Clinics certified as health care homes now serving 2 million Minnesotans

More than 2 million Minnesotans are served by clinics certified as health care homes - a new primary care model showing promise as a way to improve the quality of care, reduce costs, and be more responsive to people's needs, according to a report to the Minnesota Legislature.

"Enhancing and transforming primary care is central to Minnesota's health care reform efforts," said Minnesota Commissioner of Health, Dr. Ed Ehlinger. "This is a significant milestone in our efforts to help clinics adopt an approach that puts the patient at the center of a care team dedicated to meeting the patient's health goals."

A health care home is a primary care clinic or provider that makes better health easier to achieve. It puts patients at the center of care decisions, whether they are seeking care for common, acute, or chronic conditions.

The Minnesota Department of Health (MDH) certifies clinics as health care homes. To qualify, a clinic must provide 24-hour access, maintain a method of tracking patient health histories, monitor and report the clinic's quality performance, and provide care planning and coordination to patients. MDH has certified 170 health care homes and 1,764 clinicians. These providers care for over 2 million Minnesotans. The figure of 2 million Minnesotans served by health care home clinics comes from patient population figures submitted by the clinics during the certification process. The tally was included in the annual health care homes report that MDH and DHS submitted in May to the Minnesota Legislature.

All patients can benefit from a health care home. The designation indicates a clinic has the tools to help patients meet their health goals, such as losing weight or quitting smoking. A health care home particularly benefits patients with chronic diseases or complex illnesses by coordinating the different kinds of care and services needed.

Recognizing this value, the Minnesota Department of Human Services (DHS) offers care coordination payments of $10 to $60 a month for each patient with a chronic condition who is enrolled in a state health program, such as Medical Assistance. The payment amount depends on the complexity of the patient's health problems.

DHS Commissioner Lucinda Jesson stated, "We are committed to supporting health care homes as the crucial delivery model of a new health system. In this practice, model health care is integrated at the primary care site for all medical care. Even beyond these health care services, health care homes are the right partners to integrate medical and community services to provide care for the people and families we serve."

DHS estimates that approximately 135,000 Medicaid recipients are served by a certified health care home. Minnesota is also one of eight states where the federal Medicare program has aligned with the state program to pay for health care homes. More than 225,000 Medicare beneficiaries are expected to be served by health care homes during the three-year project.

Improved quality and reduced costs 
There is promising evidence that the health care home approach is making better health easier for Minnesotans to achieve by improving the quality of primary care clinics and reducing costs.

For example, Medica has entered into reimbursement contracts with some primary care clinics that encourage a health care home model to manage chronic diseases and prevent illness. One large provider in the Twin Cities used the health care home model to decrease per member costs by 5 percent over one year, while other comparable large system clinics saw a 2.6 percent increase in costs during the same time period.

"At Medica, we see efforts like health care homes as a key part of our strategy to increase the quality of our members' health and lower health care costs by rewarding providers for not only treating, but preventing illness," said Dr. Jim Guyn, M.D., Medica medical director of provider relations.

Dr. Leif Solberg, M.D., of the HealthPartners Research Foundation, has been studying health care homes in Minnesota and preliminary findings indicate that, "On average, health care home clinics have significantly better performance scores for diabetes and cardiovascular disease than non-health care home clinics," Solberg said.

The 2011 report and those from previous years are available online at http://www.health.state.mn.us/healthreform/homes/legreport/index.html.