Where does this website come from?
The CompareMaine website is a product of the Maine Health Data Organization (MHDO). MHDO is a state agency that collects healthcare data from health insurance companies and hospitals. In addition, the MHDO is required by law to collaborate with another State Agency, the Maine Quality Forum (MQF) on promoting the transparency of healthcare cost and quality information via a publicly accessible website.
CompareMaine replaces the former MHDO HealthCost website. With financial support from the Centers for Medicare & Medicaid Services (CMS), we have been able to enhance the content and the volume of information on the website.
Many people provided input to help make CompareMaine a usable, useful tool including the MHDO Board of Directors, the MHDO consumer advisory group, members of industry and medical associations, and technical experts.
Where does the information come from?
The cost data on this site comes from the State of Maine's all-payer claims database (APCD). We reviewed over 13 million claims from 32 health insurance plans for services in Maine from January 1, 2017 through December 31, 2017. Note: Surgical procedure cost estimates have not been updated for this release, and their costs remain reflective of the July 1, 2016 through June 30, 2017 time period due to a transition to a new episode grouping tool.
CompareMaine shows information on over 232 healthcare procedures from more than 272 facilities organized into 139 facility groups. These facilities include hospitals, physician practices, specialty care centers, labs, and radiological and imaging centers. If you search for a procedure, you may not see every facility listed. That's because not all facilities perform all procedures. And sometimes a facility performs a procedure only a few times each year, so we leave these out to protect patient privacy.
The health insurance claims do not include the public payers (MaineCare and Medicare). After these claims were excluded, a total of 6,209,576 claims from 31 payers remained in analysis. The MHDO Board of Directors will decide if the public payers will be included in a future release of CompareMaine.
CompareMaine reports on three quality measures:
- Patient survey ratings
- How well hospitals prevent complications that can result from hospital services or stays
- How well hospitals prevent infections that can result from hospital services or stays
The data for these measures come from state and national sources.
How do I navigate CompareMaine?
This video tutorial highlights the key features of the website.
How does CompareMaine calculate the cost?
The procedure cost is the average cost for a procedure at a certain facility. We calculate the average using the median, the middle number of a range of numbers ordered from lowest to highest. It includes two kinds of payments:
- The amount paid by the insurance company
- The patient's out-of-pocket costs
We also include payments to the healthcare professional (for example, the doctor or surgeon) and to the facility (for example, the hospital).
Actual out-of-pocket costs can be very different from one person to another. The amount you pay out-of-pocket may be different depending on:
- The type of insurance you have
- How much care you need
- The provider you see
If you have insurance, your carrier may have a cost-calculator tool to help see your personal out-of-pocket expenses.
Healthcare expenses can be very different in different facilities—even for the same test or service. There are many reasons for this:
- The types of patients the facility cares for
- The doctors who work there
- The equipment they use
- The agreements they have made with health insurance companies
The information in the Calculating Costs section explains how CompareMaine uses all these differences when figuring cost averages for more than 232 medical procedures.
The cost estimates on CompareMaine are median payments. They are meant to serve as a reference point for comparison. Please contact your insurance company to find out your actual payment. If you do not have insurance, please contact the facility that you are interested in. When contacted directly, facilities often report their charges, which may be higher than the actual payments they receive from insurance companies and patients.
MHDO makes every effort to provide accurate information on this website. Healthcare providers and insurance companies included on CompareMaine are sent the cost data to review for accuracy before they are released. Estimates published on this website are within 10% of payer and facility estimates.