August 2009 | Back to Table of Contents

Tracking Reform

Health Care Homes

Health Care Homes Rule Published 
The Minnesota departments of Health and Human Services published a proposed rule in July establishing the criteria and standards providers must meet in order to be certified as a health care home. 

The departments were accepting comments about the rule proposal through August 6. The rule is available at www.health.state.mn.us/healthreform/homes/proposedrule.html. 

The 2008 Health Care Reform Act calls for a health care home certification process for providers who will offer increased care coordination and primary care services for patients with chronic conditions and disabilities. Certified providers will be eligible to receive enhanced payments. 

The state has been developing these standards for about seven months. The MMA provided feedback at several key junctures. Most notably, in February the MMA, the Minnesota Academy of Family Physicians, the Minnesota Chapter of the American Academy of Pediatrics, and the Minnesota Chapter of the American College of Physicians sponsored a Health Care Home Summit in which participants reviewed and responded to the state’s early draft standards and criteria for certification. Nearly 80 physicians attended the summit. 

Health and Human Services officials are still developing the system for reimbursing certified health care homes. The MMA’s representative on the group doing this work is Amy Burt, D.O., a Park Nicollet pediatrician. 

Quality Improvement

Collecting Cost and Quality Data 
The Health Care Reform Act requires the Minnesota Department of Health to start collecting patient encounter and pricing data from health plans for the purpose of developing a provider peer grouping system. 

To fulfill this requirement, on July 1 the Health Department started sending encrypted claims data—information without identifying characteristics—to the Maine Health Information Center, which will hold the information until Minnesota Department of Health officials determine which organization will analyze it. The first report on the relative cost and quality of the state’s providers based on the data is expected in the fall of 2010. 

The data-collection system has been dubbed the Minnesota Health Care Claims Reporting System. Rules for how it will work were published in the July 6, 2009, State Register. 

The Minneapolis Star Tribune published an editorial, “Mining health data to cut down costs,” on July 10, in support of the project.

Payment Reform

Essential Benefit Set 
In July, the MMA put out a call for physicians interested in serving on a health care reform work group charged with developing an essential benefit set for health insurance. 

The Health Care Reform Act calls for the creation of a work group that will meet about six times in September and October to identify services and technologies, based on scientific evidence, that ought to be included in a basic health plan. 

Two yet-to-be-appointed MMA representatives will serve on the work group.