Beginning in 2017, the Affordable Care Act gives Minnesota and other states remarkable freedom to dramatically overhaul the law through “innovation waivers” to customize health reform to their citizens’ needs. One of the first questions that Minnesota’s soon-to-be-appointed health task force must grapple with is whether the state pursues further innovation or stays the course with current reforms.
A state long known as a health care standout didn’t ace every challenge posed by the ACA’s launch — MNsure’s struggles continue to be a source of frustration. That may lead some on the task force to conclude that a more cautious approach is warranted. But Minnesota did have other important successes that suggest that the task force should keep an open mind about taking the more challenging but potentially more rewarding “innovation waiver” route.
That’s why impressive new results from a promising state Department of Human Services (DHS) program merit the spotlight as the debate over future reforms in Minnesota kicks off.
Under Commissioner Lucinda Jesson, DHS has admirably focused on making medical assistance programs for the poor more efficient. In Minnesota, spending for Medicaid programs totaled $8.9 billion in 2013, according to the Kaiser Family Foundation. Spending on Medicaid nationally for the same year stood at $438 billion (Medicaid is funded by the states and the federal government). In 2013, Jesson launched a nation-leading Medicaid payment reform project that has drawn national praise. The voluntary program, known as the Integrated Health Partnerships, enlisted Minnesota medical providers’ help in holding down Medicaid costs by promising to share some of the savings with them. Providers also must meet quality benchmarks to ensure that care is not compromised.
In 2013, the program’s first year of operation, it delivered $14.8 million in savings. State officials recently finished tabulating results from 2014 and announced a substantial increase in savings: $61.5 million.
The nine providers participating in 2014 served 165,000 Minnesota medical assistance enrollees. Innovative steps that delivered savings included “more intensive primary care services” and “stronger relationships with mental health care providers and community resources,’’ DHS officials said. Better care coordination yielded “double-digit decreases in hospitalizations and single-digit decreases in emergency room visits.”
The savings for 2015 could be even more dramatic with more providers and enrollees participating. With other states starting to emulate it, this model could save taxpayers substantial sums nationwide. The program’s success is a reminder that Minnesota remains a health care innovator.
The task force members will no doubt scrutinize the state’s imperfect ACA rollout in the months ahead. But they shouldn’t overlook what has worked well here as they weigh the state’s health care future.