Tuesday, August 14, 2012

State gets federal approval for innovative health care payment reform

Minnesota can continue forward on effort to improve care for Medicaid enrollees while saving taxpayer dollars.

The Minnesota Department of Human Services (DHS) in August announced federal approval to implement changes to the way it pays health care providers under the state’s Medicaid program.

These changes place increased emphasis on quality of care, health care cost and overall value.

The Health Care Delivery System (HCDS) demonstration, approved by the Centers for Medicare and Medicaid Services (CMS), is another step by the Dayton Administration to improve the way health care is purchased for Medicaid in Minnesota.

“Minnesota is moving full steam ahead when it comes to reforming our health system so that we'll pay for quality of care and outcomes for our clients, not just the quantity of procedures,” said Human Services Commissioner Lucinda Jesson. “I’d like to thank our federal partners for their cooperation and support in this effort to provide better care for Minnesotans and greater savings to taxpayers.”

Historically, publicly-funded health care programs in Minnesota have been either fee-for-service paying providers per procedure) or managed care (paying a health insurance company to provide coverage). The HCDS demonstration projects will contract directly with providers in a new way that allows them to share in savings for improving quality of care and patient experience and reducing the total cost of care for Medicaid enrollees.

In this new model, people enrolled in Minnesota Health Care Programs will receive more coordinated care to improve their overall health, and health care providers will be paid based on the quality of care they provide to their patients and their ability to reduce the cost of care. This encourages providers to be innovative in how they provide care and allows them to focus on the quality of care versus the amount of care they provide.

“A key factor in reforming our health care system is working with doctors, hospitals and other providers to better coordinate care for patients. We need to look at patient care as a team effort with one overall shared goal of a healthy patient outcome,” said CMS Acting Administrator Marilyn Tavenner.

Friday, August 10, 2012

What Minnesotans are saying about improving health care

Minnesotans who participated in a series of community conversations this summer want an affordable health care system, more information to make choices, and communities that support healthy choices.

The Bush Foundation and Citizens League  recently completed a Citizen Solutions initiative around health care that involved  about 40 community conversations with more than 1,000 Minnesotans, as well as online discussions with more than 4,100 Minnesotans. The results of the four-month initiative, funded by the Bush Foundation, were shared with the Governor’s Health Care ReformTask Force on August 6. Those who attended the community conversations held a range of political beliefs,  according to the report’s appendix.

Participants said they wanted to be co-creators and co-managers of their health care, and they needed better information to succeed at that task, according to the report, “Public Conversations & PublicSolutions: Making Health and Health Care Better in Minnesota.”

They were willing to make trade-offs.  When asked about rights and responsibilities, less than one percent suggested unfettered access to care should be part of a citizen’s health rights. Participants reached the greatest consensus on the points that citizens have the right to affordable care and that they are responsible for practicing healthy behaviors.

They would like to see employers, families, communities and state decision makers support them in assuming ownership of their health. Suggestions included improving environments so that physical activity is more accessible and making healthy food more accessible and affordable.

Participants also supported policies that would help citizens experience the true costs of their behaviors, such as taxes on sodas, tobacco, or other unhealthy choices that contribute to preventable disease.

They also wanted an affordable health care system but they understood that the health care system alone does not define good health.

As for the health care system, they identified the lack of affordability as the biggest challenge, followed by the fact that the system is complicated and confusing, and doesn’t focus enough on healthy living and prevention.

In terms of cutting costs, participants prioritized cutting administrative costs, preventing avoidable conditions and unnecessary care, and improving the coordination of care.

When asked what they saw as the most effective way to create change, about one-third of attendees picked focusing on making Minnesotans more knowledgeable health consumers and one-fourth of attendees suggested focusing on community-based strategies that make healthy choices easier.