Minnesota

Minnesota is currently involved in both state and federal health reform efforts, nearly all of which are built upon a strong foundation of patient-centered medical home. The development of health care homes in Minnesota is part of the ground-breaking health reform legislation passed in May 2008. The legislation includes payment to primary care providers for partnering with patients and families to provide coordination of care in certified health care homes. In addition, the 2010 Legislature mandated that the Minnesota Department of Human Services (DHS) develop and implement a demonstration testing alternative and innovative health care delivery systems, including accountable care organizations, in the state's Medicaid program. The Integrated Health Partnerships (IHP) demonstration, formerly the Health Care Delivery Systems (HCDS) demonstration, aims to deliver higher quality and lower costs through innovative approaches to care and payment.

In 2010 Minnesota also established state certification criteria for health care homes and evaluating outcomes. The Health Care Homes program became a multi-payer program with 10 participating commercial payers in addition to Medicaid. Led by the Minnesota Department of Health, all health reform activities and programs are connected to the Health Care Homes program including their Multi-payer Advanced Primary Care Practice (MAPCP) program, the Minnesota eHealth Initiative, and their State Innovation Model grant. The state of Minnesota was also awarded a CMS planning grant for the development of a 2703 health home program. The MAPCP demonstration in Minnesota concluded in December 2014, but was extended through 2016 in six other states.

Primary Care Innovations and PCMH Activity

Dual Eligible	2703 SPA	CPC	CPC+	PCMH QHP	PCMH Legislation	Private Payer

Multi-Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program	Outcomes
Minnesota Health Care Homes (HCH)	Multi-Payer	Statewide

Public Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program
Allina Health - CMS Pioneer ACO	Medicare	Minnesota, Western Wisconsin	CMS Pioneer ACO
CMS Health Care Innovation Award - Courage Center	Grant	Saint Paul metro area	CMS Health Care Innovation Award (Round 1)
CMS Health Care Innovation Award - The Institute for Clinical Systems Improvement (ICSI)	Grant	California, Colorado, Iowa, Massachusetts, Michigan, Minnesota, Pennsylvania, Washington, Wisconsin	CMS Health Care Innovation Award (Round 1)
CMS State Innovation Model (SIM) Test Award - Minnesota	Grant	Statewide	CMS State Innovation Model (SIM)
Fairview Health Systems - CMS Pioneer ACO	Medicare	Twin Cities	CMS Pioneer ACO
Federally Qualified Health Center Urban Health Network (FUHN)	Medicaid
Hennepin Health	Medicaid	Minneapolis surrounding suburban communities
Integrated Health Partnerships Initiative	Medicaid	Statewide
Medicaid Incentives for the Prevention of Diabetes	Grant	Twin Cities
Minnesota Senior Health Options program (MSHO)	Medicare		CMS Dual Eligible Demonstration
PTN - Mayo Clinic	Grant	Iowa, Minnesota, Wisconsin	Transforming Clinical Practices Initiative (TCPI)
The DIAMOND Initiative	Medicaid	Statewide

Private Payer Programs

Program Name	Payer Type	Coverage Area	Parent Program	Outcomes
Blue Cross Blue Shield of Minnesota	Commercial	Statewide	Blue Cross Blue Shield Value-Based Care Program
HealthPartners	Commercial	Minnesota and western Wisconsin

State Legislation

Legislation	Status	Year
2008 Health Care Reform This legislation establishes standards for state certification of Health Care Homes and evaluating outcomes. It also requires that Health Care Homes receive care coordination payments from public and private health care purchasers.	Enacted	2008
HF 3696 To provide the legislature with information needed to meet the evolving health care needs of Minnesotans, the commissioner shall report to the legislature by February 15, 2023, on the volume and distribution of health care spending across payment models used by health plan companies and third-party administrators, with a particular focus on value-based care models and primary care spending.	Was Not Enacted	2022
HF 4430 establishing the Health Care Affordability Board and Health Care Affordability Advisory Council; requiring monitoring of and recommendations related to health care market trends; establishing the health care spending growth target program; requiring reports; providing for civil penalties; requiring certain transfers of funds;	Was Not Enacted	2022
SF 4188 A bill for an act relating to health; modifying data collected under the all-payer claims database and uses of this data; requiring the commissioner of health to study and report on systems used by health plan companies and third-party administrators to pay health care providers;	Was Not Enacted	2022
SF 302 Amends states all-payer claims database statute to require submission of value-based, non-claims-based payments to providers. State analysis of the data must permit calculation and reporting of the amount of those non-claims-based payments relative to overall health care payments, as well as the percentage of those payments that go to primary care. Elements of this bill were enacted as part of SF2995	Enacted as part of another bill	2023
SF 2995 This omnibus appropriations legislation would require a report on primary care spending and establish a Health Care Affordability Board that may consider establishing quality and primary care spending standards.	Enacted	2023
HF 2930 Omnibus Health Finance Bill This omnibus appropriations legislation would require the Commissioner of Health to provide a one-time report on primary care spending and establish a Health Care Affordability Commission with broader responsibility to establish broader health spending and outcome targets for the state. Elements of this bill were incorporated in the final budget bill,SF 2995.	Enacted as part of another bill	2023