Thursday, April 12, 2012

Provider Peer Grouping bill passes

Legislation signed by Gov. Mark Dayton April 5 will change Minnesota’s provider peer grouping program by giving providers more time to review their data and by making health plan use of the data optional rather than mandatory.

The provider peer grouping program was passed as part of Minnesota’s 2008 Health Care Reform Act in order to increase the transparency of Minnesota’s health care system by providing patients and consumers data comparing the cost and quality of Minnesota’s clinics and hospitals.

The act originally required health plans, the Department of Human Services, and the State Employee Group Insurance Plan to incorporate provider peer grouping data into at least one health plan offering that would include incentives for patients to use high quality, low-cost providers.

With this recent legislative change, health plans now may use the data but are not mandated to do so.

In addition, the change gives clinics and hospitals more time, 120 days rather than 90 days, to review their data before it is publicly released. The amendment also establishes a streamlined appeals process and a committee comprised of representatives from hospitals, clinics, and other stakeholders that will advise the commissioner of health about scoring methodologies and the dissemination and sharing of the data.

“This is a good compromise that will allow this important work to move forward, while also providing us with a more formal way to work closely with clinics and hospitals to make sure the data is accurate and helps patients make informed health care choices,” said Ellen Benavides, assistant commissioner, Minnesota Department of Health.

The changes go into effect July 1, 2012.