“Medicare’s Health Care Home Demonstration in Minnesota”

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 Michigan Minnesota 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?