Friday, January 3, 2014

2013 Minnesota health reform review

Here is a review of some of Minnesota’s health reform activities in 2013.

Medicaid and the Affordable Care Act
February brought significant changes for Minnesota’s public health insurance programs. Gov. Mark Dayton signed legislation Feb. 19 that providing access to quality health care coverage for an additional 35,000 low-income adults. The bill took advantage of a key component of the federal Affordable Care Act, which allows states to expand Medical Assistance (MA) eligibility.

Also in February, Gov. Mark Dayton and Human Services Commissioner Lucinda Jesson announced DHS was partnering with six major health care providers to test a new payment model that prioritizes quality, preventive care and rewards providers for achieving mutually-agreed upon health goals. The Health Care Delivery Systems Demonstration project was expected to affect the care of more than 100,000 Minnesotans and save Minnesota's Medicaid program approximately $90 million over three years.

The federal Department of Health and Human Services also provided guidance to states, including Minnesota, interested in pursuing a provision in the Affordable Care Act known as the Basic Health Plan. Based on this, DHS announced that Minnesota's nation-leading health care program for the working poor, MinnesotaCare, would have a path for being preserved and improved.
In September, Minnesota Commerce Commissioner Mike Rothman released the individual policy premium rates in advance of MNSure’s opening. The rates were the lowest average rates in the country for health insurance plans sold through exchanges. MNSure saw strong demand for coverage with 10,000 user accounts being created in the first 10 days of MNsure’s launch in October. By December, the number of people signed up topped 24,000 and more than 50,000 accounts had been created. In addition, MNsure added seven more health plans for Minnesotans in the Southeastern region of the state and extended deadlines at the end of the year.

SIM Minnesota
In February 2013 the Center for Medicare and Medicaid Innovation (CMMI) awarded Minnesota a State Innovation Model (SIM) testing grant of over $45 million to use across a three-year period ending October 2016. The goal is to help Minnesota’s providers and communities work together to create healthier futures for Minnesotans. This effort is a joint initiative of DHS and MDH. Minnesota will use the grant money to test new ways of delivering and paying for health care using the Minnesota Accountable Health Model. Taskforces were announced in June and started meeting later in the year.

Health Care Homes
The number of Minnesota’s primary care clinics choosing to become health care homes continued to rise in 2013. By the end of the year, Minnesota had more than 322 certified health care homes, or about 43 percent of primary care clinics, serving more than 3 million Minnesotans.

Quality measures
In August, Minnesota released the nation’s largest statewide patient experience survey. The survey included results from the more than 230,000 patient-completed surveys on patient experience of care—known as the Clinician and Group Surveys – Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS)—from 651 clinics. The data was collected as part of Minnesota's Statewide Quality Reporting and Measurement System.

Statewide Health Improvement Program
Minnesota’s Statewide Health Improvement Program received another round of funding from the Minnesota Legislature in 2013. The Minnesota Department of Health (MDH) awarded more than $21.2 million in Statewide Health Improvement Program (SHIP) grants in November to counties and cities across Minnesota. The grants will be used by communities – in partnership with local businesses, schools, and local governments – to implement projects and programs that will promote exercise and physical activity, improve nutrition, and decrease tobacco use.

Senior care
Reform 2020 advanced through the Legislature and received funding in 2013. The effort transforms Minnesota's Medicaid program to better meet the challenges of rising health care costs and a growing aging population while better serving Minnesotans' long-term care needs. One of the priorities of Reform 2020 is keeping more seniors and people with disabilities living in their homes and communities.

The Minnesota Legislature also passed new home care licensing regulations that the Minnesota Department of Health is in the process of implementing.

In December, the Minnesota Department of Health reported that Minnesota saw a significant slowdown in health care spending increases. Health care spending in Minnesota increased 2 percent to $38.2 billion from 2010 to 2011. In addition, Minnesota's per-person health care spending in 2011 of $7,145 was lower than the national per-person cost of $8,175. Plus, health care spending accounted for a smaller share of Minnesota's economy, 13.6 percent, compared to the national number of 16.9 percent.

A one-of-a-kind DHS program that provides nursing homes additional payment for quality improvement projects showed promise for encouraging overall nursing home quality improvement, according to a study published this month in the journal Health Affairs. Researchers analyzed the impact that the Performance-based Incentive Payment Program (PIPP) had on care quality in participating nursing homes.

A new report from the Commonwealth Fund found Minnesota was among the best states in the nation when it came to health care for low-income individuals.