Providing Minnesotans with better health care at lower cost
One reason health care costs have grown so quickly is because the health care system has historically paid for care based on the number of services provided, with few incentives for quality or value. Health reform begins to change this trend by incentivizing providers to improve patient care and lower costs.
Minnesota’s health reform efforts are leading the nation; we are the first state to make available information about both health care cost and quality. This information on how well providers treat common diseases like diabetes and depression is a powerful tool for health plans, consumers and employers to choose high-quality health care providers.
- How does Minnesota measure quality in health care?
The Minnesota Department of Health (MDH) established and annually updates a core set of standardized health care quality measures for physician clinics and hospitals. These measures include care for diabetes, coronary artery and heart disease, asthma, and depression. Measures are developed in consultation with health care providers and are based on medical evidence. Providers are required to submit data on these measures and MDH publicly reports this information.
- How are the quality measures be used?
The measures are used to develop a system to reward providers when they provide quality care, or make improvements over time. These payments are sometimes called “pay-for-performance” incentives. The State Employee Group Insurance Program and the Minnesota Department of Human Services must use this incentive system.
- How can I find health care providers that provide high-quality, lower cost services?
The Minnesota Department of Health has been developing a system to compare physician clinics and hospitals based on cost and quality. The results will be reported in a consumer-friendly way beginning early in 2012. This information will also be used by health plans, state agencies, and local government to help consumers select high-quality, low –cost providers. Providers can also use this information to improve their quality and reduce costs.
- I have heard the term “accountable care organizations.” What are these?
Accountable care organizations (ACO) are a model for paying for and delivering health care that pays providers based on the quality of care they provide and the total cost of care. Health systems in Minnesota have been developing ACO models for several years and they now have the opportunity to use the model with Medicare patients through the Center for Medicare and Medicaid Innovation. Health reform created this Center which has broad authority to try new payment and care delivery models that improve health care quality and decrease cost, including ACOs.
The Minnesota Department of Human Services (DHS) is also exploring how an ACO model could be used to improve care and bring down costs for enrollees in the state’s Medicaid program beginning in 2012.