Minnesota Health Care Homes (HCH)
Program Location:
Saint Paul, MN
Number of Practices:
359
Payer Type:
Multi-Payer
Payers:
State employee group insurance
Blue Plus (Blue Cross Blue Shield of Minnesota)
HealthPartners
Itasca Medical Care
Medica
Metropolitan Health Plan
Preferred One
Primewest Health
South County Health Alliance
UCare Minnesota
Accreditation/Recognition:
State based
Reported Outcomes
Description:
Minnesota's health care homes, also known nationally as medical homes, are an important component of Minnesota's comprehensive, nation-leading 2008 health reform law. The goal of health care homes is to transform primary care; patients and families are at the center of their care, and the right care is provided at the right time, in the right place. Minnesota's Department of Health (MDH) and Department of Human Services (DHS) are collaborating to support clinics and clinicians in creating health care homes in the state. The health care home is both a redesign of care delivery and payment reform. This statewide initiative serves 3.3 million Minnesotans through 322 certified health care homes, 42% of which are primary care clinics.
**Minnesota health care homes also participated in the Medicare Multi-payer Advanced Primary Care Practice (MAPCP) demonstration Project. The demonstration added Medicare to Minnesota’s existing multi-payer health care home initiative as a payer for certified health care homes. The Minnesota Departments of Health and Human Services jointly applied for the demonstration project, with guidance from a wide array of stakeholders. The demonstration began in 2011 and was extended until 12/31/2014. Through Minnesota's participation in the Medicare Multi-payer Advanced Primary Care Practice (MAPCP) demonstration, certified health care homes were reimbursed for care coordination services provided to fee-for-service Medicare beneficiaries.
Click here for an interactive map of certifed Health Care Homes.
Click here for the January 2015 Report to the Minnesota Legislature
Related News & Resources
Payment Model:
Health care homes are eligible for care coordination payments. Providers may be eligible for a quality-based incentive payment for either achieving a certain level of performance or for a certain amount of improvement, but not both. See more information here.
Medicaid PMPM Payment:
Tier 1 (1-3 Major Condition Groups) $10.14
Tier 2 (4-6 Major Condition Groups) $20.27
Tier 3 (7-9 Major Condition Groups) $40.54
Tier 4 (10+ Major Condition Groups) $60.81
Medicare demonstration PMPM Payment:
Tier 1 (1-3 Major Condition Groups) $10.14
Tier 2 (4-6 Major Condition Groups) $20.27
Tier 3 (7-9 Major Condition Groups) $30.00
Tier 4 (10+ Major Condition Groups) $45.00
Fewer ED / Hospital Visits:
University of Minnesota Evaluation (February 2016) report evaluated the program from July 2010- December 2014
- While Health Care Homes saw an increase in emergency department and skilled nursing home use relative to non-Health Care Homes, they also saw major decreases in the use of hospital services, which was the primary driver of cost savings.
HealthPartners Industry Report (2009):
- 39% fewer ER visits
- 24% fewer hospital admissions
- 40% reduction in readmission rates
- 30% reduction in length of stay
Improved Health:
University of Minnesota Evaluation (February 2016) report evaluated the program from July 2010- December 2014
- Using Statewide Quality Reporting and Measurement System (SQRMS) data, HCH clinics had better quality of care for Diabetes, Vascular, Asthma (for children and adults), Depression, and Colorectal Cancer screening.
- Using Medicare and Medicaid data, both number of hospital admissions and the length of hospital stays showed modest benefits that were significant among Medicaid enrollees, but non-significant among Medicare and Dual Eligible enrollees.
Minnesota Department of Health (January 2014):
- Improved colorectal cancer screenings, asthma care, diabetes care, vasucal care and follow up care for depression
Improved Patient/Clinician Satisfaction:
University of Minnesota Evaluation (February 2016) report evaluated the program from July 2010- December 2014
- Patient experience, as measured by the 2013 Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, was positive across both HCH and non-HCH clinics, with little differences between the two. However, Communication with one’s doctor showed a significant, but small, benefit for HCH clinics.
Improved Access:
Minnesota Department of Health (January 2014):
- Increased access to HCHs across all regions in 2013
Cost Savings:
University of Minnesota Evaluation (February 2016) report evaluated the program from July 2010- December 2014
- Overall spending on medical services for Medicaid, Medicare and Dual Eligible beneficiaries in HCHs was approximately $1 billion less than if those patients had been attributed to a non-HCH settings
- Overall, medical costs for enrollees who could be attributed to a HCH clinic were 9% less than enrollees at non-HCH clinics.
- This is primarily due to lower spending for inpatient hospital admissions, hospital outpatient visits, and pharmacy.
Minnesota Department of Health (January 2014):
- Medicaid HCH enrollees had 9.2% lower costs than Medicaid enrollees in non-HCH clinics
HealthPartners Industry Report (2009):
- 20% reduction in inpatient costs
- Outpatient cost savings of $1
Other Outcomes:
Minnesota Department of Health (January 2014):
- 100% of the certified HCHs applied for recertification
