Note about MN Advantage Health Insurance plans

To our patients with Minnesota Advantage Health Insurance

As you may know, the Minnesota Advantage Health Plan has placed Gateway Clinic in cost level 4 for the 2023 plan year.  Cost level placement is based on total cost of all healthcare services provided to members that are assigned to Gateway Clinic.  Gateway Clinic services are only 9.6% of that total cost.  Cost level placement is assigned to primary care clinics based on four categories.  Below are the categories along with a description, the cost allocation, and where our costs are high or low.

  • Pharmacy: Costs associated with medications.  This is 25% of total cost.  It is 19% more expensive than the state average.  Gateway Clinic does not have control of these costs.
  • Hospital outpatient: Hospital costs for outpatient services like surgery. This is 28% of total cost.  It is 19% more expensive than the state average.  Gateway Clinic does not have control of these costs.
  • Hospital inpatient: Hospital costs associated with being hospitalized.  12% of total cost.  It is 13% lower cost than the state average.  Gateway Clinic does not have control of these costs.
  • Physician services: Costs associated with physician services, most of which are provided in the clinic.  35% of total cost.  7% lower cost than the state average.  This includes Gateway Clinic.

Although our physician services and hospital inpatient costs are low, hospital outpatient and pharmacy costs are very high.  These two high cost categories is why Gateway Clinic is assigned a cost level 4.

Minnesota Advantage Plan provided Gateway Clinic the option to take an -83% reduction in our 2023 Minnesota Advantage Plan clinic rates, which would make up for the high cost hospital outpatient and pharmacy costs.  That option would place us in a cost level 2, but we were unable to accept that significant of a reduction.  Other health systems that operate both clinics and hospitals can take a reduction on their clinic rates when they are able to make up for the reduction through their hospital revenue.  As an independent clinic, we unfortunately do not have that ability to do that.

We want to make you aware of a few things to consider for 2023.  Preventive care services and prescription drugs are the highest utilized services and there is no cost difference for those services from a level 2 to level 4.  At Gateway Clinic we offer a prompt pay discount and a financial assistance program.  With these programs you would be able to reduce your co-pay and coinsurance amounts for services at Gateway Clinic from a level 4 to a level 2.  If you want to take advantage of those programs in 2023, call our patient account office at 218-485-2053 to enroll in one or more of these programs.

Next month we open Northern Lakes Surgery Center.  Visit www.northernlakessurgery.com for more information.  This surgery center will reduce the cost of hospital outpatient surgeries – it will save patients money and it will positively impact our cost level placement in future years.

At Gateway Clinic, we continue to strive to provide you quality, affordable health care, and we appreciate you entrusting your care to us.  We hope to continue to be your provider of choice.

Sincerely,

Gateway Family Health Clinic, Ltd.