MMA Viewpoint
MMA Vision Shapes Health Care Reform
We can be proud that the MMA has led in shaping health care reform in Minnesota. The legislation that passed this session starts us on the road to achieving the health care reform goals the MMA proposed in 2005.
We had our share of ups and downs this session. But in the end, we played a major part in enacting an important reform bill, and we avoided dangerous pitfalls. The mounting pressure to hold down costs made change in our health care system all but inevitable. We wanted to make sure there would be real improvements, not just cost cutting. We called for market-based reforms, while others advocated for more drastic change, including putting the government in control.
We knew it was critical for physicians to be major players in health care reform. MMA physicians served on task forces working on reform through the summer of 2007. Nearly all of the recommendations in our Physicians Plan for a Healthy Minnesota emerged as legislative proposals.
We urged policymakers to draft legislation that would provide universal coverage, disease prevention through public health initiatives, care coordination and payment reform through medical homes, and meaningful quality measurement and improvement. In the end, the Legislature passed a bill that moves us toward those goals.
The bill makes more people eligible for subsidized health coverage and establishes a work group to design an essential benefit set. It supports medical homes with care coordination fees that help prevent the complications of chronic disease. The bill also invests in programs to combat obesity and tobacco use, and establishes a process to create standard, valid quality and cost information. This emphasis on disease prevention will result in better health for our patients.
We also blocked provisions that would have been a step backward. In January, the governor’s task force came up with a scheme that we saw as a serious problem—the Level 3 payment proposal, which would have made physicians accountable for the total cost of care. We immediately expressed strong opposition. We charged that Level 3 was a return to capitation, which has been tried and failed, and warned that it would lead to more consolidation. MMA lobbyists were at the Capitol every day, talking to influential legislators and those on the crucial committees that deal with health care reform. MMA CEO Robert Meiches, M.D., testified against the scheme, which he told lawmakers was “extremely complex, not understood, internally inconsistent, and increases the administrative burden on the system.” An alert went out to MMA members urging them to encourage their lawmakers to vote for payment reform that promotes medical homes and care coordination and to vote against Level 3. Many of you called your legislators and contributed to our success. In the end, Level 3 was not included in the final bill.
We also blocked a 3 percent cut to outpatient physician services in our public health care programs, new prior authorization requirements, and a $5 fee increase for all professional licenses. And we greatly improved plans to use the Health Care Access Fund (HCAF). The bill borrows $50 million from the fund that will be repaid if reforms result in savings. This is significantly better than an earlier proposal to transfer $250 million from the HCAF and use $48 million each year to offset General Fund spending on health care programs.
As an MMA member, you can be proud that you’re part of an organization that has been working so diligently to make sure that there is real health care reform rather than just attempts to reduce the cost of care. This bill is a good start. We’ll keep working together to achieve our goals.