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HF 3499

as introduced - 89th Legislature (2015 - 2016) Posted on 04/06/2016 01:00pm

KEY: stricken = removed, old language.
underscored = added, new language.

Bill Text Versions

Introduction Posted on 03/23/2016

Current Version - as introduced

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A bill for an act
relating to health; making changes to the statewide quality and reporting system
using measures that correlate with health disparities; amending Minnesota
Statutes 2015 Supplement, section 62U.02, subdivisions 1, 3.


Section 1.

Minnesota Statutes 2015 Supplement, section 62U.02, subdivision 1,
is amended to read:

Subdivision 1.


(a) The commissioner of health shall develop a
standardized set of measures by which to assess the quality of health care services offered
by health care providers, including health care providers certified as health care homes
under section 256B.0751. Quality measures must be based on medical evidence and be
developed through a process in which providers participate. The measures shall be used
for the quality incentive payment system developed in subdivision 2 and must:

(1) include uniform definitions, measures, and forms for submission of data, to the
greatest extent possible;

(2) seek to avoid increasing the administrative burden on health care providers;

(3) be initially based on existing quality indicators for physician and hospital
services, which are measured and reported publicly by quality measurement organizations,
including, but not limited to, Minnesota Community Measurement and specialty societies;

(4) place a priority on measures of health care outcomes, rather than process
measures, wherever possible; and

(5) incorporate measures for primary care, including preventive services, coronary
artery and heart disease, diabetes, asthma, depression, and other measures as determined
by the commissioner.

(b) Effective July 1, 2016, the commissioner shall stratify quality measures by
race, ethnicity, preferred language, and country of origin beginning with five measures,
and stratifying additional measures to the extent resources are available. On or after
January 1, 2018, the commissioner may deleted text beginrequiredeleted text endnew text begin stratify new text end measures deleted text beginto be stratifieddeleted text end by other
sociodemographic factors new text beginor by composites of multiple sociodemographic factors new text endthat
according to reliable data are correlated with health disparities and have an impact on
performance on quality or cost text begin The commissioner may also stratify measures
using composite indicators or proxies that combine multiple sociodemographic factors
that are correlated with health disparities.
new text end New methods of stratifying data under this
paragraph must be tested and evaluated through pilot projects prior to adding them to the
statewide system. In determining whether to add additional sociodemographic factors and
developing the methodology to be used, the commissioner shall consider the reporting
burden on providers and determine whether there are alternative sources of data that could
be used. The commissioner shall ensure that categories and data collection methods are
developed in consultation with those communities impacted by health disparities using
culturally appropriate community engagement principles and methods. The commissioner
shall implement this paragraph in coordination with the contracting entity retained
under subdivision 4, in order to build upon the data stratification methodology that has
been developed and tested by the entity. Nothing in this paragraph expands or changes
the commissioner's authority to collect, analyze, or report health care data. Any data
collected to implement this paragraph must be data that is available or is authorized to be
collected under other laws. Nothing in this paragraph grants authority to the commissioner
to collect or analyze patient-level or patient-specific data of the patient characteristics
identified under this paragraph.

(c) The measures shall be reviewed at least annually by the commissioner.

Sec. 2.

Minnesota Statutes 2015 Supplement, section 62U.02, subdivision 3, is
amended to read:

Subd. 3.

Quality transparency.

(a) The commissioner shall establish standards for
measuring health outcomes, establish a system for risk adjusting quality measures, and
issue annual public reports on provider quality beginning July 1, 2010.

(b) Effective July 1, 2017, the risk adjustment system established under this
subdivision shall adjust for patient characteristics deleted text beginidentified under subdivision 1, paragraph
deleted text end that are correlated with health disparities and have an impact on performance
on cost and quality measuresnew text begin, including but not limited to the patient characteristics
identified under subdivision 1, paragraph (b)
new text end. The risk adjustment method may consist of
reporting based on an actual-to-expected comparison that reflects the characteristics of
the patient population served by the clinic or text begin The risk adjustment may be based
on composite indicators that are based on multiple sociodemographic factors that are
correlated with health disparities, including but not limited to composite proxy indicators
based on the patient's address. Data needed for development and implementation of risk
adjustment may be obtained from sources other than provider data submitted under
paragraph (c).
new text end The commissioner shall implement this paragraph in coordination with any
contracting entity retained under subdivision 4.

(c) By January 1, 2010, physician clinics and hospitals shall submit standardized
electronic information on the outcomes and processes associated with patient care to
the commissioner or the commissioner's designee. In addition to measures of care
processes and outcomes, the report may include other measures designated by the
commissioner, including, but not limited to, care infrastructure and patient satisfaction.
The commissioner shall ensure that any quality data reporting requirements established
under this subdivision are not duplicative of publicly reported, communitywide quality
reporting activities currently under way in Minnesota. Nothing in this subdivision is
intended to replace or duplicate current privately supported activities related to quality
measurement and reporting in Minnesota.