Tracking Reform
Quality Improvement
Statewide Quality Reports Released
The Minnesota Department of Health released its first statewide report on health care quality November 18.
The annual report of risk-adjusted quality data for physician clinics and hospitals is a requirement of the state’s 2008 health care reform law.
The report, which was made available online as a PDF document, measured the extent to which physician clinics provided optimal diabetes care and optimal vascular care in 2009. The report also includes clinic data about asthma care, preventive screening rates, and the appropriate use of antibiotics, based on 2008 HEDIS data reported by MN Community Measurement.
Although the information in the state’s report is similar to that provided by MN Community Measurement in its report, the state report includes data on more clinics (520 altogether) and the results are risk-adjusted based on whether a patient has commercial insurance coverage or is covered through Medicare or one of Minnesota’s public programs.
The Department of Health organized the statewide report by region—Northwest/West Central, Northeast/Central, Twin Cities Metro, and Southwest/Southeast/South Central.
The report also includes more than 40 quality measures submitted by hospitals. Quality data for hospitals were drawn from the Centers for Medicare and Medicaid Services Hospital Compare, Appropriate Care, Agency for Healthcare Research and Quality, and the Healthcare Associated Infection measures. To find the report, go to www.mnmed.org/measures.
E-prescribing Mandate Takes Effect in January
In order to comply with Minnesota state law, all prescribers, group purchasers, and dispensers of prescription medications must have an electronic prescription drug program in place by January 1, 2011.
The requirement is part of Minnesota’s 2008 health care reform act. The law does not impose any penalties for noncompliance. But starting in 2012, the Centers for Medicare and Medicaid Services will start withholding 1 percent of Medicare payments from physicians who are not using an e-prescribing system.
Electronic prescribing can be done through a full-featured electronic health record (EHR) system or through a stand-alone system. (Using a stand-alone e-prescribing system can be a first step toward EHR adoption.)
E-prescribing involves having a secure bidirectional electronic information exchange between prescribers, pharmacists and pharmacies, and payers or pharmacy benefit managers. The exchange may be done directly or go through an intermediary network.
E-prescribing systems route prescriptions, check a prescribed drug against the formulary of drugs covered by a patient’s health plan, check for patient drug allergies or sensitivities, identify potential drug interactions, access patients’ prescription medication histories from external sources such as claims databases, and send or receive acknowledgement that a prescription has been filled.
To learn more, go to www.health.state.mn.us/e-health/eprescribing/.
Federal Reform
New HSA Reimbursement Rules
Beginning January 1, 2011, employers providing health savings accounts, medical savings accounts, health reimbursement arrangements, and flexible spending accounts will not be able to offer pre-tax reimbursement for purchases of over-the-counter drugs that are not prescribed by a doctor.
Consumers who have such accounts will either have to pay for basics such as cold medicine and pain relievers out of pocket or obtain a prescription from a physician. Insulin will be exempt from these new restrictions, as will a number of other health-related expenses such as medical devices, eyeglasses, contact lenses, and co-pays and deductibles.
Additional Health Care Homes Certified
In November, the Minnesota Department of Health announced that an additional 26 health care homes had been certified. The new health care homes include 16 HealthPartners clinics, Bluestone Physician Services in Stillwater, SMDC Health System-Duluth Clinic, NorthPoint Health and Wellness in Minneapolis, North Suburban Family Physicians in Lino Lakes and Roseville, RiverWay Clinics in Andover, Anoka, and Elk River, and Fairview Health Services clinics in Maple Grove and Andover.