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Back to Table of Contents | February 2011

Tracking Reform

Federal Reform

Nine Changes to Expect in 2011
Minnesota physicians can expect the following changes as a result of passage of the Patient Protection and Affordable Care Act in 2011:

  1. The “doughnut hole,” which affects some Medicare Part D recipients, will begin to be closed with discounts on brand-name drugs and subsidies for generic drugs.
  2. Medicare will pay a 10 percent bonus to primary care physicians, if 60 percent or more of their charges are for office, nursing facility, and home visits. General surgeons serving in underserved areas will also see a 10 percent Medicare bonus payment.
  3. Medicare beneficiaries will be entitled to free annual checkups; certain screenings also will be free.
  4. The Center for Medicare and Medicaid Innovation will evaluate new methods of providing care that reduce cost while maintaining or improving quality.
  5. The Community-Based Care Transitions Program, designed to reduce hospital readmissions, will be tested.
  6. Insurance companies must spend between 80 and 85 percent of their revenue from premiums on medical care and improvements for patients.
  7. The government will begin eliminating overpayments to Medicare Advantage programs.
  8. The Secretary of Health and Human Services will finalize a national quality-improvement strategy.
  9. States will be eligible for five-year grants to develop, implement, and evaluate alternative medical liability reform initiatives. The wild card factor, however, will be whether attempts to repeal or legally challenge the act or parts of it will succeed.

The wild card factor, however, will be whether attempts to repeal or legally challenge the act or parts of it will succeed.

Dayton Signs Early Medicaid Expansion
In a sharp break with his predecessor, Gov. Mark Dayton signed an executive order to allow Minnesota to take advantage of an early Medicaid expansion option included in the Patient Protection and Affordable Care Act. The move will add approximately 95,000 Minnesotans to Medical Assistance (the state’s version of Medicaid), including 32,000 people from the General Assistance Medical Care program and 51,000 low-income workers from MinnesotaCare, the state’s subsidized insurance program. Approximately 12,000 previously uninsured Minnesotans also will be added to Medicaid.

Dayton also signed an executive order reversing Gov. Tim Pawlenty’s policy that barred state agencies from seeking grant money related to the federal health care reform law.

The MMA supported both moves.

Electronic Health Records

Meaningful Use Assistance The Minnesota Department of Human Services has launched a website designed to offer physicians and other providers basic information about implementation of electronic health records (EHRs) and the meaningful use criteria tied to them. Care providers who demonstrate meaningful use of EHR technology will be eligible for financial rewards from Medicaid and Medicare.

The website offers information about eligibility for the program, the incentives being offered, and links to resources including a hospital EHR incentive calculation template. In addition, providers can sign up for email updates about EHR implementation and meaningful use. Go to www.dhs.state.mn.us and search for electronic health records.

Health Care Homes

Health Care Home Quality Measures Released
The Minnesota Department of Health has released the 2011 quality measures that must be submitted by certified health care homes. They are: optimal vascular care, optimal asthma care, patient experience, and cost-effectiveness. The measures were drawn from the recommendations of the Health Care Homes Outcomes Measurement Advisory Work Group, which included representatives from the public and private health care sectors.

Certified health care homes will be required to submit quality measurement data in 2011. A submission deadline has not been set. The information will then be used by the Department of Health for benchmarking purposes, to recertify health care homes, and to evaluate the health care home program.

Department officials are expected to release more information about specific measurement tools and the data- submission process. Information about the health care homes program can be found at www.health.state.mn.us/healthreform/homes/index.html.

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