Minnesota is a national leader in healthcare delivery reforms, studying spending flows, providing consumer-facing transparency and promoting overall population health. A portion of this success can be attributed to the high quality healthcare organizations present in the state, such as the Mayo Clinic. There is also a significant penetration of HMOs in the Minnesota healthcare market, which differentiates the state from many others.
In 2008, the state passed a comprehensive slate of healthcare reforms targeting public health, chronic care management, payment reform, transparency, administrative efficiency and healthcare cost containment. The reforms also included improvements in healthcare purchasing and an all-payer claims database (APCD). A recent report by the Minnesota Department of Health recommended that the legislature allow expanded use of this data. An independent, nonprofit community organization, MN Community Measurement, provides critical consumer-facing information on provider specific costs and quality.
Minnesota ranked 7 out of 47 states plus DC, with a score of 54 out of 80 possible points in the Hub's 2021 Healthcare Affordability State Policy Scorecard.
Telehealth visits are commonplace in primary care clinics, and research finds no harms to cost
of care in Minnesota, reports The Minnesota Star Tribune. Telehealth use increased from 3%
of primary care visits among privately insured Minnesotans in 2019 to more than 20% in 2021
according to a recent report from the Minnesota Department of Health. These visits, which
surged during the pandemic, continue at high levels without increasing overall health care
costs. The Minnesota Department of Health’s study found no significant long-term cost
savings, but telehealth remains valued for improving access, especially for rural and low-
income communities.
Minnesotans who find themselves burdened by medical debt may find some relief thanks to a
new state law, reports WCCO News. Minnesota’s Debt Fairness Act, effective September
2024, enhances medical debt protections. The law bans reporting medical debt to credit
bureaus and garnishment for those earning below minimum wage, capping garnishment at
10% for others. Providers are also barred from denying necessary care due to outstanding
debt.
Many Minnesotans struggle to find and afford fertility care, reports MPR News. Rural
Minnesotans, in particular, face significant challenges accessing and affording fertility care due
to logistical and financial burdens. High deductibles contribute to the cost burdens, which is
made more complex by the variation in deductible costs between patients. Although state and
federal policymakers have discussed coverage mandates for fertility care, little progress has
been made.
Hospitals face new penalties if they fail to notify Minnesotans of closures or substantial changes
that can reduce local access to care, reports the Minnesota Star Tribune. Under the updated
law, Minnesota hospitals must now notify the public six months before closing or reducing
services or face fines up to $60,000. This law aims to protect local access to care, especially in
rural areas. Public hearings will be held to allow community input on hospital changes, although
the state cannot prevent the closures.
Beginning October 2024, Minnesota will prohibit reporting medical debt to credit bureaus and
transferring medical debt to spouses, reports CBS News Minnesota. Additionally, providers may
not withhold care due to outstanding medical debt and wage garnishment will be limited based
on income.
By Carolina Cummings | CBS News Minnesota | Nov. 2, 2023
All Minnesota hospitals must now screen patients to determine if they are eligible for financial
assistance before referring medical debt for collections, reports CBS News Minnesota. The new
law took effect on November 1, 2023, and prohibits hospitals from sending any outstanding debt
to collections, making changes to payment plans, or offering patients a loan to pay the debt until
they check eligibility and help those patients apply.
Lawmakers in Minnesota have allocated $1.1 million to establish a nine-member Prescription Drug Affordability Board and an eighteen-member Prescription Drug Advisory Council to provide expert advice to the board on cost issues, reports Minnesota Public Radio. The board, in consultation with the advisory council, will be responsible for conducting cost reviews of prescription drugs and establishing upper payment limits if the drug is determined to cause affordability challenges for the health care system or patients. The legislation also prohibits "excessive price increases" for generic or off-patent drugs. Distributors that raise the prices of generic drugs by 15 percent in one year or 40 percent over three years would face penalties.
Minnesota has passed legislation to set the foundation to introduce a public option for residents with incomes above 200 percent of the federal poverty level, reports Axios. The measure requires the state to submit a waiver application to CMS seeking approval to implement a public option and to conduct a study and actuarial analysis prior to the implementation of the program. The program is expected to augment the existing MinnesotaCare program and begin offering coverage in 2027.
Minnesota has expanded their MinnesotaCare program to allow all low-income residents, regardless of immigration status, to enroll, reports the Minnesota Reformer. The state plans to start enrolling undocumented residents by 2025. Approximately 17 percent of Minnesota's uninsured population consists of undocumented individuals, and the proposal is expected to expand coverage to an additional 40,000 residents.
The new Minnesota Prescription Drug Price Transparency (RxPT) initiative reveals high and varied prices, according to the Minnesota Department of Health (MDH). The initiative includes detailed data available in several interactive dashboards on the MDH Prescription Drug Price Transparency website. Cursory findings from the data demonstrate that prescription drug prices have grown significantly faster than the rate of inflation. The dashboard, along with the accompanying report, provides information for consumers and policymakers as they examine prescription drug prices and efforts to curb rising prices
A new nursing program at the University of St. Thomas’ Morrison Family College of Health will focus on health equity and enroll at least 30 percent of the student body from historically excluded communities, reports the Sahan Journal. Currently, 91 percent of registered nurses in Minnesota are white and the school hopes to help create a more diverse and equity-focused nursing workforce. By relying less on academic metrics and more on an applicant’s background, St. Thomas hopes they will meet their benchmark. The nursing program will inject social justice advocacy into the curriculum by deploying nursing students on the streets of downtown Minneapolis to provide care for those experiencing homelessness through a partnership with Minneapolis Downtown Improvement District.
Minnesota passed a law in June 2021 to implement a partial fix to the “family glitch” for low-income families by leveraging the state’s Basic Health Program—MinnesotaCare—to provide coverage to those with incomes between 133 and 200 percent of the federal poverty level, according to a post in Health Affairs Forefront. The plan provides coverage with low premiums, limited copays and no deductibles. The state will finance the entire cost of expanding MinnesotaCare to this newly eligible group with one-time general fund dollars and funds from Minnesota’s Health Care Access Fund. However, there is no federal Basic Health Plan financing, as newly eligible enrollees don’t qualify for a premium tax credit in a Marketplace Plan. The “family glitch” refers to an IRS interpretation of the premium tax credit eligibility requirement for those purchasing a Qualified Health Plan on the health insurance Marketplaces that results in some spouses and dependents being denied access to premium subsidies even when they do not have access to affordable employer coverage. An employer offer of coverage is considered affordable if the employee’s contribution toward the cost of the premium for employee-only coverage does not exceed 9.83 percent of the employee's household income, not whether the offer is affordable for a family.
Patients who initiated COVID-19 testing at a large safety-net health system in Minneapolis were disproportionately white and English-speaking, according to a study by the University of Minnesota School of Public Health. Patients who initiated testing through the emergency department, however, were disproportionately Black, Native American, non-English speaking and had one or more pre-existing conditions. In addition, the study found that testing initiated through telehealth and outpatient encounters was associated with lower rates of subsequent inpatient and intensive care unit care than testing initiated in more care-intensive settings, such as emergency departments. Researchers posit that the inequities point to structural root causes, including barriers to timely testing access, delays in care seeking, difficulty accessing telehealth services and higher rates of pre-existing conditions among patients who require higher levels of care. However, these inequities could also be partially explained by clinician and clinic variations in telehealth use.
The University of Minnesota’s Center for Antiracism Research for Health Equity got an additional $300,000 in state funding to create a model curriculum for antiracism and implicit bias training in hospitals and birthing centers statewide, reports Fox 9 KMSP. The funding comes from the recently passed Dignity in Pregnancy and Childbirth Act, which includes other provisions intended to address and better understand disparities in maternal and infant morbidity and mortality. The new law was based on research indicating that more than half of maternal deaths are preventable, and that racism and bias in the healthcare system create disproportionate barriers to high-quality care.
Before the COVID-19 pandemic hit, Minnesota medical providers were improving on care metrics for low-income Minnesotans, reports the Mankato Free Press. These findings stem from MN Community Measurement’s latest report, which compared treatment quality for patients on public Minnesota Health Care Programs to patients with other types of insurance. Overall, care gaps for patients with public health insurance plans narrowed in 2019, with a greater percentage of patients with these plans receiving diabetes care, breast cancer screenings and colorectal screenings than in the previous year. All other health measures in the report showed similarly narrowed gaps where comparisons were possible. However, researchers posit that post-pandemic findings could look drastically different, with postponement of care and increases in telehealth potentially playing large roles.
The Minnesota governor’s office announced the publication of vaccination data by race and ethnicity, made possible through a partnership between the state and the Minnesota Electronic Health Record Consortium, reports KSTP. The data will inform additional targeted strategies to ensure equitable distribution of vaccine to Minnesotans disproportionately impacted by COVID-19 as a result of systemic inequities. There is hope that the ongoing partnership will also provide the infrastructure needed for future public health crises.
Minnesota adults face high levels of healthcare affordability burdens, reports AboutHealthTransparency.org. A survey of more than 1,070 Minnesota adults, conducted by Altarum's Healthcare Value Hub from Oct. 30, 2020 to Nov. 27, 2020, found that more than half (51%) experienced healthcare affordability burdens in the past year. In addition, even more are worried about affording healthcare in the future and high numbers are worried about becoming ill from the coronavirus. The survey also revealed regional differences in how Minnesota adults experience healthcare affordability burdens. Fifty-seven percent of residents in the Southern region face these burdens, the highest in the state, and 51% of Southern region adults reported skipping a recommended medical test or treatment due to cost. Forty-one percent of Twin Cities Metro area residents, by comparison, reported doing the same.
Medicaid plays an essential role in reducing health disparities and Minnesota has been a leader in longstanding public reporting of health disparities for the state and Medicaid program, including social risk factors, according to a report from AcademyHealth and the Disability Policy Consortium. The report, created in response to the disproportionate impact of COVID-19 on Black, Latino, Native American, Asian and other people of color, people with disabilities, and people living in poverty, explains how state Medicaid programs can respond to health disparities. Minnesota has continued to develop reporting measures on health disparities, particularly within the Medicaid population, to inform their Medicaid value-based payment model for the Integrated Health Partnership Initiative, which is required to propose a health equity measure tied to interventions intended to reduce health disparities. The report provides more information to support state Medicaid programs measure and address health disparities, emphasizes the importance of an intersectional approach to disparity measurement, and urges state Medicaid programs to invest in data and analysis to measure health disparities.
Between 2014 and 2019 the Minnesota Department of Revenue took $81.6 million in refunds from about 24,000 taxpayers per year to pay medical debt that some of the state’s largest nonprofit hospitals said they were owed, reports the Star Tribune, with some Minnesotans’ refunds seized more than once. Only one other state, South Carolina, takes individual tax refunds on behalf of private healthcare companies. In Minnesota, hospitals and other healthcare firms do not need a court judgement or order before retaining the state to take tax refunds on their behalf, and the Department of Revenue earns a $15 fee for every collection made through this program and does not check to ensure a health provider’s claim is valid before seizing a refund. Hospitals insist that they have begun to take on dangerous amounts of debt from uncompensated care – in 2017, Minnesota hospitals provided $691 million in uncompensated care, with 25 percent of that total considered bad-debt, according to the Minnesota Hospital Association’s 2018 Community Benefit Report.
A new course at the University of Minnesota is teaching undergraduate medical students cultural competency skills, reports the Minnesota Daily. The course focuses on teaching medical professionals about differences in cultural practices and how to communicate with patients who may have a history of medical mistreatment. Leaders in the program say they hope teaching these skills will lead to broader reform in the medical field. The instructor is seeking to make the class a regular offering.
NorthPoint Health & Wellness Center has doubled the rates for childhood vaccinations and health screenings, resulting in prevention of disease and lower costs for treatment and care over its fifty-year history. The center is a community health and dental clinic and social services agency in Minneapolis that was founded to increase access to healthcare and social services in a community that is now 90 percent Black, Latinx or Asian, reports NPR. NorthPoint’s measures, including stocking a free-food shelf with healthy, culturally relevant food, has increased its reach in the diverse community—something many medical centers struggle with. NorthPoint is a community health clinic, not a hospital, so it does not face many of the commercial revenue pressures as many private hospitals and can focus on its mandate to improve public health through a lens of race in the community. This has allowed their community-oriented primary care approach to flourish and improve health outcomes and lower healthcare costs.
School-based health clinics have begun to use telemedicine, videos and an app to connect with and treat students, reports Fox 9. The clinics, which regularly help thousands of kids each year with many services, from physicals to mental health support, have had to adapt during the pandemic. Minnesota Community Care, which runs 10 clinics in St. Paul Public High Schools, adapted out of concern about meeting unmet student medical needs with students out of school
PhRMA, the drug industry lobbying association, sued the state of Minnesota over a newly enacted law meant to prevent people who cannot afford their insulin from rationing it, reports STAT News. The Alec Smith Emergency Insulin Act allows Minnesotans who would otherwise forgo their insulin to immediately pick up a 30-day supply of the drug from a pharmacy for $35, while drug makers would be forced to provide the insulin for free or face hefty fines. PhRMA is seeking a permanent injunction that would prevent the law from going into effect.
Neary all Minnesota health plans have agreed to continue waiving copayments related to the care of COVID-19 through September 30, reports the West Central Tribune. Minnesota health plans had been required to cover testing without cost sharing but had agreed to waive copays for hospitalizations until June 1. The agreement removes the potential that 570 patients now in the hospital with the illness would have to face thousands of dollars in medical bills on top of lost wages. The Minnesota Department of Health has also announced $97.6 million in healthcare grants across the state, to pay for additional staffing, PPE and other expenses associated with preparation for the pandemic
The Governor of Minnesota signed into law the Alec Smith Insulin Affordability Act to provide relief to residents struggling to afford their insulin, reports the Office of the Governor. The bill contains emergency and long-term components, which take effect on July 1, 2020. The emergency provisions allow eligible individuals in urgent need of insulin to go to their pharmacy once in a 12-month period and receive a one-time, 30-day supply of insulin for a $35 co-pay. The long-term program requires manufacturers to provide insulin to eligible individuals for up to one year, with the option to renew annually. Insulin will be available in 90-day increments for a co-pay of no more than $50.
The Minnesota Hospital Association says healthcare systems and medical centers across the state are facing a financial hit of $2.9 billion over the next 90 days due to COVID-19, reports the Star Tribune. The biggest factor is that hospitals and health systems are seeing a decline of $2.8 billion in revenue due to postponed elective surgeries that help preserve scarce supplies needed for handling COVID-19 patients. Minnesota hospitals and health systems are collectively losing $31 million in revenue per day from reduced patient volumes, the association says.
SHADAC has released an update to Minnesota's Uninsured Profile Tool in partnership with the Blue Cross Blue Shield Foundation of Minnesota. The update enables users to view the rates and characteristics of the uninsured population by state, region, county, and ZIP code and by state legislative district. The profile, which is available for download on the SHADAC site, also includes an updated version of the companion interactive map.
The Minnesota Attorney General unveiled a task force report that makes 14 recommendations for lowering prescription drug prices, ranging from new legislation to stronger enforcement, according to the Crookston Times. The 14 recommendations mentioned in the report fall into three broad categories: to make the markets work better for consumers; to use the government’s purchasing power to make drugs more affordable and accessible; and to require more transparency and accountability in the market.
State health officials in Minnesota are alarmed by the high number of incidents of adverse health events reported in a statewide report in March 2019, reports Modern Healthcare. The state requires hospitals and ambulatory surgery centers to report the 29 adverse events called "never events," but it's difficult for the Minnesota Health Department to get a sense of what the numbers mean, as this set of 29 events only represents a small percentage of situations. The state is considering tracking diagnostic errors and expanding the program to other settings where patients now get care, like outpatient clinics, as well as releasing an aggregate report of events from across the state, rather than reporting them by facility.
With enrollment for Minnesota’s health plans set to begin, many are watching to see the effects of insurers’ recent announcements of insulin out-of-pocket caps, according to the Star Tribune. Those who purchase coverage through MNsure or from Medica and UCare will have their out-of-pocket spending on each insulin prescription capped at $25 per month, regardless of annual deductibles. When asked, insurance companies have explained that an amendment in the state’s recent omnibus healthcare spending law makes it illegal for Minnesota insurers to profit from selling insulin. Consumers who use insulin note that it is an important necessity for them, but that other medical necessities are still expensive, like insulin pumps and glucose monitors.
Blue Cross Blue Shield of Minnesota announced that they will cover insulin costs next year with $0 co-pay, according to Alpha News MN. The insurance company's CEO cited the skyrocketing costs of insulin as a reason for the measure, which have risen by over 300 percent, noting that their first responsibility is to improve the health and financial stability of their members. Previously, Minnesota Medical Insurer Medica and UCare announced that they will cap insulin costs at $25 a month.
A new law requires clinics that are part of a larger hospital or health system to publicly disclose that patients may receive a separate charge for the facility, resulting in higher out-of-pocket costs, according to the Grand Forks Herald. The hope is that these disclosures will lower the number of Minnesotans who experience surprise medical bills. A Healthcare Value Hub survey of adult Minnesotans in 2019 revealed that nearly half experienced healthcare affordability burdens in the past year.
The Minnesota Hospital Association claims Blue Cross Blue Shield (BCBS) of Minnesota, the state’s largest not-for-profit health insurer, may be breaking the law by imposing a slate of new policies designed to deny or delay access to routine colonoscopies and hundreds of other hospital services, according to The Star Tribune. The hospital trade group has asked state officials to investigate these practices and stop the insurer from imposing new policies that do not comply with state law and discriminate against in-network providers by limiting coverage for patients who do not receive prior authorization for services and if there are cheaper in-network service options nearby. BCBS claims that healthcare costs continue to rise to unprecedented levels and hospitals must work with payers and plan sponsors to improve the sustainability of healthcare costs.
Minnesota lawmakers have extended to 2023 a moratorium that blocks the state’s nonprofit HMOs from being sold to for-profit companies, according to The Star Tribune. The measure was first adopted two years ago as a temporary measure to block conversion transactions, as lawmakers were concerned that nonprofit assets could wrongly be shifted to investor-owned carriers in a merger or acquisition.
Early results of Minnesota’s certified community paramedic programs indicate that these house calls improve patient satisfaction and reduce spending on medical care. According to Minnesota Public Radio, these paramedics visit patients at home to help them transition out of the hospital and manage chronic conditions. A local hospital, Region Hospital, implemented a three-year pilot project that made nearly 1,000 home visits to help people manage diabetes and high blood pressure and resulted in large improvements in patient health and cost savings.
Health care spending for Minnesota businesses and their workers jumped 9.6% last year - nearly triple the national growth rate. According to the Star Tribune, Minnesota was an early user of strategies such as moving workers to high-deductible health plans and enticing them to pick cheaper generic prescription drugs. The Minnesota Health Action Group reported the results of it's annual survey of employers regarding workplace benefits. The survey showed that for the first time, the number of businesses offering high-deductible plans exceeded those offering classic preferred provider plans and that cost-sharing by workers increased by 3 percentage points from last year.
Six Minnesota diabetes activists traveled to Canada to purchase $1,265 worth of insulin that would have cost them $12,400 in the U.S. According to the Star Tribune, insulin prices in the U.S. doubled between 2012 and 2016, with cases of insulin rationing becoming more common. The high price of insulin reflects many factors, including patent protections that keep competitors out of the market.
The overall cost of healthcare in Minnesota grew at a relatively low rate during 2016, but the broader trend points toward a doubling of expenses over the next decade, reports the Star Tribune. A report by the Minnesota Department of Health projected that annual health costs – totaling $47.1 billion in 2016 – will reach $94.2 billion by 2026. This means that Minnesota would spend $1 out of every $6 generated by the state's economy on healthcare. Spending growth will likely result from higher prices, greater use of services and advanced technology costs. Additionally, demographic shifts will boost Medicare enrollment and spending for people with multiple chronic ailments.
Starting January 2019 four employers in the Twin Cities are offering a new "SmartCare" program, a new employee health plan with a limited network of doctors and hospitals, according to the Star Tribune. This limited clinic choice is another example of how health insurers are offering lower premiums, with consumers agreeing to have their care coordinated by a small subset of doctors and hospitals, and pay more out of pocket to visit other healthcare providers. Narrow network health plans have been around for decades, but they are making new appearances in the Minnesota insurance market recently, particularly in the market where individuals under 65 buy their own coverage. The first SmartCare clinic has seen a 10 to 20 percent reduction in total cost.
Attorney General Lori Swanson, who is leaving office next year, is reminding lawmakers that legislation blocking nonprofit health plans from becoming for-profit companies will expire next year, and requires follow-on legislation, according to the Star Tribune. For decades, Minnesota required HMOs to be nonprofit, but Republicans pushed for opening the market to investor-owned companies. Swanson highlighted this issue in a letter to Governor-elect Tim Walz, noting the importance to protect Minnesota taxpayers from having billions of dollars in nonprofit health plan assets converted to for-profit use, without providing sufficient compensation to the public.
Healthcare spending at Minnesota clinics slowed sharply last year as physicians discouraged wasteful services and encouraged patients to choose lower-cost sources for prescription drugs, labs and imaging, according to the Minnesota Star Tribune. Per patient costs varied widely based on where patients received their primary care, ranging to a two and a half times difference in price, according to the total cost of care report. For example, specialty clinics, like the Mayo Clinic as well as rural providers tended to have higher prices. The report suggests that doctors managed costs by steering patients to low cost clinics instead of hospitals for outpatient services which declined spending on those outpatient hospital services by 1 percent in 2017 following a 7.3 percent increase in 2016. Business leaders said this comparison information is vital as health care costs increases and the payment burden falls more heavily on patients. Minnesota is currently the only state where detailed price information is published.
The Minnesota Attorney General Lori Swanson targeted drug manufacturers in a lawsuit for inflating the cost of insulin medication, according to the Star Tribune. Swanson is accusing others of being complicit in price-gauging sick patients with diabetes as well as the drug manufacturers. The lawsuit named three drug companies, Sanofi-Aventis, Novo Nordisk and Eli Lilly, that have tripled the list prices of their synthetic insulin medication since 2002. These medications are crucial to people with diabetes to manage their blood sugar and reduce their risk of disability, even death. Swanson is saying part of the price hike is due to the rebate structure implemented by pharmacy benefit managers (PBMs) who have ignored the impact of these rising costs have on patients. PBMs currently play a role in deciding which drugs are listed on insurance companies' preferred list. Because the PBM profits come through rebates, manufacturers have incentives to curry favor with them by raising prices and inflating rebates. Rising prices of insulin have raised concern over the past year with everyone from the President to Senator Amy Klobuchar appealing directly to insulin manufacturers, demanding legislation to compel the companies to lower their prices. Minnesota is the first state to bring a case against the insulin manufacturers.
Lowering overall cost of healthcare is a nonpartisan issue, according to a report from United States of Care. United States of Care profiled the Minnesota healthcare system because the state has a history of being a national leader in expanding coverage and access to healthcare, resulting in one of the highest rates of coverage in the nation. One imminent healthcare issue Minnesota is looking at is funding the Health Care Access Fund (HCAF), which is responsible for funding Medical Assistance Medicaid, MinnesotaCare and other public assistance programs. The provider tax that funds HCAF expires in 2020, so Minnesota legislators need to start thinking about ways to make up this $241 million line item. Other 2019 priorities for Minnesota include modernizing access for patient information, reducing costs of drugs and the future of medical assistance. Some longer term goals include funding for mental health and substance abuse, access to care in rural areas and health equity. Successful solutions to these short- and long-term goals will require continued collaboration and creativity.
In Minnesota, hospital bills for the same surgery can vary dramatically from one patient to another, even the procedure is performed at the same facility, according to a report from The Star Tribune. The findings from the state Health Department, came from a study of thousands of records detailing payments by private health insurers and consumers to hospitals for four common procedures: a simple appendectomy, spinal fusion, major bowel surgery, and removal of uterine fibroids. The report found that the differences patients paid for an appendectomy can range from $6,600 to $35,000 at the same hospital. Researchers did not find any significant difference between the patients to account for the large difference in price. Rather, these variations reflect a market that is not working well. There are many factors to account for the price variation, but the largest reason is through the negotiation of fees between hospitals and insurers.
Two Minnesota healthcare giants—Mayo Clinic and Blue Cross blue Shield of Minnesota—have agreed to a unique five-year contract that will downside risk and eliminate some prior authorizations, according to Modern Healthcare. This change will be implemented in part to lift restrictions on Mayo Clinic’s patients with serious or complex illnesses and make coverage more seamless under Blue Cross policies. Both companies have decided it is better to work together rather than aiming administrative artillery at each other. The agreement will add more conditions and treatments that don’t need prior authorization under the new contract, and will expand the amount of value-based care that will take place between the companies.
Minnesota’s Accountable Communities for Health, is a community-led model of delivering healthcare (both medical and non-medical) that targets patients with substantial health and social needs, according to a brief by SHADAC. The brief describes the development and implementation of the Accountable Communities in Minnesota, as well as the key components of implementing the model across the state.
According to the Twin Cities Pioneer Press, a report released Wednesday by the Minnesota Department of Health examined the wide range of prices Minnesotans pay hospitals for four procedures — hip and knee replacements and normal and C-section births. They found that Minnesotans could pay up to eight times more for certain medical procedures depending on the hospital they choose, but it’s hard to know which facilities offer the most affordable services.
Better efforts to coordinate care have resulted in a 22 percent drop in hospitalizations for diabetes according to researchers at the Minnesota Health Department. The decline between 2006 and 2014 resulted in fewer hospitalizations for diabetes related health problems (other than extremely high or low blood sugar levels). In 2008 the state launched several initiatives to control health care spending related to chronic conditions, focusing on obesity and smoking, improving disease management in primary care, and quality improvement systems that measure care and outcomes as part of state-wide partnership targeting diabetes.
Rural medical clinics coordinate patient care better than Twin Cities clinics, on average, according to a new Minnesota survey that suggests small facilities and do-it-all small-town doctors still offer advantages in an era of modern medicine.
The Minnesota Nurses Association announced that it would pay off approximately 1,800 patients’ debts on the anniversary of its strike against five Allina Health hospitals in the Twin Cities, according to the Star Tribune.
A new report from the Minnesota Department of health showed the state spent $54.9 million on low-value healthcare services in 2014, according to the Star Tribune. The report reviewed claims data for 1.46 million patients and evaluated the use of 28 low-value services as defined by the Choosing Wisely campaign.
The Mayo Clinic is renowned for diagnosing and treating medicine’s most complex patients. However, according to the Wall Street Journal, it must adapt to new payment policies from Medicare, high-deductible health plans and insurers’ restrictions on out-of-network care that are putting pressure on hospital revenue across the U.S to maintain its approach.
Gov. Mark Dayton refused to sign a $542 million reinsurance bill, but allowed it to become law, according to Fox 9. The bill subsidizes health insurance companies in the individual market, helping to defray costly claims. Lawmakers who supported the bill hope that the savings will be passed to consumers in the form of reduced premiums. The Governor’s reservations about the source of funding for the insurance subsidies and failure to include a MinnesotaCare buy-in option on the individual market led to his decision against signing the bill. However, in a letter to the House Speaker, Dayton has pledged to allow the bill to become law by failing to act upon it within three days, as required by law.
A Minnesota nonprofit issued a report identifying the highest-cost health clinics in the state in an effort to help consumers, according to the Star Tribune. Minnesota Community Measurement used claims data from the state’s largest health plans to find clinics with the highest prices and highest utilization rates. The report found that overall the total cost of care increased 5.6 percent overall from 2014 to 2015, while the total cost of pharmacy spending increased 9.3 percent.
The new plan, proposed by Governor Mark Dayton, would reduce health insurance premiums by 25 percent for Minnesotans who don’t qualify for subsidies, according to CBS Minnesota. The plan is being introduced after plans were approved for rate increases of 55 percent for 2017.
Patients who are more involved in the self management of their health are less likely to be hospitalized or to develop chronic conditions compared to less “activated” patients, according to a new study in Health Services Research. Researchers analyzed the behavior of nearly 100,000 patients at Fairview Health Services in Minnesota, an innovation-focused Accountable Care Organization (ACO).
As hospitals move toward value-based payment models, they are increasingly investing in primary care, according to the Star Tribune. Primary care is seen as the linchpin of population-based health strategies that emphasize improved access and care coordination.
Minnesota progressives and elected officials in the state's Democratic Farmer-Labor party are yearning to get back to the future with MinnesotaCare, the state's public insurance program for low-to-moderate income residents who earn too much to qualify for Medicaid, according to the XPostFactoid Blog. Prior to ACA implementation, MinnesotaCare was available to Minnesotans with incomes up to 275% of the Federal Poverty Level. In 2015, the plan was converted under the ACA into a Basic Health Plan, which qualified it for federal funding but cut off eligibility at 200% FPL. Former enrollees above that income level were sent to the ACA marketplace, where both premiums and out-of-pocket costs are considerably higher. A task force appointed by the governor recommended in mid-January that the state seek an ACA innovation waiver to restore MinnesotaCare eligibility to 275% FPL, with funding equivalent to the cost of federal marketplace subsidies for enrollees up to that income threshold.
Minnesotans with a chronic disease spent an average of $12,800 a year on healthcare in 2012, roughly eight times the amount spent by those without such a condition. The finding was revealed in a report by the Minnesota Department of Health and was made possible by a 2014 law allowing the agency to use Minnesota's all-payer claims database for analyses pertaining to the cost and quality of care.
New research shows that while the healthcare marketplace in Minnesota is lower cost for those who are a part of the Medicare program, those privately insured pay more for their care reports The StarTribune. This research calls into question the long held belief that the region is an area that should be modeled in many areas of federal health policy. The Minnesota Hospital Association disputes this recent research claiming that the research focused too closely on the list prices and did not take into account the long-term quality and cost metrics.
Associated Press: Consumers who purchase insurance through MNSure—Minnesota’s state-run insurance exchange—could experience rate hikes between 14 and 49 percent. In response, state regulators and lawmakers have begun looking into methods to reign in these price increases in an individual market that is smaller and more expensive than both regulators and insurance companies expected.
Rochester’s NBC affiliate KTTC reports on a Mayo Clinic pilot program to expand telemedicine services in rural southeast Minnesota. The program uses telemedicine kiosks with advanced diagnostic tools that enable providers to evaluate and communicate with patients in rural areas of the state. The state legislature recently required private insurance companies to reimburse providers for telemedicine services and legislators from rural Minnesota have sent a letter to Congress pushing for reimbursement for Medicare patients.
Minnesota Public Radio: More than one million emergency department (ED) visits and more than 70,000 hospital admissions in Minnesota possibly could have been prevented, according to a study by the Minnesota Department of Health. Researchers found $1.9 billion potentially preventable ED visits and hospital admissions in 2012. They said about two-thirds of ED visits likely could have been avoided if patients had better access to preventative care or better-coordinated healthcare.
Minnesota’s obesity rate has held level since 2008 according to Minneapolis NBC affiliate KARE11. This story attributes these results to the Statewide Health Improvement Program (SHIP) that was a part of the state’s 2008 healthcare reform.
This report from the Woodrow Wilson School at Princeton University examines how the state of Minnesota could use Section 1332 of the Affordable Care Act to advance health reform. The Minnesota Department of Human Services and MNsure--the state's health insurance marketplace--have expressed an interest in using a Section 1332 waiver to pursue a triple aim of improving patient experience and population health, while reducing per capita costs. This report explores the possibilities that such a waiver could unlock.
Much of the healthcare in Minnesota is provided by hospitals and insurers that are classified as nonprofit. This Star Tribune commentary finds the excess of revenue over expenses at these nonprofits is “eye-popping.” The authors argues that Minnesota needs a state standard that separates actual charitable activities from those that more closely resemble business promotion.
According to the Star Tribune, Minnesota’s enviable health rankings arise from a number of causes. The state has a relatively strong economy with high levels of employment. Employers have provided comprehensive health coverage, and taxpayers provide generous public programs. Nonetheless, it is unsustainable for an increasingly large percentage of resources to be devoted to health care. Is nonprofit health care benefiting the community?
Lucinda Jesson, the commissioner of the Minnesota Department of Human Services, stated in the Star Tribune that the DHS was able to save over $1 billion and created greater transparency and value in Minnesota healthcare purchasing—which works state wide to develop common strategies for performance measurement, promote greater transparency of healthcare costs, and creating greater accountability for healthcare results. This story explores what actions have been taken to achieve these reductions and what additional steps are being taken.
The Star Tribune reported on an analysis that finds dramatic spending variations depending on the clinics that Minnesotans choose—from $269 to $826 per patient—even after adjusting for sicker or more problematic patients. The analysis, by MN Community Measurement, a non-profit agency formed a decade ago to compare clinics by the cost and quality of care, was billed as a major advance in the consumer healthcare movement.Clinics have previously been ranked on their costs for individual procedures, such as colonoscopies. But that approach doesn’t take into account which clinics are least expensive overall, perhaps because they had fewer medical errors or could deliver quality care with fewer procedures.
The Star Tribune reported that “healthcare homes” – open for enrollment to any Minnesota resident—which were passed as part of the state’s 2008 health reforms, have reduced medical costs while improving the quality of care. This story highlights research done by the University of Minnesota on the impact these “healthcare homes” have on providers and patients.