Tracking Reform
Health care reform is taking shape in the state as work groups and organizations under contract with the state flesh out the 2008 Health Care Reform Act. Minnesota Medicine is tracking developments related to issues that will affect how Minnesota physicians practice medicine—payment reform, health care homes, quality improvement, public health, and coverage expansion. For more information, go to the MMA website, www.mmaonline.net.
Quality improvement
1,400 Measures and Counting
In December, MN Community Measurement, which is under contract to develop a standard set of measures for assessing quality of care, completed the first of several tasks: It developed a comprehensive inventory of existing hospital and clinic quality measures. For the most part, MN Community Measurement pointed lawmakers to the Agency for Health Care Research and Quality (AHRQ) National Quality Measures Clearinghouse database, which includes more than 1,400 measures and tracks another 500 that are under development.
The inventory will be used as a starting point for the development of a set of Minnesota-specific measures for improving and rewarding quality and performance. MN Community Measurement is partnering with the University of Minnesota, Stratis Health, the Minnesota Medical Association, and the Minnesota Hospital Association on the project.
The inventory is available at www.health.state.mn.us/healthreform/measurement/Quality_Measures_Inventory.pdf.
Payment Reform
Baskets of Care Committee to Meet
The 14-member Baskets of Care Steering Committee is scheduled to meet for the first time on January 9. The MMA appointed to the committee David Estrin, M.D., a pediatrician with South Lake Pediatrics in Minnetonka and Plymouth, and Michael Tedford, M.D., an ENT physician at the Ear, Nose, and Throat Clinic and Hearing Center in Edina. This group will define at least seven baskets of care (sets of services associated with a procedure or condition).
The baskets of care provision is intended to test whether alternatives to current fee-for-service payment methods will yield flexibility and innovation among providers, as well as more transparent and simplified pricing for patients. Providers that choose to test the model will set a standard price for a particular basket that must be paid by all payers (excluding government programs). Recommendations on the basket definitions must be presented to the commissioner of health by May 6.
Health Care Homes
ICSI Proposes Outcomes Criteria
The Institute for Clinical Systems Improvement (ICSI), under state contract, released draft recommendations for how the state should evaluate health care homes.
ICSI’s 14-page report suggested that health care homes be judged on patient experience, cost and utilization, system effectiveness, and health outcomes. The report then went into extensive detail about specific areas of focus within each of these categories.
The MMA Health Care Reform Oversight Task Force reviewed the proposed recommendations and submitted a five-page letter stating that the proposed framework was too complex and confusing, that the outcomes needed to be simpler and more straightforward, and that the results expected from health care homes need to be realistic. In addition, the MMA questioned how, and how often, the state intends to conduct its evaluation. The MMA comments are available at www.mmaonline.net.
ICSI has since submitted its final recommendations to Minnesota Commissioner of Health Sanne Magnan, M.D.
Criteria Work Group Meets
The work group that will recommend criteria for certifying health care homes held its first meeting on December 18. The MMA appointed Keith Stelter, M.D., a family physician at Immanuel St. Joseph’s Clinic in Mankato, to the group.
Who's Ready?
The Minnesota Academy of Pediatrics Foundation was awarded the contract to assess the readiness of Minnesota’s primary care clinics to implement the health care home model as well as to assess consumer understanding of health care homes. The foundation will partner with the Minnesota Academy of Family Physicians, the Minnesota Chapter of the American College of Physicians, and Stratis Health to finish these assessments by May 30, 2009.