Maria was 27, morbidly obese and sedentary. Her diabetes was out of control. She was stressed, anxious and angry. Then she enrolled in the care coordination program at Lake Region Healthcare in Fergus Falls. Just one year later, Maria (not her real name) is on her way to achieving a healthy weight, has lowered her blood sugar, and she’s feeling good about life.
“I have become the person I always wanted to be and that is a person in charge of her health,” Maria said recently. “That is all due to this program and (care coordinator) Nicole. I hope care coordination stays a part of the health care system forever.”
The program that has changed Maria’s life is part of Lake Region’s Integrated Health Partnership (IHP) work in collaboration with the Minnesota Department of Human Services (DHS). Minnesota was one of the first states to implement an Accountable Care Organization to improve care for low-income people in its Medicaid program.
“Health care providers who participate in IHPs work together on innovative ways to ensure that people have access to affordable, high-quality care. Low-income patients across our state are benefiting from this work,” said DHS Commissioner Emily Piper. “These changes have built on Gov. Mark Dayton’s health care reforms, saving nearly $213 million for the state in the program’s first four years.”
This nationally watched initiative is an example of programs that are at risk under U.S. House and Senate proposals to repeal and replace the Affordable Care Act. Instead of focusing on this type of innovation and helping other states learn from our work, Minnesota is unfortunately scrambling to simply maintain the status quo, Piper said.
Statewide, IHP savings in calendar year 2016 totaled more than $45 million, with Lake Region alone saving $420,821. The preliminary 2016 savings come on top of savings of $87.5 million in 2015, $65.3 million in 2014 and $14.8 million in 2013, when the IHP began.
Minnesota’s IHP now covers more than 462,000 people in publicly funded health care programs and continues to expand, with 21 provider groups now involved. Providers that deliver care for less than the targeted cost are eligible to share the savings; some providers also share the downside risk if costs are higher than targeted. As providers progress into their second and third years in the IHP, a portion of their payment is tied to their performance on quality metrics.
Beginning in 2018, DHS will expand and enhance the IHP model in several important ways. DHS will introduce multiple tracks to accommodate a diverse set of provider systems, add a quarterly population-based payment to support care coordination and infrastructure needs, and modify the quality measurements methodology. Letters of intent to apply must be received no later than 4:30 p.m. Aug. 18, 2017; applications must be submitted by 4:30 p.m. Sept. 1, 2017. Find more information in the /dhs/assets/2019-ihp-rfp_tcm1053-294430.pdfRequest for Proposals document.
“The Department of Human Services is proud to partner with providers from across Minnesota in this innovative health care reform effort,” Piper said. “IHP gives participating providers the flexibility to develop their own approaches to improving care.”
Lawrence Massa, president and CEO of the Minnesota Hospital Association, said: “We are demonstrating that with the right set of incentives and appropriate flexibility, DHS and health care providers can work together to lower the cost of care while maintaining high quality.”
The IHP is a significant part of a $45 million federal State Innovation Model (SIM) grant supporting health care reform in Minnesota. Several providers participating in the IHP have also received SIM grants for their work.