More than 2 million Minnesotans now get care in medical clinics that aim to improve treatment and reduce costs by offering a coordinated team approach to health care -- especially for those patients with difficult medical conditions -- the state Department of Health said Tuesday.

The model, known as a "health care home,'' represents a core element of a sweeping 2007 state law designed to reform Minnesota's health care system by raising quality, controlling costs and improving accountability.

While still a new effort, the health care home system has resulted in a 5 percent reduction in costs for patients whose care is paid for by Medica, said Dr. Jim Guyn, medical director of provider relations at the state's second-largest health insurer. That compares with a 2.6 percent increase in other clinics.

At HealthPartners Research Foundation, researcher Dr. Leif Solberg said preliminary findings show that "on average, health care home clinics have significantly better performance scores for diabetes and cardiovascular disease" than other clinics.

Since the program's start two years ago, the state has certified 170 health care home clinics that offer 24-hour access and monitor and track patients' health, report their quality measures to the state and encourage patients to be part of the medical team focused on improving their health.

Hitting the 2 million patient mark "is a significant milestone in our efforts [to] put the patient at the center of a care team dedicated to meeting the patient's health goals," said state Health Commissioner Dr. Ed Ehlinger.

Other parts of the effort include giving consumers more information about cost and quality at clinics and hospitals, and paying for good results rather than merely for the numbers of procedures performed.

Focus on chronic illness

Although the health care home clinics now serve roughly two-fifths of Minnesotans, far fewer than the 2 million actually receive the model's full complement of intensive and coordinated care. That is typically reserved for patients with complex or chronic conditions such as heart disease or diabetes -- diseases that account for a large share of overall health spending and which were at the center of the 2007 reform effort.

Among those getting that higher level of care are about 135,000 low-income people on Medicaid. Over the next three years, a new pilot program will add more than 225,000 older people on the federal Medicare fee-for-service program.

Patients in those clinics who later develop complex conditions could be moved quickly into a higher level of care, officials said.

The 170 clinics certified as health care homes represents about 24 percent of clinics in the state. But because most are larger clinics, they care for about 38 percent of the state population.

Warren Wolfe • 612-673-7253