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Cover slide. Marie Maes-Voreis, RN MA, Director Health Care Homes. Health Reform in Minnesota. Minnesota’s Three Reform Goals Healthier communities Better health care Lower costs. Institute of Medicine’s Triple Aim. MN Health Reform. Health Care H ome is not:. Health Care H ome is:.

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  1. Cover slide Marie Maes-Voreis, RN MA, Director Health Care Homes

  2. Health Reform in Minnesota Minnesota’s Three Reform Goals • Healthier communities • Better health care • Lower costs Institute of Medicine’s Triple Aim

  3. MN Health Reform

  4. Health Care Home is not: Health Care Home is: Health Care Home A nursing home or home health care A restrictive network A service that only benefits people living with chronic or complex conditions Population clinical care redesign Transformed services to meet a new set of patient-and family-centered standards to achieve triple aim Foundation to new payment models such as ACOs Community partnerships that build healthy communities

  5. Primary Care Population Based Care Delivery Redesign, What is different?

  6. HCH Certification Updates Certified Clinicians: 2900 Approximately 2.8 million patients receiving care in a certified HCH. # Certified Clinics: 253 Total 35% of Primary Care Clinics in Minnesota (6 in border states) Applicants are from all over the state. Variety of practice types such as solo, rural, urban, independent, community, FQHC and large organizations. All types of primary care providers are certified, family medicine, pediatrics, internal medicine, med/peds and geriatrics.

  7. Distribution of Providers Across Planning Regions % of MN Clinics % of Health Care Home Providers N=214 HCH’s

  8. % NP and PA Providers by Planning Region N=214 HCH’s

  9. Health Care Home Standards

  10. Consumer Perspective: Better Health Made Easy

  11. Legislative Requirements for HCH Care Coordination Payment [256B.073] • DHS and MDH develop a system of per-person care coordination payments to certified HCHs by January 1, 2010 • Fees vary by thresholds of patient complexity • Agencies consider feasibility of including non-medical complexity information • Implemented for all public program enrollees by July 1, 2010 Payment Methodology Resources: http://www.health.state.mn.us/healthreform/homes/payment/index.html 35

  12. Multi-Payer Investment in HCH’sPrimary Care Transformation SOURCE: Adapted from MDH Health Economics Program, Medicare enrollment data and SEGIP enrollment data

  13. Analysis of HCH Payment Process • DHS is conducting, with assistance of a consultant, an assessment of tier tool, billing/payment process , and methodological issues, barriers, and potential solutions • Will specifically look at how any potential changes will impact the Medicaid program, and MAPCP • Solutions considered by DHS for Medicaid will be coordinated with MDH and take other payers into consideration

  14. MAPCP Demonstration: CMS Goals • CMS joined state-led, multi-payer medical home initiatives in progress by adding Medicare FFS enrollees to those initiatives • Evaluate the impact of advanced primary care on quality, utilization, and expenditures • Ensure budget neutrality. 37

  15. MAPCP Demo Activities • Participating in MAPCP independent evaluation. • Implementation of the MAPCP Resources Tool Kit for Coordination of Care and Transition Management for Elders, Resources Workgroup. • Learning Collaborative Workshops for HCH’s for care coordination, behavioral health, other. • DHS Medicare / Medicaid claims feedback reports.

  16. MDH Charge Alzheimers Legislation passed in 2011(Minnesota Statutes 62U.15) directs Commissioner of Health to: 1. Review currently available quality measures for identification of people with Alzheimer’s and related dementias. 2. Develop a HCH learning collaborative curriculum which includes best practices for ID and management of Alzheimer's. 3. Review the literature to estimate differences in outcomes and costs comparing current practices to practice with “best practices” management.

  17. Capacity Building / Practice Facilitation • Regional HCH Nurses Support Technical Assistance • Grants: Learning Community Grants • Technical Support / Learning Collaborative • Mini-Grants to support care coordination measures • MAPCP Demonstration Workgroups • Purchaser / BHCAG Tool Kit • Building partnerships with Communities 28

  18. Learning Collaborative Activities • May 1, 2013 • 1:00pm-4:30pm • May 2, 2013 • 8:00am-4:45pm • Next Date: November 2013

  19. HCH Evaluation: • Minnesota Statute §256B.0752 directs the commissioners to complete a comprehensive evaluation report of the HCH model three and five years after implementation. • The first HCH evaluation legislative report is due to the legislature December 15, 2013 • Second HCH evaluation legislative report is due to the legislature December 15, 2015. 45

  20. Early Evidence Supporting HCH Transformation in MN AHRQ TransforMN Study, HealthPartners Research Foundation: Preliminary studies show on average HCH clinics have significantly better performance scores for diabetes and cardiovascular disease than other clinics. 2011 Medical Home Transformation: A Gradual Process and a Continuum of Attainment Dr. Leif Solberg

  21. State Innovation Model Grant (SIM) $45 million grant to boost reform efforts • 2/21/2013 (CMS) announced MN as the winner of SIM grant to help drive Minnesota's efforts to provide better care at a lower cost. • Minnesota was one of six states to receive the highest level of the award. • Minnesota's winning grant proposal was for its Minnesota Accountable Health Model. • DHS / MDH are partners with the community in implementation.

  22. Health Care Home As Foundation to ACO’s or Total Cost of Care Payment Methods 52

  23. Health Care Homes Contact Information health.healthcarehomes@state.mn.us http://www.health.state.mn.us/healthreform/homes/index.html 654-201-5421

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