Tracking Reform
Quality Improvement
State Releases First Public Report on Quality
This month, the Minnesota Department of Health will release its first public report using information gathered through the statewide quality reporting system. According to department officials, 915 Minnesota clinics completed a survey regarding their use of health information technology and approximately 850 submitted data on optimal diabetes care and optimal vascular care. This is more than double the number of clinics reporting data to MN Community Measurement in 2009.
One difference between the state and MN Community Measurement reports is that the state is publishing risk-adjusted results; initially, the state will only adjust for differences in patients’ payer type (whether they are insured by commercial insurance, state public programs, or Medicare). MN Community Measurement has not risk-adjusted its results but intends to add the adjusted rates to its website and include them in its annual report.
Peer Grouping Analysis Begins
The Minnesota Department of Health has announced that the claims database that will serve as one of the principal sources of data for Minnesota’s provider peer-grouping project has reached the target threshold to allow analysis to begin. The aim of provider peer grouping is to develop comparative data on clinic and hospital costs and quality of care. The health department wanted to make sure that at least 85 percent of commercially insured enrollees were represented in the data before Mathematica, the state’s vendor, began its examination. In addition to commercial insurance claims, the database also includes claims from Medical Assistance and Medicare enrollees.
The MMA and MMIC Group are developing a variety of resources to assist physicians in preparing for and responding to the peer-grouping results.
Health Care Homes
CMS Invites States to Apply for Demonstration Projects
In June, the Centers for Medicare and Medicaid Services (CMS) issued a formal solicitation for proposals from states to implement a Medicare advanced primary care practice demonstration project. U.S. Secretary of Health and Human Services Kathleen Sebelius originally introduced the program in September 2009, noting it was developed to allow states to include Medicare patients in efforts intended to improve the delivery of primary care. Having the chance to include Medicare patients in Minnesota’s health care home initiative, for example, would provide a significant boost to the effort because it would create the critical mass of patients needed to sustain it.
The MMA has called for a medical home or health care home for all Minnesotans in its health care reform proposals and views the inclusion of Medicare patients as an important step in moving the state health care home effort forward. The Minnesota departments of Health and Human Services are coordinating Minnesota’s application, which is due August 3. CMS expects to select up to six states to participate in the demonstration project.
Federal Reform
Governor Forms New Federal Reform Task Force
Gov. Tim Pawlenty has announced the formation of a new health care reform task force to help Minnesota prepare for the changes brought about by the Patient Protection and Affordable Care Act. A provision included in the final state health and human services budget bill passed by the Legislature this year created the new 17-member group, which is charged with “advising and assisting the governor and the Legislature regarding state implementation of federal health care reform legislation.”
In particular, the group is expected to develop recommendations for state law and program changes necessary to comply with the federal health care reform legislation. It also will provide recommendations for implementing provisions of the federal legislation that are optional for the state. In developing recommendations, the task force will consider the extent to which federal funding to the state can be maximized.
The group will hold its first meeting this month and is expected to issue its final report and recommendations by December 15, 2010.