Updates

CompareMaine 9.0—December 2020

The cost data has been updated and represents average payments for the time period April 1, 2019 through March 31, 2020.

The quality data was updated to reflect the most recent time periods available:

  • HCAHPS Patient Experience Summary Star (10/1/18 – 9/30/19)
  • Healthcare-Associated Infections (10/1/18 – 9/30/19)
  • Preventing Serious Complications (7/1/17 – 6/30/19)
  • Preventing Falls with Injury (10/1/18 – 9/30/19)
  • Preventing Pressure Ulcers (10/1/18 – 9/30/19)
  • Unplanned Hospital-Wide Readmissions (7/1/18 – 6/30/19)

The dashboards for infusion therapy, chiropractic care and trends over time have been updated for the time period April 1, 2019 through March 31, 2020.

The dashboard for prescription drug costs and utilization has been updated for the time period July 1, 2019 through June 30, 2020.

New Procedures Added to CompareMaine

A new category for Emergency Department Visits is included on CompareMaine, along with estimates for the following 25 procedures:

  • CT scan of blood vessel of head, with contrast (CPT Code 70496)
  • CT scan of blood vessels in chest, with contrast (CPT Code 71275)
  • X-ray of lower back, minimum four views (CPT Code 72110)
  • MRI scan of pelvis, with and without contrast (CPT Code 72197)
  • MRI scan of abdomen, with and without contrast (CPT Code 74183)
  • Abdominal ultrasound of pregnant uterus, less than 14 weeks, single or first fetus (CPT Code 76801)
  • Abdominal ultrasound of pregnant uterus, greater than or equal to 14 weeks, single or first fetus (CPT Code 76805)
  • Ultrasound of pregnant uterus, 1 or more fetus (CPT Code 76815)
  • Vaginal ultrasound of pregnant uterus (CPT Code 76817)
  • Ultrasound of fetus (CPT Code 76819)
  • Screening digital tomography of both breasts (CPT Code 77063)
  • Blood test, basic group of blood chemicals (CPT Code 80048)
  • Obstetric blood panel (CPT Code 80055)
  • Blood test for coagulation assessment (CPT Code 85730)
  • Electrocardiogram (ECG or EKG), with interpretation and report (CPT Code 93000)
  • Cardiovascular stress test (CPT Code 93017)
  • Ultrasound of veins in arm or leg (CPT Code 93971)
  • Sleep monitoring (CPT Code 95810)
  • Sleep monitoring, with continued pressured respiratory assistance (CPT Code 95811)
  • Emergency department visit, very minor (CPT Code 99281)
  • Emergency department visit, low complexity (CPT Code 99282)
  • Emergency department visit, moderate severity (CPT Code 99283)
  • Emergency department visit, problem of high severity (CPT Code 99284)
  • Emergency department visit, problem with significant threat to life or function (CPT Code 99285)
  • Fentanyl Citrate injection (CPT Code J3010)

New Episodes of Care Added to CompareMaine

These bundled payments show the cost over the entire course of an episode of care, instead of each service individually, and provide a more accurate representation of healthcare costs a patient may incur. Optum Symmetry’s Episode Treatment Grouper® (ETG) was used for the following new procedures:

  • Removal of tonsils and adenoid glands patient younger than age 12 (CPT Code 42820)
  • Colonoscopy with removal of polyps or growths using an endoscope (CPT Code 45385)
  • Repair of groin hernia patient age 5 years or older (CPT Code 49505)

New Facilities Added to CompareMaine

Added 70 new healthcare facilities, including 5 that currently exist within CompareMaine facility groups.

CPT Codes

The following CPT codes were added as replacements for expired codes:

  • CPT Code 77047 (MRI scan of both breasts, without contrast) and CPT Code 77049 (MRI scan of both breasts, without and with contrast) for CPT Code 77059 (MRI scan of both breasts, without and/or with contrast). CPT Code 77047 does not have enough volume to be displayed at this time.
  • CPT Code 96156 (Health and behavior assessment) for CPT Code 96150 (Health and behavior assessment for 15-minute session).
  • CPT Code 96158 (Health and behavior intervention for 30-minute session) for CPT Code 96152 (Health and behavior intervention for one person for 15-minute session).

CompareMaine 8.0—December 2019

The cost data has been updated and represents average payments for the time period April 1, 2018 through March 31, 2019.

The quality data was updated to reflect the most recent time periods available:

  • HCAHPS Patient Experience Summary Star (10/1/17 – 9/30/18)
  • Healthcare-Associated Infections (10/1/17 – 9/30/18)
  • Preventing Serious Complications (7/1/16 – 6/30/18)
  • Preventing Falls with Injury (1/1/18 – 12/31/18)
  • Preventing Pressure Ulcers (1/1/18 – 12/31/18)
  • Unplanned Hospital-Wide Readmissions (7/1/17 – 6/30/18)

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

  • Cervical biopsy (Colposcopy) (CPT Code 57454)
  • CT scan of neck, with contrast (CPT Code 70491)
  • Electrocardiogram (ECG or EKG) (CPT Code 93005)
  • Electrocardiogram (EGC or EKG) monitoring (CPT Code 93270)
  • MRI scan of lower spinal canal, before and after contrast (CPT Code 72158)
  • Ultrasound of heart (Echocardiogram) (CPT Code 93306)
  • Upper gastrointestinal (GI) endoscopy without biopsy (CPT Code 43235)
  • Upper gastrointestinal (GI) endoscopy with biopsy (CPT Code 43239)

CompareMaine 7.0—May 2019

The cost data has been updated and represents average payments for the time period July 1, 2017 through June 30, 2018.

Three new quality measures were added, in addition updating the quality data to reflect the most recent time periods available:

  • HCAHPS Patient Experience Summary Star (1/1/17 – 12/31/17)
  • Healthcare-Associated Infections (1/1/17 – 12/31/17)
  • Preventing Serious Complications (10/1/15 – 6/30/17)
  • Preventing Falls with Injury (7/1/17 – 6/30/18) *new*
  • Preventing Pressure Ulcers (7/1/17 – 6/30/18) *new*
  • Unplanned Hospital-Wide Readmissions (7/1/16 – 6/30/17) *new*

New Episode Grouping Software

MHDO transitioned to Optum Symmetry’s Episode Treatment Grouper® (ETG) to group episodes of care. These bundled payments show the cost over the entire course of an episode of care, instead of each service individually, and provide a more accurate representation of healthcare costs a patient may incur. The ETG is used for the following procedures:

  • Colonoscopy with biopsy for noncancerous growth
  • Colonoscopy without biopsy for encounter for preventative health services
  • C-section (Cesarean delivery)
  • Vaginal delivery
  • Carpal tunnel release surgery
  • Gallbladder removal
  • Hip replacement
  • Knee replacement
  • Surgical arthroscopy of knee
  • Surgical arthroscopy of shoulder

Once the episodes are created, MHDO uses custom logic to produce cost estimates. Health care services performed at the same time but are not associated with the same diagnosis code are not grouped into a given episode.

New Procedure Added to CompareMaine

Estimates for Comprehensive Metabolic Panel (CPT Code 80053) are now included on the website.

Infusion Therapy Services Added

Added four high cost, high utilization infusion therapy services:

  • J1569: Gammagard Liquid Injection (500 mg) (Brand Name: Gammagard Liquid®)
  • J1745: Infliximab Injection (Brand Name: Remicade®)
  • J7120: Ringers Lactate Infusion (up to 1000 cc)
  • J9310: Rituximab Injection (100 mg) (Brand Name: Rituxan®)

CPT Codes

The following CPT codes were added as replacements for expired codes:

  • CPT Code 97763 (Orthotic management and training and prosthetic training) for CPT Code 97762 (Evaluation of orthotic or prosthetic use)
  • CPT Code 71046 (X-ray of chest, 2 views) for CPT Code 71020 (X-ray of chest, 2 views, front and side)

CompareMaine 6.0—September 2018

The cost data has been updated and represents average payments for the time period January 1, 2017 through December 31, 2017. Note: The cost estimates for the 10 surgical procedures listed below 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. MHDO hopes to complete this transition in early 2019 and will provide more information when it becomes available as to the impact of the estimates on CompareMaine.

  • Carpal Tunnel Surgery
  • Colonoscopy with biopsy for noncancerous growth
  • Colonoscopy without biopsy for encounter for preventative health services
  • C-section Delivery
  • Gallbladder Removal
  • Hip Replacement
  • Knee Arthroscopy
  • Knee Replacement
  • Shoulder Arthroscopy
  • Vaginal Delivery

The quality data have been updated to reflect the most recent information and time periods available:

  • HCAHPS Patient Experience Summary Star (10/1/2016-9/30/2017)
  • Healthcare-Associated Infections (10/1/2016-9/30/2017)
  • Preventing Serious Complications (10/1/2015-6/30/2017)

Status of the Clinician & Group CAHPS and Patient-Centered Medical Homes CAHPS Patient Experience Data: Due to outdated data, the inability to locate another consistent data source, or establish an alternate collection method, the 2014 Clinician & Group CAHPS and Patient-Centered Medical Homes CAHPS Patient Experience Data previously reported on CompareMaine for free-standing primary care and specialty practices has been removed in this update and will be reported as Not Available. Hospital CAHPS (H-CAHPS) patient experience will continue to be shown for associated hospital-based primary care and specialty practices.

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

  • Diagnostic Mammogram, one breast, with computer-aided detection (CPT Code 77065)
  • Diagnostic Mammogram, both breasts, with computer-aided detection (CPT Code 77066)
  • Screening Mammogram, both breasts, with computer-aided detection (CPT Code 77067)
  • Physical Therapy Evaluation, Low Complexity (CPT Code 97161)
  • Physical Therapy Evaluation, Moderate Complexity (CPT Code 97162)
  • Physical Therapy Evaluation, High Complexity (CPT Code 97163)
  • Physical Therapy Re-Evaluation (CPT Code 97164)
  • Occupational Therapy Evaluation, Low Complexity (CPT Code 97165)
  • Occupational Therapy Evaluation, Moderate Complexity (CPT Code 97166)
  • Occupational Therapy Evaluation, High Complexity (CPT Code 97167)
  • Low Dose CT Scan for Lung Cancer Screening (CPT Code G0297)
  • Health and behavior re-assessment for 15-minute session (CPT Code 96151)

Procedure Volume Added to the Data Display

The number of times a facility has performed a service or procedure annually for covered individuals reported in MHDO’s All Payer Claims Database (includes private and public payers) has been added to the data display, underneath the average total cost and cost breakdown.

Added Average Cost Data for Chiropractic Procedures

Chiropractic cost and volume data for the 4 procedures listed below displayed by county, is available on CompareMaine.

  • Chiropractic treatment, 1+ non-spinal regions (98943)
  • Chiropractic treatment, 1-2 spinal regions (98940)
  • Chiropractic treatment, 3-4 spinal regions (989410)
  • Chiropractic treatment, 5 spinal regions (98942)

CompareMaine Trends Over Time

An interactive report allows users to compare the average total costs for hundreds of healthcare procedures at different facilities across the state of Maine, as reported on CompareMaine over time.

CompareMaine 5.0—March 2018

The MHDO is pleased to release CompareMaine 5.0. Below is a summary of the updates included in this release:

The cost data has been updated and represents average payments for the time period July 1, 2016 through June 30, 2017.

The quality data have been updated to reflect the most recent information and time periods available:

  • HCAHPS Patient Experience Summary Star (1/1/16-12/31/16)
  • Healthcare-Associated Infections (1/1/16-12/31/16)
  • Preventing Serious Complications (7/1/14-9/30/15)

The MHDO is currently exploring options for updating the CG CAHPS patient experience data for a future release.

New Procedures Added to CompareMaine

Estimates for the following procedures are now included on CompareMaine:

  • Heart vessel study using drugs or exercise, single study (CPT Code 78451)
  • Negative or vacuum pressure wound therapy (CPT Code 97606)
  • Psychotherapy for crisis, each additional 30 minutes (CPT Code 90840)

Disclaimer

Added an interactive disclaimer to remind users that the average cost estimates for specific healthcare procedures represent an average payment to facilitate comparison between providers and health insurance companies and do not reflect what an individual’s out of pocket costs may be.

CompareMaine 4.0—October 2017

The cost data has been updated and represents the average payments for the time period October 1, 2015 through December 31, 2016. The average total cost also breaks down to show costs paid to the healthcare facility and professional(s) providing services, if applicable.
The quality data have been updated to reflect the most recent information and time periods available:

  • HCAHPS Summary Star (7/1/15-6/30/16)
  • Healthcare-Associated Infections (7/1/15-6/30/16)

CPT Codes

CPT Code 72082 (X-ray of entire spine, thoracic and lumbar) replaced CPT Code 72010 (X-ray of entire spine).

New Procedures Added to CompareMaine

Estimates for skin lesions (CPT Codes 17000 and 17110) are now included on CompareMaine.

Facilities

We have updated our facility listing as described below:

Community Clinical Services

  • B Street Health Center
  • CCS Family Health Center
  • CCS Psychiatry at Central Maine Family Practice
  • Second Street Health Center

Penobscot Community Health Care

  • Brewer Medical Center
  • Capehart Community Clinic
  • Helen Hunt Health Center
  • Jackman Community Health Center
  • Pediatrics
  • Penobscot Community Health Center
  • Seaport Community Health Center
  • Specialty Clinic
  • Summer St. Community Clinic
  • Winterport Community Health Center

Pines Health Services

  • Kimball Community Health Center
  • Pines Caribou Health Center
  • Presque Isle Health Center
  • St. John Valley Health Center
  • Washburn Health Center
  • Women and Children’s Center

Portland Community Health Center

  • Portland Community Health Center (PCHC)
  • PCHC at Brickhill
  • PCHC at Franklin Towers
  • PCHC at Preble St.
  • PCHC at Riverton Park

HOMETOWN Health Center (Formerly Sebasticook Family Doctors)

  • Canaan
  • Dexter
  • Dover-Foxcroft
  • Newport
  • Pittsfield

CompareMaine 3.0—December 2016

The quality data were updated to reflect the most recent information and time periods available:

  • HCAHPS Summary Star (10/1/2014-9/30/2015)
  • Preventing Serious Complications (7/1/2013-6/30/2015)
  • Healthcare-Associated Infections (10/1/2014-9/30/2015)

Also, in July 2016, the Centers for Medicare and Medicaid (CMS) added an "Overall Hospital Quality Star Rating" to their Hospital Compare website. The new overall hospital quality star rating comprises of 64 quality measures and will allow you to compare hospitals quality using one metric. First Release of the Overall Hospital Quality Star Rating on Hospital Compare.

CompareMaine 2.0—June 2016

Based on feedback we received since launching the site in the fall of 2015, we have added colonoscopies, digital mammograms and 28 other new procedures to this release. We also added 8 new facilities and made several enhancements to the site. The cost data has been updated for the time period October 1, 2014 through September 30, 2015. The quality data have been updated to the most recent time periods available. For more detail, see below.

Site Enhancements:

  • Alphabetized procedure categories and procedures on "Compare Costs and Quality";
  • Enhanced the search function within the site;
  • Improved Search Engine Optimization to make it easier for users to find the site;
  • Added a Methodology section and moved information there from the About section;
  • Added "Choose a Topic" header on the individual facility pages to make it clearer that users can view different procedures.

Procedure Changes: This document contains a list of procedures that were added and removed in this release.

Facility Changes: This document contains a list of facilities that were added and removed in this release.