ST. PAUL — A state analysis of medical claims in Minnesota in 2012 shows care for chronic health conditions cost nearly $23 billion.

The state Department of Health was able to put a dollar figure on the cost of chronic health conditions for the first time. Care for patients with at least one chronic condition accounted for 83 percent of medical spending in the analysis.

State Health Economist Stefan Gildemeister said the findings challenge the state’s reputation as healthy and low-spending. His team analyzed medical claims of 4.5 million residents covered by public and private insurance in 2012.

“I think we would have expected Minnesota to be maybe in a little bit healthier place,” Gildemeister said. “Turns out that’s not entirely the case.”

About 35 percent of insured people in Minnesota have at least one chronic condition, which includes heart disease, asthma and diabetes. Care for insured patients with high blood pressure cost nearly $13.5 billion, accounting for nearly half of all medical spending for the insured in 2012.

The data omits costs for treating the uninsured and doesn’t include people in several specialized health programs.

State Health Commissioner Ed Ehlinger said a different approach to managing disease is needed in light of the findings. He said the state needs to do better at preventing persistent health problems in the first place.

The state’s analysis also found costs for treating chronic conditions vary widely based on location. Costs for kidney failure patients in Houston County in southeastern Minnesota totaled just over $24,000 in the analysis, but that figure was more than double for similar patients from west-central Minnesota’s Stevens County.

Ehlinger said the reasons for such discrepancies are a mystery, but that officials would like to look into it more.

The Department of Health hopes to analyze insurance data from other years, but will need reauthorization. Legislative approval for use of the database expires in June.