“Medicare’s Health Care Home Demonstration in Minnesota” Age and Disability Odyssey Conference 6/21/11 Ross Owen DHS Health Care Administration

Health Care Home (HCH) Initiative Components “Real Transformation” Statewide certification process with Learning Collaborative support “Real Reimbursement” Multi-payer payment methodology “Real Results” Measurement of “Triple Aim” outcomes with provider accountability

MN’s Unique HCH Payment System Monthly per-person care coordination payment to clinics, adjusted by the level of patient complexity 5 Tiers of Patient Complexity: Populations will differ Provider assessment of patient complexity  Administrative standard for billing

MAPCP Demonstration: CMS Goals Join state-led, multi-payer medical home initiatives in progress by adding payment for Medicare FFS enrollees to them Evaluate the impact of advanced primary care on quality, utilization, and expenditures Ensure budget neutrality

Demo Sites Awarded in November 2010 New York North Carolina Maine MichiganMinnesota Pennsylvania Rhode Island Vermont

MN’s Population by Insurance Status: The Payment Reform “Critical Mass” Challenge SOURCE: Adapted from MDH Health Economics Program, Medicare enrollment data and SEGIP enrollment data

MN MAPCP Demo: Quick Facts All certified HCHs will be eligible to participate by billing for their eligible Medicare patients The demo will last 3 years Over 200,000 MN beneficiaries are projected to participate Dollars will go from Medicare directly to the practices using a similar rate structure to FFS Medicaid (est. to start October 2011)

MAPCP Further Opportunities Fostering partnerships between HCHs and community resources focused on Medicare beneficiaries Engaging providers (esp. rural) who would not otherwise have considered being a HCH Linkage between MN and the CMS Center for Innovation

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