Minnesota Legislature
HF 237
1st Engrossment - 90th Legislature (2017 - 2018) Posted on 03/08/2017 12:58pm
Bill Text Versions
| Engrossments | ||
|---|---|---|
| Introduction | Posted on 01/12/2017 | |
| 1st Engrossment | Posted on 02/01/2017 |
Current Version - 1st Engrossment
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A bill for an act
relating to human services; directing the commissioner of human services to
establish a health care delivery pilot program created by or including North
Memorial Health Care; amending Minnesota Statutes 2016, section 256B.0758.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2016, section 256B.0758, is amended to read:
256B.0758 HEALTH CARE DELIVERY PILOT PROGRAM.
new text begin Subdivision 1. new text end
new text begin Pilot projects. new text end
(a) The commissioner deleted text begin maydeleted text end new text begin shallnew text end establish a health care
delivery pilot program to test alternative and innovative integrated health care delivery
networks, including accountable care organizations deleted text begin or adeleted text end new text begin . Pilot projects may be established
bynew text end community-based collaborative care deleted text begin networkdeleted text end new text begin networks including but not limited to care
networks new text end created by or including North Memorial Health Care. If required, the commissioner
shall seek federal approval of a new waiver request or amend an existing demonstration
pilot project waiver.new text begin The pilot program shall target groups with a higher incidence of poor
overall health relative to the general population due to a combination of medical, economic,
behavioral health, cultural, and geographic risk factors.
new text end
(b) deleted text begin Individuals eligible fordeleted text end The pilot program shall deleted text begin bedeleted text end new text begin servenew text end individuals whonew text begin :
new text end
new text begin (1)new text end are eligible for medical assistance under section 256B.055new text begin or MinnesotaCare under
chapter 256L;
new text end
new text begin
(2) reside in the service area of the care network;
new text end
new text begin
(3) have a combination of multiple risk factors identified by the care network and
approved by the commissioner; and
new text end
new text begin (4) have agreed to participate in the pilot projectnew text end .
The commissioner may identify individualsnew text begin who are potentially eligiblenew text end to be enrolled in
the pilot program based on zip code ornew text begin other geographic designation, diagnosis, utilization
history, or other factors indicatingnew text end whether the individuals would benefit from an integrated
health care delivery network.
(c) In developing a payment system for the pilot programs, the commissioner shall
establish a total cost of care for the individuals enrolled in the pilot program that equals the
cost of care that would otherwise be spent for these enrollees in the prepaid medical assistance
program.
new text begin
(d) Participation in the pilot program is limited to no more than six pilot projects,
including North Memorial Health Care's care network and up to five additional
community-based care network pilot projects meeting criteria established by the
commissioner. The commissioner shall consider the following criteria when selecting the
additional pilot projects:
new text end
new text begin
(1) the care network serves a high percentage of patients who are enrolled in Minnesota
health care programs or are uninsured, compared to the overall Minnesota population;
new text end
new text begin
(2) the population in the care network's geographic service area experiences substantially
poorer overall health compared to the overall Minnesota population;
new text end
new text begin
(3) health care providers in the care network have lower quality-of-care scores under
some traditional quality measures due to economic, behavioral health, cultural, and
geographic factors of the patients served rather than the clinical expertise of the providers
in the care network; and
new text end
new text begin
(4) the health care utilization history of the population in the care network's service area
provides an opportunity to improve health outcomes and reduce total cost of care through
better patient engagement, coordination of care, and the provision of specialized services
to address nonclinical risk factors and barriers to access.
new text end
new text begin
(e) The commissioner shall seek to authorize at least one rural pilot project, at least one
community-based primary care safety net project, and at least one behavioral health-focused
pilot project.
new text end
new text begin Subd. 2. new text end
new text begin Requirements related to integrated health partnerships. new text end
new text begin
(a) The
commissioner may require pilot project care networks to meet the conditions and
requirements for integrated health networks under section 256B.0755, except as follows:
new text end
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(1) standardized quality of care and patient satisfaction standards for integrated health
partnerships must be waived, changed, or risk-adjusted based on the economic, behavioral
health, cultural, and geographic risk factors of the patients served;
new text end
new text begin
(2) participating care networks must be paid a monthly care coordination fee of at least
$12 per enrolled person per month, in addition to any other payments, gain sharing, or health
care home payments that would otherwise be received;
new text end
new text begin
(3) patient attribution to the care network shall be based on the patients who meet the
criteria in this section and have agreed to participate in the pilot project;
new text end
new text begin
(4) requirements establishing a minimum number of persons in order to be eligible to
participate in the integrated health partnership do not apply; and
new text end
new text begin
(5) the commissioner shall waive or modify integrated health partnership requirements
that may discourage participation by rural, independent, community-based, and safety net
providers.
new text end
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(b) An existing integrated health partnership that meets the criteria in this section is
eligible to participate in the pilot project while continuing as an integrated health partnership
and qualifies for the integrated health partnership exceptions in paragraph (a).
new text end
new text begin
(c) All pilot projects authorized under this section are eligible to receive the information
and data provided by the commissioner to integrated health partnerships.
new text end
new text begin Subd. 3. new text end
new text begin Payment and quality measurement reforms. new text end
new text begin
The commissioner, in
consultation with the commissioner of health, pilot project care networks, and organizations
with expertise in serving the patients and communities identified in this section, shall design
and administer the pilot project in a manner that allows the testing and evaluation of new
care models, payment methods, and quality-of-care measures to determine the extent to
which these initiatives:
new text end
new text begin
(1) improve outcomes and reduce the total cost of care for specific high-risk groups of
patients enrolled in Minnesota health care programs; and
new text end
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(2) reduce administrative burdens and costs for health care providers and state agencies.
new text end