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

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Presentation on theme: "“Medicare’s Health Care Home Demonstration in Minnesota” Age and Disability Odyssey Conference 6/21/11 Ross Owen DHS Health Care Administration."— Presentation transcript:

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

2 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

3 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

4 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

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

6 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

7 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)

8 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

9 QUESTIONS?


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