A Look at Minnesota's Health Care Delivery and Payment Reforms

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<p>The landmark health reform legislation that Minnesota enacted in 2008 includes a number of provisions to make health care delivery more efficient and reduce costs. In a <a href="/publications/fund-reports/2010/mar/reforming-health-care-delivery-through-payment-change-and">new report</a> from The Commonwealth Fund and the National Academy for State Health Policy (NASHP), researchers provide a window into the state's efforts to transform care delivery and offer insights for other states contemplating similar changes and for federal officials charged with implementing national health reform. <br /><br />In addition to establishing a statewide health improvement program and enhancements to insurance coverage, Minnesota's reforms call for: </p>
<li>the collection and reporting of all-payer health care encounter data to make health care pricing and quality more transparent to purchasers and consumers;  </li>
<li>the transparent ranking of providers, based on a combination of risk-adjusted cost and quality measures; </li>
<li>uniform definitions for at least seven "baskets of care," and standard quality measurements for those baskets; </li>
<li>a single, statewide system of quality-based incentive payments to health care providers, to be used by both public and private payers; and  </li>
<li>standards for certifying providers as medical homes that coordinate care for people with complex or chronic conditions, and additional care coordination payments to providers meeting those standards. </li>
<p>Lead author Anne Gauthier of NASHP says Minnesota's reforms lay the foundation for an expansion of the "accountable care" model of fully integrated and coordinated health care delivery, which has already gained considerable traction in the state, as well as other models of bundled payment. As demonstrations of accountable care organizations and other payment reforms proceed under the federal Patient Protection and Affordable Care Act, Minnesota, the authors say, will serve as an "excellent testing ground."<br /><br /></p>