Tracking Reform
MMA Asking for New Peer Grouping Timeline
The MMA plans to seek legislation that would give health care providers more time to understand and improve their cost and quality scores before such data is publicly reported or used by the state or health plans to make payment decisions.
Minnesota is in the midst of an experiment to develop a uniform methodology for calculating and comparing the cost and quality of medical care. The information will be used in a payment approach known as peer grouping. In preparation for peer grouping, health plans have been submitting claims data to the Maine Health Information Center since July. The Minnesota Department of Health, with the help of the Peer Grouping Advisory Committee, is expected to define the methodology to be used in peer grouping by January 1, 2010.
According to the current timeline, providers will receive their scores in June. Those scores will be reported to the public in September, and the state’s public and private health plans will start making benefit and payment changes based on those scores in January of 2011.
In September, MMA leaders met with Commissioner of Health Sanne Magnan, M.D., and told her they would like to see the timeline altered. The MMA supports greater transparency regarding the cost and quality of health care. However, in September the Board of Trustees directed staff to work to ensure that education and quality-improvement components are built into the timeline.
“Physicians deserve adequate time to digest the results, make practice improvements, and be assured of the validity of the data before the information is made public or used,” says Janet Silversmith, the MMA’s director of health policy. “We’d like to see the provider community have some reasonable time to respond and adapt to this relatively new and untested approach to measuring clinic and hospital performance.”
MMA Launches Quality Reporting Education Campaign
The MMA is leading a campaign to educate physicians about the state’s new quality-reporting system. The state is requiring clinics to report on the extent to which they provide optimal care management for patients with diabetes and ischemic vascular disease and on their adoption and use of health information technology. The first report of clinic performance will be released to the public in July of 2010.
Through a contract with the Minnesota Department of Health, the MMA is holding educational events and producing online and print materials that explain the new quality-reporting requirements and opportunities. All clinics need to register for the new reporting system by January 1, 2010. Go to https://data.mncm.org/login to register.
Registration Begins
Minnesota clinics and clinicians that offer care coordination, the ability to create care plans, and electronic care tracking can start applying to become certified as health care homes.
To apply for certification, clinics or providers must first submit a letter of intent to the Minnesota Department of Health using an online form available at www.health.state.mn.us/healthreform/homes/certification/intent.html.
Once the Department of Health receives the letter of intent, clinics and clinicians will be able to apply for certification, a process that includes a site visit.
Providers who become certified will be eligible for enhanced payments under Minnesota’s 2008 Health Care Reform Act.
Scale of Program Debated
Differing viewpoints about the scale of the state’s health care home program surfaced at a September meeting of a work group that will make recommendations about how to pay participating providers. The payments are scheduled to begin in July.
Health plan representatives expressed concern about the financial burden of paying for care coordination if the state embraces an approach that would allow for a large number of clinics to offer patients health care home services.
Physician representatives noted that the significant infrastructure and system changes required for becoming certified as a health care home, coupled with the reality that services must be offered to all patients seen at a particular clinic, make it essential that the model is widely implemented. The MMA strongly supports health care homes for all patients and is urging the state to adopt payment mechanisms that will support and sustain broad health care home development.
Minnesota Medicine is updating readers monthly as Minnesota implements key components of the 2008 Health Care Reform Act. Additional information is available online at www.mmaonline.net and at the Minnesota Department of Health’s website, www.health.state.mn.us/healthreform/.