)
  7. Paid Claims Volume (PDF)
  8. Percentage of Paid Claims by Line of Business and Age Group (PDF)
  9. Unique Billing Providers (PDF)
  10. Unique Claims (PDF)
  11. Unique Consumers (PDF)
  12. Utilization and Payment Statistics by Diagnosis Group Graph (PDF)
  13. Utilization and Payment Statistics by Diagnosis Group Table (PDF)
  14. Utilization and Payments by Line of Business and Diagnosis Group Summary (PDF)