Minnesota

Blue Cross and Blue Shield of Minnesota offers a “shared incentive” payment model with four of Minnesota’s largest care systems. The model is “designed to make healthcare more affordable and to improve the health status and quality of care delivered to the Blues plan’s members,” the plan says. The approach “is designed to create a longer-term, collaborative partnership approach where hospitals and clinics are rewarded for providing care that improves quality and utilizes resources effectively.

The Pioneer Accountable Care Organization (ACO) program is designed to improve clinical quality and patient experience while reducing the total cost of care for Medicare beneficiaries. Based in Minneapolis, Fairview Health Services is a non-profit health care system providing the full continuum of clinical care—from prevention of illness and injury to care for the most complex medical conditions.

Allina provides health care for approximately one third of the population living in Minnesota and western Wisconsin. The Pioneer model of accountable care aligns payment with quality and value, rather than paying solely for the volume of services. This CMS program is for health care systems across the country that are the most integrated and that are ready to accept accountability for the well-being of the communities they serve. The key to this work is increasing quality, improving the patient experience, and lowering the cost of care.

The primary prevention goal of the Minnesota Medicaid Incentives for Prevention of Diabetes targets weight loss as the gateway to long-term reductions in diabetes, improved cardiovascular health, and reduced health care expenditures. Working with the state health department and the local and national YMCAs, the state Medicaid program will enroll Medicaid beneficiaries between the ages of 18 and 75 who live in the Twin Cities metro area, and who have been diagnosed with pre-diabetes or who have a significant risk of developing type 2 diabetes.

Minnesota received $45 million to implement and test its State Health Care Innovation Plan, which builds on the state's Health Care Homes program and Medicaid Accountable Care Organizations. The Minnesota Accountable Health Model will ensure that every citizen of the state of Minnesota has the option to receive team-based, coordinated, patient-centered care that increases and facilitates access to medical care, behavioral health care, long term care, and other services. To better integrate care and services for the whole person across the continuum of care (including health care, mental hea

The Institute for Clinical Systems Improvement (ICSI) of Bloomington, Minnesota is receiving an award to improve care delivery and outcomes for high-risk adult patients with Medicare or Medicaid coverage who have depression plus diabetes or cardiovascular disease. The program will use care managers and health care teams to assess condition severity, monitor care through a computerized registry, provide relapse and exacerbation prevention, intensify or change treatment as warranted, and transition beneficiaries to self-management.

Courage Center is receiving an award to test a community-based medical home model to serve 300 adults with disabilities and complex health conditions, particularly complex neurological conditions, in Minneapolis - St. Paul metropolitan area. The intervention will coordinate and improve access to primary and specialty care, increase adherence to care, and empower participants to better manage their own health. Over 50 Independent Living Skills Specialists, Peer Leaders, and other health professionals will be trained with enhanced skills to fulfill the medical home mission.