HF 1873

1st Engrossment - 85th Legislature (2007 - 2008) Posted on 12/15/2009 12:00am

A bill for an act
relating to health; requiring annual reports on cost containment goals;
establishing a health care transformation task force; modifying goals for
universal coverage; establishing a demonstration project for community-based
health care initiative; modifying performance payments for medical groups;
requiring a physician-directed care coordination program; requiring a payment
reform plan; providing grants for community collaboratives; establishing health
care payment reform pilot projects; requiring a study; appropriating money;
amending Minnesota Statutes 2006, sections 62J.04, subdivision 3; 62J.81,
subdivision 1; 62Q.165, subdivisions 1, 2; 62Q.80, subdivisions 3, 4, 13,
14, by adding a subdivision; 256.01, subdivision 2b; 256B.0625, by adding a
subdivision; proposing coding for new law in Minnesota Statutes, chapter 62J;
repealing Minnesota Statutes 2006, section 62J.052, subdivision 1.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:

Subd. 3.

Cost containment duties.

The commissioner shall:

(1) establish statewide and regional cost containment goals for total health care
spending under this section deleted text begin and deleted text end new text begin , new text end collect data as described in sections 62J.38 to 62J.41 to
monitor statewide achievement of the cost containment goals new text begin , and annually report to the
legislature on whether the goals were achieved and, if not, what action should be taken to
ensure that goals are achieved in the future new text end ;

(2) divide the state into no fewer than four regions, with one of those regions being
the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
Wright, and Sherburne Counties, for purposes of fostering the development of regional
health planning and coordination of health care delivery among regional health care
systems and working to achieve the cost containment goals;

(3) monitor the quality of health care throughout the state and take action as
necessary to ensure an appropriate level of quality;

(4) issue recommendations regarding uniform billing forms, uniform electronic
billing procedures and data interchanges, patient identification cards, and other uniform
claims and administrative procedures for health care providers and private and public
sector payers. In developing the recommendations, the commissioner shall review the
work of the work group on electronic data interchange (WEDI) and the American National
Standards Institute (ANSI) at the national level, and the work being done at the state and
local level. The commissioner may adopt rules requiring the use of the Uniform Bill
82/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
forms or procedures;

(5) undertake health planning responsibilities;

(6) authorize, fund, or promote research and experimentation on new technologies
and health care procedures;

(7) within the limits of appropriations for these purposes, administer or contract for
statewide consumer education and wellness programs that will improve the health of
Minnesotans and increase individual responsibility relating to personal health and the
delivery of health care services, undertake prevention programs including initiatives to
improve birth outcomes, expand childhood immunization efforts, and provide start-up
grants for worksite wellness programs;

(8) undertake other activities to monitor and oversee the delivery of health care
services in Minnesota with the goal of improving affordability, quality, and accessibility of
health care for all Minnesotans; and

(9) make the cost containment goal data available to the public in a
consumer-oriented manner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 2.

Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:

Subdivision 1.

Required disclosure of estimated payment.

(a) A health care
provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
to by that designee, shall, at the request of a consumer, provide that consumer with a good
faith estimate of the deleted text begin reimbursement deleted text end new text begin allowable payment new text end the provider deleted text begin expects to receive
from the health plan company in which the consumer is enrolled deleted text end new text begin has agreed to accept from
the consumer's health plan company for the services specified by the consumer, specifying
the amount of the allowable payment due from the health plan company new text end . Health plan
companies must allow contracted providers, or their designee, to release this information.
deleted text begin A good faith estimate must also be made available at the request of a consumer who
is not enrolled in a health plan company. deleted text end new text begin If a consumer has no applicable public or
private coverage, the health care provider must give the consumer a good faith estimate
of the average allowable reimbursement the provider accepts as payment from private
third-party payers for the services specified by the consumer and the estimated amount
the noncovered consumer will be required to pay. new text end Payment information provided by a
provider, or by the provider's designee as agreed to by that designee, to a patient pursuant
to this subdivision does not constitute a legally binding estimate of the new text begin allowable charge
for or new text end cost new text begin to the consumer new text end of services.

(b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at
the request of an enrollee or the enrollee's designee, provide that enrollee with a good
faith estimate of the deleted text begin reimbursement deleted text end new text begin allowable amount new text end the health plan company deleted text begin would
expect to pay to deleted text end new text begin has contracted for with new text end a specified provider within the network new text begin as total
payment new text end for a health care service specified by the enrollee new text begin and the portion of the allowable
amount due from the enrollee and the enrollee's out-of-pocket costs new text end . deleted text begin If requested by the
enrollee, the health plan company shall also provide to the enrollee a good faith estimate
of the enrollee's out-of-pocket cost for the health care service. deleted text end An estimate provided to
an enrollee under this paragraph is not a legally binding estimate of the deleted text begin reimbursement deleted text end
new text begin allowable amount new text end or new text begin enrollee's new text end out-of-pocket cost.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2007.
new text end

Sec. 3.

new text begin [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.
new text end

new text begin Subdivision 1. new text end

new text begin Task force. new text end

new text begin The Health Care Transformation Task Force consists of:
new text end

new text begin (1) the Legislative Commission on Health Care Access established under section
62J.07;
new text end

new text begin (2) the commissioners of human services, health, and commerce;
new text end

new text begin (3) four persons designated by the SmartBuy alliance to represent private sector
purchasers, including one representing public employers, one representing large
employers, one representing small employers, and one representing labor unions; and
new text end

new text begin (4) six persons designated by the partnership for action to transform health care,
a multisector policy alliance of hospitals and health systems, health plan companies,
physicians, and other health care organizations.
new text end

new text begin Subd. 2. new text end

new text begin Public input. new text end

new text begin The commissioner of health shall review available research
and conduct statewide, regional, and local surveys, focus groups, and other activities to
determine Minnesotans' values, preferences, opinions, and perceptions related to health
care and to the issues confronting the task force, and shall report the findings to the task
force.
new text end

new text begin Subd. 3. new text end

new text begin Inventory and assessment of existing activities. new text end

new text begin The task force shall
complete an inventory and assessment of all public and private organized activities,
coalitions, and collaboratives working on tasks relating to health system improvement
including, but not limited to, patient safety, quality measurement and reporting,
evidence-based practice, adoption of health information technology, disease management
and chronic care coordination, medical homes, access to health care, cultural competence,
prevention and public health, consumer incentives, price and cost transparency, nonprofit
organization community benefits, education, research, and health care workforce. By
December 15, 2007, the task force shall present recommendations to the legislature, the
governor, and to those working on these activities on how these activities may be made
more effective and how coordination and communication may be improved.
new text end

new text begin Subd. 4. new text end

new text begin Action plan. new text end

new text begin By December 15, 2007, the task force shall develop and
present, to the legislature and the governor, a statewide action plan for transforming the
health care system to improve affordability, quality, and access. The plan may consist of
legislative actions, administrative actions of governmental entities, collaborative actions,
and actions of individuals and individual organizations. The plan must include specific
and measurable goals and deadlines for affordability, quality, and access. The plan must
include a method of coordination and communication among the activities identified
under subdivision 3.
new text end

Sec. 4.

Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:

Subdivision 1.

Definition.

It is the commitment of the state to achieve universal
health coverage for all Minnesotans new text begin by the year 2010 new text end . Universal coverage is achieved
when:

(1) every Minnesotan has access to a full range of quality health care services;

(2) every Minnesotan is able to obtain affordable health coverage which pays for the
full range of services, including preventive and primary care; and

(3) every Minnesotan pays into the health care system according to that person's
ability.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 5.

Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:

Subd. 2.

Goal.

It is the goal of the state to make continuous progress toward
reducing the number of Minnesotans who do not have health coverage so that by January
1, deleted text begin 2000, fewer than four percent of the state's population will be without health coverage deleted text end new text begin
2010, all Minnesota residents have access to affordable health care new text end . The goal will be
achieved by improving access to private health coverage through insurance reforms and
market reforms, by making health coverage more affordable for low-income Minnesotans
through purchasing pools and state subsidies, and by reducing the cost of health coverage
through cost containment programs and methods of ensuring that all Minnesotans are
paying into the system according to their ability.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 6.

Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Demonstration project. new text end

new text begin The commissioner of health shall award a
demonstration project grant to a community-based health care initiative to develop and
operate a community-based health care coverage program to operate within Carlton,
Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years
and must comply with all the requirements of this section.
new text end

Sec. 7.

Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:

Subd. 3.

Approval.

(a) Prior to the operation of a community-based health care
coverage program, a community-based health initiative shall submit to the commissioner
of health for approval the community-based health care coverage program developed by
the initiative. deleted text begin The commissioner shall only approve a program that has been awarded
a community access program grant from the United States Department of Health and
Human Services. deleted text end The commissioner shall ensure that the program meets the federal grant
requirements and any requirements described in this section and is actuarially sound based
on a review of appropriate records and methods utilized by the community-based health
initiative in establishing premium rates for the community-based health care coverage
program.

(b) Prior to approval, the commissioner shall also ensure that:

(1) the benefits offered comply with subdivision 8 and that there are adequate
numbers of health care providers participating in the community-based health network to
deliver the benefits offered under the program;

(2) the activities of the program are limited to activities that are exempt under this
section or otherwise from regulation by the commissioner of commerce;

(3) the complaint resolution process meets the requirements of subdivision 10; and

(4) the data privacy policies and procedures comply with state and federal law.

Sec. 8.

Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:

Subd. 4.

Establishment.

deleted text begin (a) deleted text end The initiative shall establish and operate upon approval
by the commissioner of health a community-based health care coverage program. The
operational structure established by the initiative shall include, but is not limited to:

(1) establishing a process for enrolling eligible individuals and their dependents;

(2) collecting and coordinating premiums from enrollees and employers of enrollees;

(3) providing payment to participating providers;

(4) establishing a benefit set according to subdivision 8 and establishing premium
rates and cost-sharing requirements;

(5) creating incentives to encourage primary care and wellness services; and

(6) initiating disease management services, as appropriate.

deleted text begin (b) The payments collected under paragraph (a), clause (2), may be used to capture
available federal funds.
deleted text end

Sec. 9.

Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:

Subd. 13.

Report.

(a) The initiative shall submit quarterly status reports to the
commissioner of health on January 15, April 15, July 15, and October 15 of each year,
with the first report due January 15, deleted text begin 2007 deleted text end new text begin 2008 new text end . The status report shall include:

(1) the financial status of the program, including the premium rates, cost per member
per month, claims paid out, premiums received, and administrative expenses;

(2) a description of the health care benefits offered and the services utilized;

(3) the number of employers participating, the number of employees and dependents
covered under the program, and the number of health care providers participating;

(4) a description of the health outcomes to be achieved by the program and a status
report on the performance measurements to be used and collected; and

(5) any other information requested by the commissioner of health or commerce or
the legislature.

(b) The initiative shall contract with an independent entity to conduct an evaluation
of the program to be submitted to the commissioners of health and commerce and the
legislature by January 15, deleted text begin 2009 deleted text end new text begin 2010 new text end . The evaluation shall include:

(1) an analysis of the health outcomes established by the initiative and the
performance measurements to determine whether the outcomes are being achieved;

(2) an analysis of the financial status of the program, including the claims to
premiums loss ratio and utilization and cost experience;

(3) the demographics of the enrollees, including their age, gender, family income,
and the number of dependents;

(4) the number of employers and employees who have been denied access to the
program and the basis for the denial;

(5) specific analysis on enrollees who have aggregate medical claims totaling over
$5,000 per year, including data on the enrollee's main diagnosis and whether all the
medical claims were covered by the program;

(6) number of enrollees referred to state public assistance programs;

(7) a comparison of employer-subsidized health coverage provided in a comparable
geographic area to the designated community-based geographic area served by the
program, including, to the extent available:

(i) the difference in the number of employers with 50 or fewer employees offering
employer-subsidized health coverage;

(ii) the difference in uncompensated care being provided in each area; and

(iii) a comparison of health care outcomes and measurements established by the
initiative; and

(8) any other information requested by the commissioner of health or commerce.

Sec. 10.

Minnesota Statutes 2006, section 62Q.80, subdivision 14, is amended to read:

Subd. 14.

Sunset.

This section expires December 31, deleted text begin 2011 deleted text end new text begin 2012 new text end .

Sec. 11.

Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:

Subd. 2b.

Performance payments.

new text begin (a) new text end The commissioner shall develop and
implement a pay-for-performance system to provide performance payments to new text begin :
new text end

new text begin (1) eligible new text end medical groups new text begin and clinics new text end that demonstrate optimum care in serving
individuals with chronic diseases who are enrolled in health care programs administered
by the commissioner under chapters 256B, 256D, and 256L deleted text begin . deleted text end new text begin ;
new text end

new text begin (2) medical groups that implement effective medical home models of patient care
that improve quality and reduce costs through effective primary and preventive care, care
coordination, and management of chronic conditions; and
new text end

new text begin (3) eligible medical groups and clinics that evaluate medical provider usage patterns
and provide feedback to individual medical providers on that provider's practice patterns
relative to peer medical providers.
new text end

new text begin (b) The commissioner shall also develop and implement a patient incentive health
program to provide incentives and rewards to patients who are enrolled in health care
programs administered by the commissioner under chapters 256B, 256D, and 256L, and
who have agreed to and meet personal health goals established with their primary care
provider to manage a chronic disease or condition including, but not limited to, diabetes,
high blood pressure, and coronary artery disease.
new text end

new text begin (c) The commissioner may receive any federal matching money that is made
available through the medical assistance program for managed care oversight contracted
through vendors including consumer surveys, studies, and external quality reviews as
required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations,
title 42, part 438, subpart E. Any federal money received for managed care oversight is
appropriated to the commissioner for this purpose. The commissioner may expend the
federal money received in either year of the biennium.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 12.

Minnesota Statutes 2006, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 49. new text end

new text begin Physician-directed care coordination services. new text end

new text begin The commissioner
shall develop and implement a physician-directed care coordination program for medical
assistance recipients who are not enrolled in the prepaid medical assistance program and
who are receiving services on a fee-for-service basis. This program provides payment
to primary care clinics for care coordination for people who have complex and chronic
medical conditions. Clinics must meet certain criteria such as the capacity to develop care
plans; have a dedicated care coordinator; and have an adequate number of fee-for-service
clients, evaluation mechanisms, and quality improvement processes to qualify for
reimbursement.
new text end

Sec. 13. new text begin HEALTH CARE PAYMENT SYSTEM REFORM.
new text end

new text begin Subdivision 1. new text end

new text begin Payment reform plan. new text end

new text begin The commissioners of employee relations,
human services, commerce, and health shall develop a plan for promoting and facilitating
changes in payment rates and methods for paying for health care services, drugs, devices,
supplies, and equipment in order to:
new text end

new text begin (1) reward the provision of cost-effective primary and preventive care;
new text end

new text begin (2) reward the use of evidence-based care;
new text end

new text begin (3) discourage underutilization, overuse, and misuse;
new text end

new text begin (4) reward the use of the most cost-effective settings, drugs, devices, providers,
and treatments; and
new text end

new text begin (5) encourage consumers to maintain good health and use the health care system
appropriately.
new text end

new text begin Subd. 2. new text end

new text begin Report. new text end

new text begin The commissioners shall submit a report to the legislature by
December 15, 2007, describing the payment reform plan. The report must include
proposed legislation for implementing those components of the plan requiring legislative
action or appropriations of money.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 14. new text begin COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER
THE UNINSURED.
new text end

new text begin Subdivision 1. new text end

new text begin Community collaboratives. new text end

new text begin The commissioner of health shall
provide grants to and authorization for up to three community collaboratives that satisfy
the requirements in this section. To be eligible to receive a grant and authorization under
this section, a community collaborative must include:
new text end

new text begin (1) one or more counties;
new text end

new text begin (2) one or more local hospitals;
new text end

new text begin (3) one or more local employers who collectively provide at least 300 jobs in the
community;
new text end

new text begin (4) one or more health care clinics or physician groups; and
new text end

new text begin (5) a third-party payer, which may be a county-based purchasing plan operating
under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan
company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.
new text end

new text begin Subd. 2. new text end

new text begin Pilot project requirements. new text end

new text begin (a) Community collaborative pilot projects
must:
new text end

new text begin (1) identify and enroll persons in the community who are uninsured, and who have,
or are at risk of developing, one of the following chronic conditions: mental illness,
diabetes, asthma, hypertension, or other chronic condition designated by the project;
new text end

new text begin (2) assist uninsured persons obtain private-sector health insurance coverage if
possible or enroll in any public health care programs for which they are eligible. If the
uninsured individual is unable to obtain health coverage, the community collaborative
must enroll the individual in a local health care assistance program that provides specified
services to prevent or effectively manage the chronic condition;
new text end

new text begin (3) include components to help uninsured persons retain employment or to become
employable, if currently unemployed;
new text end

new text begin (4) ensure that each uninsured person enrolled in the program has a medical home
responsible for providing, or arranging for, health care services and assisting in the
effective management of the chronic condition;
new text end

new text begin (5) coordinate services between all providers and agencies serving an enrolled
individual; and
new text end

new text begin (6) be coordinated with the state's Q-Care initiative and improve the use of
evidence-based treatments and effective disease management programs in the broader
community, beyond those individuals enrolled in the project.
new text end

new text begin (b) Projects established under this section are not insurance and are not subject to
state-mandated benefit requirements or insurance regulations.
new text end

new text begin Subd. 3. new text end

new text begin Criteria. new text end

new text begin Proposals must be evaluated by actuarial, financial, and clinical
experts based on the likelihood that the project would produce a positive return on
investment for the community. In awarding grants, the commissioner of health shall
give preference to proposals that:
new text end

new text begin (1) have broad community support from local businesses, provider counties, and
other public and private organizations;
new text end

new text begin (2) would provide services to uninsured persons who have, or are at risk of
developing, multiple, co-occurring chronic conditions;
new text end

new text begin (3) integrate or coordinate resources from multiple sources, such as employer
contributions, county funds, social service programs, and provider financial or in-kind
support;
new text end

new text begin (4) provide continuity of treatment and services when uninsured individuals in
the program become eligible for public or private health insurance or when insured
individuals lose their coverage;
new text end

new text begin (5) demonstrate how administrative costs for health plan companies and providers
can be reduced through greater simplification, coordination, consolidation, standardization,
reducing billing errors, or other methods; and
new text end

new text begin (6) involve local contributions to the cost of the pilot projects.
new text end

new text begin Subd. 4. new text end

new text begin Grants. new text end

new text begin The commissioner of health shall provide implementation grants
of up to one-half of the community collaborative's costs for planning, administration, and
evaluation. The commissioner shall also provide grants to community collaboratives to
develop a fund to pay up to 50 percent of the cost of the services provided to uninsured
individuals. The remaining costs must be paid for through other sources or by agreement
of a health care provider to contribute the cost as charity care.
new text end

new text begin Subd. 5. new text end

new text begin Evaluation. new text end

new text begin The commissioner of health shall evaluate the effectiveness
of each community collaborative project awarded a grant, by comparing actual costs
for serving the identified uninsured persons to the predicted costs that would have
been incurred in the absence of early intervention and consistent treatment to manage
the chronic condition, including the costs to medical assistance, MinnesotaCare, and
general assistance medical care. The commissioner shall require community collaborative
projects, as a condition of receipt of a grant award, to provide the commissioner with all
information necessary for this evaluation.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2007.
new text end

Sec. 15. new text begin HEALTH CARE PAYMENT REFORM PILOT PROJECTS.
new text end

new text begin Subdivision 1. new text end

new text begin Pilot projects. new text end

new text begin (a) The commissioners of health, human services,
and employee relations shall develop and administer payment reform pilot projects for
state employees and persons enrolled in medical assistance, MinnesotaCare, or general
assistance medical care, to the extent permitted by federal requirements. The purpose of
the projects is to promote and facilitate changes in payment rates and methods for paying
for health care services, drugs, devices, supplies, and equipment in order to:
new text end

new text begin (1) reward the provision of cost-effective primary and preventive care;
new text end

new text begin (2) reward the use of evidence-based care;
new text end

new text begin (3) reward coordination of care for patients with chronic conditions;
new text end

new text begin (4) discourage overuse and misuse;
new text end

new text begin (5) reward the use of the most cost-effective settings, drugs, devices, providers,
and treatments;
new text end

new text begin (6) encourage consumers to maintain good health and use the health care system
appropriately.
new text end

new text begin (b) The pilot projects must involve the use of designated care professionals or
clinics to serve as a patient's medical home and be responsible for coordinating health
care services across the continuum of care. The pilot projects must evaluate different
payment reform models and must be coordinated with the Minnesota senior health options
program and the Minnesota disability health options program. To the extent possible, the
commissioners shall coordinate state purchasing activities with other public employers
and with private purchasers, self-insured groups, and health plan companies to promote
the use of pilot projects encompassing both public and private purchasers and markets.
new text end

new text begin Subd. 2. new text end

new text begin Payment methods and incentives. new text end

new text begin The commissioners shall modify
existing payment methods and rates for those enrollees and health care providers
participating in the pilot project in order to provide incentives for care management,
team-based care, and practice redesign, and increase resources for primary care, chronic
condition care, and care provided to complex patients. The commissioners may create
financial incentives for patients to select a medical home under the pilot project by
reducing, modifying, or eliminating deductibles and co-payments for certain services, or
through other incentives. The commissioners may require patients to remain with their
designated medical home for a specified period of time. Alternative payment methods
may include complete or partial capitation, fee-for-service payments, or other payment
methodologies. The payment methods may provide for the payment of bonuses to medical
home providers or other providers, or to patients, for the achievement of performance
goals. The payment methods may include allocating a portion of the payment that
would otherwise be paid to health plans under state prepaid health care programs to the
designated medical home for specified services.
new text end

new text begin Subd. 3. new text end

new text begin Requirements. new text end

new text begin In order to be designated a medical home under the pilot
project, health care professionals or clinics must demonstrate their ability to:
new text end

new text begin (1) be the patient's first point of contact 24 hours a day, seven days a week;
new text end

new text begin (2) provide or arrange for patients' comprehensive health care needs, including the
ability to structure planned chronic disease visits and to manage chronic disease through
the use of disease registries;
new text end

new text begin (3) coordinate patients' care when care must be provided outside the medical home;
new text end

new text begin (4) provide longitudinal care, not just episodic care, including meeting long-term
and unique personal needs;
new text end

new text begin (5) utilize an electronic health record and incorporate a plan to develop and make
available to patients that choose a medical home an electronic personal health record that
is prepopulated with the patient's data, consumer-directed, connected to the provider,
24-hour accessible, and owned and controlled by the patient;
new text end

new text begin (6) systematically improve quality of care using, among other inputs, patient
feedback; and
new text end

new text begin (7) create a provider network that provides for increased reimbursement for a
medical home in a cost-neutral manner.
new text end

new text begin Subd. 4. new text end

new text begin Evaluation. new text end

new text begin Pilot projects must be evaluated based on patient satisfaction,
provider satisfaction, clinical process and outcome measures, program costs and savings,
and economic impact on health care providers. Pilot projects must be evaluated based
on the extent to which the medical home:
new text end

new text begin (1) coordinated health care services across the continuum of care and thereby
reduced duplication of services and enhanced communication across providers;
new text end

new text begin (2) provided safe and high-quality care by increasing utilization of effective
treatments, reduced use of ineffective treatments, reduced barriers to essential care and
services, and eliminated barriers to access;
new text end

new text begin (3) reduced unnecessary hospitalizations and emergency room visits and increased
use of cost-effective care and settings;
new text end

new text begin (4) encouraged long-term patient and provider relationships by shifting from
episodic care to consistent, coordinated communication and care with a specified team of
providers or individual providers;
new text end

new text begin (5) engaged and educated consumers by encouraging shared patient and provider
responsibility and accountability for disease prevention, health promotion, chronic
disease management, acute care, and overall well-being, encouraging informed medical
decision-making, ensuring the availability of accurate medical information, and facilitated
the transfer of accurate medical information;
new text end

new text begin (6) encouraged innovation in payment methodologies by using patient and provider
incentives to coordinate care and utilize medical home services and fostering the
expansion of a technology infrastructure that supports collaboration; and
new text end

new text begin (7) reduced overall health care costs as compared to conventional payment methods
for similar patient populations.
new text end

new text begin Subd. 5. new text end

new text begin Rulemaking. new text end

new text begin The commissioners are exempt from administrative
rulemaking under chapter 14 for purposes of developing, administering, contracting
for, and evaluating pilot projects under this section. The commissioner shall publish a
proposed request for proposals in the State Register and allow 30 days for comment
before issuing the final request for proposals.
new text end

new text begin Subd. 6. new text end

new text begin Regulatory and payment barriers. new text end

new text begin The commissioners shall study state
and federal statutory and regulatory barriers to the creation of medical homes and provide
a report and recommendations to the legislature by December 15, 2007.
new text end

Sec. 16. new text begin HEALTH CARE SYSTEM CONSOLIDATION.
new text end

new text begin The commissioner of health shall study the effect of health care provider and health
plan company consolidation in the four metropolitan statistical areas in Minnesota on:
health care costs, including provider payment rates; quality of care; and access to care.
The commissioner shall separately consider hospitals, specialty groups, and primary care
groups. The commissioner shall present findings and recommendations to the legislature
by December 15, 2007.
new text end

Sec. 17. new text begin APPROPRIATIONS.
new text end

new text begin (a) $....... is appropriated from the general fund to the commissioner of human
services for the biennium beginning July 1, 2007, to provide performance payments under
Minnesota Statutes, section 256.01, subdivision 2b.
new text end

new text begin (b) $....... is appropriated from the general fund to the commissioner of health for
the biennium beginning July 1, 2007, to provide grants to community collaboratives
under section 14.
new text end

new text begin (c) $....... is appropriated from the general fund to the commissioner of health for the
biennium beginning July 1, 2007, to establish the Health Care Transformation Task Force
under Minnesota Statutes, section 62J.84.
new text end

new text begin (d) $1,050,000 is appropriated for the biennium beginning July 1, 2007, from the
general fund to the commissioner of health for the demonstration project grant described
in Minnesota Statutes, section 62Q.80, subdivision 1a. This is a onetime appropriation
and is available until June 30, 2012.
new text end

new text begin (e) $....... for the fiscal year ending June 30, 2008, and $....... for the fiscal year
ending June 30, 2009, are appropriated from the general fund to the commissioner of
health for the medical education and research fund administered under Minnesota Statutes,
section 62J.692, to expand multidisciplinary education and training programs and primary
care education initiatives, to maintain Minnesota's primary care workforce capacity.
new text end

new text begin (f) $....... for the fiscal year ending June 30, 2008, and $....... for the fiscal year
ending June 30, 2009, are appropriated to the commissioner of health to work with
institutions of higher education to establish or fund existing initiatives to recruit and
retain nurse educators in nursing education programs, in order to expand the educational
capacity needed to address Minnesota's nursing shortage.
new text end

Sec. 18. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2006, section 62J.052, subdivision 1, new text end new text begin is repealed effective
August 1, 2007.
new text end