Health

Health Policy

Statewide Outcome(s):

The Health Policy Division supports the following statewide outcome(s).

Minnesotans are healthy

Context:

Keeping Minnesotans healthy is a team effort, involving public health, the health care system, and the public. When the health care system is not performing as effectively as possible, it diminishes the health of Minnesotans in two ways: the cascading, adverse impacts of illness and injury are more pronounced; and it consumes scarce resources that are needed for wages, jobs, education, the environment and other determinants of overall health.

Like the nation overall, Minnesota has unsustainable rates of health care spending growth. In the past ten years, health care spending more than doubled, reaching $37.7 billion in 2010. Without any changes to the underlying trends, spending is projected to double again in ten years, consuming about $1 out of every $5 of the state's economy. At the same time, the quality and safety of health care in Minnesota markedly varies between different clinics, hospitals, and health care providers. Many providers are still working towards adoption and effective use of health information technology. Minnesota faces potential workforce shortages that may worsen due to population trends and new demands associated with health reform initiatives. These challenges present unique opportunities to implement thoughtful, data-driven policy solutions to meet the state’s current and future health and health care needs.

The Division of Health Policy (DHP) is an important part of the team that helps keep Minnesotans healthy. The health policy division provides credible, objective policy research, analysis, design, and implementation of programs and reforms to improve population health and health care value, quality, efficiency and accessibility. Its products – data, analysis, recommendations, alternatives, standards, and reports – are used by policy makers, consumers, health professionals, payers, and purchasers. The division’s work focuses on the following policy areas:

·         Healthcare cost/spending and utilization, access to healthcare, insurance coverage, and cost drivers;

·         Healthcare workforce supply/demand, workforce projections, and support for workforce development;

·         Measurement of provider quality, cost and safety;

·         Administrative simplification;

·         Adoption/use of health information technology;

·         Maintenance of the state’s vital records system;

·         Trends in health behaviors, health status, and health disparities; and

·         Federal/state health reform issues, including payment reform and care delivery innovation.

The health policy division’s work helps slow the growth of health spending while increasing affordable access to quality health care for all Minnesotans. Its work to support local public health helps to ensure that local agencies are able to appropriately plan for and implement interventions to improve population health and to reduce health disparities between different groups of Minnesotans. Approximately 60 percent of the division’s budget comes from a fund that supports medical education (which includes both state and federal dollars), 15 percent comes from federal grants and the remaining amount comes from a mix of state funding and fees.

Strategies:

·   Collect data and perform research to inform policy makers; analyze data to monitor and understand health care access and quality, market conditions and trends, health care spending, capital investments, health status and disparities, health behaviors and conditions, impact of state/federal health and payment reform initiatives, and prevalence of disease and risk behaviors.

·   Collaborate with providers, payers, consumers and other stakeholders to develop standards and best practices for exchange of business and clinical data.

·   Provide leadership and technical assistance to health care organizations and consumers on statutory mandates for use of health information technology, such as electronic medical records, and simplifying administrative processes, such as billing.

·   Provide technical assistance to local public health, consumers, and other stakeholders about using data effectively for planning and taking steps and actions to improve local health.

·   Administer the statewide hospital trauma system, collect and analyze trauma data for system improvement and interagency coordination, and provide technical expertise to hospitals caring for trauma patients.

·   Award $30-$40 million in MERC funds each year to clinical training sites for doctors and other clinicians.

·   Strengthen Minnesotans’ access to quality health care services by directing state and federal assistance to safety net health care providers, including community clinics and rural providers.

·   Analyze and report on Minnesota’s rural and underserved urban health care delivery system and health workforce in order to focus planning for future needs.

·   Collect information on adverse health events in Minnesota hospitals and ambulatory surgical centers, and provide information about patient safety in Minnesota to providers, health plans, patients, and others.

·   Administer a secure, integrated web-based vital records system so that health care providers can enter accurate birth and death information, citizens can obtain birth and death records and health researchers have timely information that will help improve response to public health issues and emergencies.

Our key partners in performing this work include other state agencies (particularly the Departments of Human Services and Commerce), providers, payers, consumers, non-profit organizations such as Minnesota Community Measurement and Stratis Health, academic organizations, and numerous state/national organizations.

Results:

In large part as a result of work led by DHP, Minnesota has made great strides in achieving adoption and meaningful use of electronic health records and expanding use of e-prescribing, with significant potential to reduce medical errors and improve patient care; in establishing a robust, statewide trauma system that helps to ensure that trauma patients get to the appropriate level of care as quickly as possible in order to save lives; in processing birth and death records efficiently using a secure, web-based system, and in reducing health care administrative costs an estimated $40- $60 million, among other goals. The indicators below were chosen to illustrate a cross-section of the work that DHP performs, though they do not cover all areas of DHP’s work.

Much of DHP’s work focuses on providing high-quality, reliable research, policy and data analysis, and standards development work for legislators, policymakers, providers, payers, and consumers. DHP’s work creates an environment in which these entities have the information they need to improve healthcare quality/safety, reduce costs and improve population health. Seeing changes in statewide indicators related to these efforts will be difficult in the short term, given that many factors outside of MDH’s control may influence the outcomes, but they are critical in order to achieve MDH’s – and the state’s – long term goals.

Performance Measures Notes:

* DHP staff provides advice to the Governor’s health reform task force on coverage options that will link more Minnesotans with affordable health care coverage options. HP staff also closely monitor progress to ensure that policies have the intended outcomes or can be appropriately revised.

Sources: Minnesota Department of Health

Data for percentage of prescriptions routed electronically is for 2008 and 2011

Data for state wide uninsured rate is for 2001 and 2011

Data on trauma centers is for 2006 and 2011

Data for death registrations is for 2010 and 2012