Reform Update: 'We're ahead of the game,' Minn. says about reform

Minnesota leaders say their state is well positioned for healthcare reform's focus on new payment models, ramped-up quality reporting and collaborative approaches to care.

“I think we're ahead of the game,” said Lucinda Jesson, commissioner of the Minnesota Department of Human Services. Jesson was a panelist at the May 31 event, held at the University of Minnesota, which included a keynote address by Dr. Robert Berenson, senior fellow at the Urban Institute.

Much of the session centered on preparation for the ACA's “game changers,” such as patient-centered medical home models and dual-eligible programs, Jesson said.

Minnesota began looking closely at payment reform as far back as 2007, and the state started implementing a patient-centered medical home program in 2010. The state's private insurers also took an active interest early on in alternate payment models, she added.

And last August, Minnesota was the first state to get the green light from the CMS to form a Medicaid accountable care organization, an ACO that now comprises 100,000 enrollees, spread among six large provider groups. The state just issued a request for proposals for a second wave of providers for that ACO, calling specifically for those who take care of complex patients who tend to disproportionately drive costs, Jesson said.

“It helps that these changes are something we've been working on for a long time,” she said. “The challenge is choosing the right financial incentives. We don't want it to be such a big risk that no one wants to play, but it has to be significant enough to drive improvement.”

Jim Chase, president of Minnesota Community Measurement, a Minneapolis-based not-for-profit, agreed with Jesson, adding that the state's prior emphasis on quality reporting and its robust measurement infrastructure would prove useful as providers explore new models such as ACOs.

On the flip side, Chase said, it also puts additional pressure on groups such as his to ensure the measures selected are the right ones and the load on providers is not too substantial.

“We need to be very careful that we're not asking for too much from our practices and that we're trying to find ways to lessen that reporting burden,” Chase said.

Mattel Children's Hospital, Los Angeles, is touting a $1.6 million grant from the Washington, D.C.-based Patient-Centered Outcomes Research Institute. The hospital, part of the Ronald Reagan University of California Los Angeles Medical Center, plans to use the funds to study the use of videoconferencing technology to provide behavioral health services to pediatric patients. In a news release, the hospital said the project will investigate whether its approach is “an effective, efficient, and family-centered way” to provide such services to children in underserved, low-income communities. The grant is part of $88 million in comparative effectiveness research funding awards announced by PCORI in mid-May.

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