Care Coordination/Care Management in Minnesota
Minnesota encourages health care providers to coordinate the provision of high quality care to Minnesota residents. The state has developed a number of programs to encourage care coordination among its physicians, hospitals, and health plans that increases the quality of care and lowers health care costs. One of the main ways the state does this is by establishing health care homes within Minnesota. The health care homes must be patient centered and allow for participation by the patient and his or her family in making health care related decisions.1 The state also addresses health disparities by requiring appropriate care given a patient’s race, ethnicity, and primary language.2 The law also provides for per person coordination payments to certified health care homes for providing care coordination services or having an on site employee that coordinates care.3 The state provides financial incentives to providers that meet certain quality benchmarks.4 The law also requires all health plans within the state to have health care homes as a part of their provider networks, and develop payment models for the medical homes.5
Minnesota has also encouraged the use of health care homes and other coordinated care programs in medical assistance programs. Health care homes are to be provided to beneficiaries of medical assistance programs, such as Medicaid, with chronic conditions to allow for comprehensive care management.6 Minnesota has also developed a disease management program to control the costs and outcomes of Medicaid beneficiaries with chronic conditions.7 The law also authorizes the Commissioner of Human Services to develop innovative health care delivery systems, such as accountable care organizations to be used to provide services to individuals eligible for medical assistance or enrolled in Medicaid. The Commissioner may provide incentive payments to providers who reach certain quality and performance benchmarks.8 The Seniors’ Agenda for Independent Living (SAIL) project is authorized by the law as a demonstration project for collaborative long term care to ensure cost effectiveness and quality care for Medicare and other elderly beneficiaries.9
Minnesota also promotes the use of health care cooperatives to contain health care costs, improve quality, and increase access to health care services. The cooperatives are made up of health care providers, consumers, governmental entities, and local businesses to encourage competitiveness in the health care sector.10 The state provides grants for the establishment of e-health collaboratives, used to implement interoperable electronic health records to exchange information and better coordinate care.11
The state also encourages patients to take part in the management of their care. Patients should participate in the planning of their care, and have the right to refuse care.12