1. GOVERNOR’S HEALTH CARE REFORM TASK FORCE APRIL 2, 2012 Total Cost of Care Contracting in Minnesota: Current Activity

2. Payment and Delivery System Reform Large scale changes are already underway, albeit in early stages Commercial insurers, Medicare and Medicaid are all participating with larger provider organizations

3. Significant Commercial Payer and Provider Involvement in Total Cost of Care Payment Commercial insurers in Minnesota are adopting Total Cost of Care (TCOC) strategies with provider organizations. Examples of payers with multiple TCOC contracts: BCBCMN, HealthPartners and Medica Examples of providers with TCOC contracts: Allina, Fairview, Essentia, HealthEast, Park Nicollet

4. Three Medicare Pioneer ACOs in Minnesota 1. Allina Hospitals & Clinics 2. Fairview Health Systems 3. Park Nicollet Health Services

5. Hennepin County Health Care also forming an ACO The Hennepin County ACO will include: Hennepin County Medical Center NorthPoint Health and Wellness Center Metropolitan Health Plan Human Services and Public Health Department Proposed ACO will serve more than 200,000 residents (Pilot will be limited to 12,000) Plans to offer integrated social, behavioral and medical services Source: http://hennepin.us/portal/site/HennepinUS/menuitem.b1ab75471750e40fa01dfb47ccf06498/?vgnextoid=53268cee046a2310VgnVCM20000098fe4689RCRD

6. Minnesota Medicaid Health Care Delivery Systems (HCDS) Demonstration Project In 2010, the Legislature mandated that Minnesota Department of Human Services (DHS) test new and alternative health care delivery systems. HCDS creates a structure for provider organizations to voluntarily contract with DHS to care for Minnesota Health Care Programs (MHCP) patients in both fee‐for‐service and managed care using a total cost of care payment model. Currently undergoing contract amendments Performance period will begin in 2 nd Quarter 2012