Tracking Reform
Payment Reform
Essential Benefit Set Group Releases Report
The essential benefit set (EBS) work group submitted its final report to the Minnesota Legislature on January 15.
As required by the 2008 health care reform legislation, the Commissioner of Health convened the work group to design an EBS to be offered by health insurers. The objective of the EBS was to encourage greater use of effective health care services. The EBS was specifically required to include a broad range of services and procedures that research has shown to be clinically effective and cost-efficient.
The group did its work last fall with the help of Cirdan Health Systems and Consulting, the Minnesota Center for Health Care Ethics, and the Minnesota Department of Health.
The work group did not recommend a list of services and procedures to be included in the benefit set. Rather, it proposed establishing an EBS-certified product category. An EBS-certified product is “any health insurance product that provides coverage based on scientific study and evidence of clinical and cost effectiveness.” EBS-certified products should provide a level of coverage that is comprehensive, affordable, and accessible.
The work group recommended that a state agency evaluate whether insurance products meet EBS certification standards. They also called for ongoing oversight and maintenance of certified EBS products by a panel of health care system stakeholders.
To see the recommendations, go to www.health.state.mn.us/healthreform/essential/FinalReport.pdf.
Quality Improvement
Group Releases Consumer Engagement Report
A group tasked with developing recommendations and action steps for increasing consumer engagement in health care in order to improve outcomes and reduce costs released its report in January.
The report describes a future in which individuals are engaged in their health care and take responsibility for their behaviors and communities are responsible for creating healthy environments. Action steps noted in the report include increasing public demand for best practices, promoting the use of health care homes and shared decision-making, creating a website with cost and quality information about health care providers, and developing a payment model that encourages consumers to make smart purchasing choices.
The report is available at www.health.state.mn.us/healthreform/consumer/ConsumerEngagementReport.pdf.
Quality Reporting Registration Deadline Nears
Physicians have until February 10 to register for Minnesota’s new statewide quality-reporting program.
Physicians and clinics that are registered should be on the lookout for information about the program’s health information technology survey, which will need to be completed by March 15.
For information about registering, go to www.mmaonline.net/measure. To read the final rule for implementing quality-reporting program go to www.health.state.mn.us/healthreform/measurement/adoptedrule.html.