Minnesotas healthcare payment reform efforts, which experiment with bundled reimbursement and quality incentives, could serve as a bellwether for national efforts, Robert Chase, chairman of the Mayo Clinics contracting and payer relations department, told attendees in a breakout session on negotiating strategies with managed-care plans at the Healthcare Financial Management Associations Annual National Institute.
Minn. payment reform initiatives touted as example
The states Legislature in 2008 agreed to multiple reforms, including bundled payments. Insurers, providers and Minnesotas Health Department face some deadlines for adoption in the next six months. By the end of the year, healthcare providers that agree to bundle care for any of seven conditions must set prices. Meanwhile, the Minnesota Health Department must establish quality measures for the seven conditions by Dec. 31. The conditions are: pediatric asthma; diabetes without complications other than hypertension or hyperlipidemia; lower back pain; obstetric care; adult preventive care; pediatric preventive care; and total knee replacement.
Chase said Minnesota hospitals must now determine how to package and price such packaged services. Minnesotas experiment with bundles has created uncertainty about how packaging care for a condition will affect relationships among providers, he said. Under the law to create such bundled payments, Minnesotas Health Department will publicly report comparative cost and quality data from providers starting in July 2010. The state estimated that payment and other changes adopted in 2008 would blunt healthcare spending by $6.9 billion through 2015, a 12% decline off projected spending without reforms.
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