Protecting Medicaid & Innovation in Minnesota

Throughout 2017, TakeAction Minnesota members have organized to defend Medicaid by collecting and sharing stories, mobilizing Minnesotans to vociferously oppose bills that would harm Medicaid, and by training individuals on the threats to the state’s Medicaid innovations like Integrated Health Partnerships (IHPs – also called “accountable care organizations”) and Minnesota Senior Health Options.

TakeAction has also continued in our role as a convener of health care advocacy organizations in Minnesota to protect all of our public health care programs and improve the transparency and effectiveness of Integrated Health Partnerships – to better protect and reflect the needs of Minnesotans.

These initiatives have presented some unique challenges. To date, Minnesota’s Integrated Health Partnerships have been all but invisible to people enrolled in programs, existing instead as a data-sharing contractual relationship between the Department of Human Services and provider organizations to encourage care coordination and experiment with different population health interventions – regardless of their managed care or Fee-For-Service payment arrangements. DHS already considers Integrated Health Partnerships to be a major success in just a handful of years serving over 460,000 enrollees: ER visits are down 7%, hospital stays are down 14%, and program costs have decreased by $213 million. However, without the awareness or engagement of people enrolled in the program, it is more payment reform than true transformation in people’s lives.

Our policy discussions with DHS officials have continued. They recently released a Request for Comment on a “Next Generation” pilot of Integrated Health Partnerships in the seven-county metro area to build on their accomplishments. Key differences in this pilot from existing Integrated Health Partnerships include prospective enrollment by individuals with a primary care provider (or another primary provider relationship, such as a mental health provider or OB-GYN) rather than with a Managed Care Organization (MCO), and the option for provider organizations to establish direct contractual relationships with DHS – without a MCO – for the care they provide through these programs

We are encouraged that our DHS continues to develop the Integrated Health Partnerships program and push it forward, rather than considering their early results to be good enough. At the time of writing this blog post, we are drafting comments that will urge DHS to establish a robust engagement and education process to make true delivery transformation for Minnesotans possible at the level of the enrollee-provider relationship; and to offer recommendations on ways for system savings to be reinvested into upstream interventions on social determinants of health.

2018 promises to be a pivotal year in Minnesota politics, shaping what’s possible in health care policy for many years to come. TakeAction Minnesota members will continue our decade-long work to protect and expand our public health care programs, Medicaid and MinnesotaCare. Their success has been strengthened by every one of our state’s innovations, including the ongoing development of Integrated Health Partnerships, and our engagement with people enrolled in public health care programs. 

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