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Payment Reform for Primary Care – Minnesota DHS efforts

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Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Jeff Schiff

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Payment Reform for Primary Care – Minnesota DHS efforts Jeff Schiff, MD MBA Medical Director Minnesota Health Care Programs Minnesota Department of Human Services
Current payment reform efforts in Minnesota ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Today ,[object Object],[object Object],[object Object],[object Object]
Primary Care Orientation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary Care Orientation ,[object Object],[object Object]
Primary Care ,[object Object],[object Object]
Primary Care ,[object Object],[object Object]
Minnesota history from 2004 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical home now ,[object Object],[object Object],[object Object],[object Object],[object Object]
Breakthrough learning collaborative ,[object Object],[object Object],[object Object],[object Object]
Breakthrough learning collaborative ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breakthrough Series (9-12 month time frame) Select Topic Planning Group Develop Framework & Changes Participants Prework Supports E-mail Visits Phone Assessments Senior Leader Reports LS 1 LS 3 LS 2 Summits, Guides, Publications, etc. A D P S A D P S
Which system is the unit of health care practice, intervention, measurement, focus? (Batalden) Self-care system Geopolitical, market system Macrosystem Mesosystem Microsystem Individual care-giver & patient system
Clinical microsystem ,[object Object],[object Object],[object Object],[object Object]
Possible implications relevant for leading health care redesign & improvement ,[object Object],[object Object],[object Object],[object Object]
Dovetails with national attention to Medical Home ,[object Object],[object Object],[object Object]
Primary Care Orientation What is Primary Care? ,[object Object],[object Object],[object Object],[object Object],[object Object]
What is a medical home? ,[object Object],[object Object],[object Object],[object Object]
And… ,[object Object],[object Object],[object Object],[object Object]
PDCC legislative proposal ,[object Object],[object Object],[object Object]
Model development ,[object Object],[object Object],[object Object],[object Object],[object Object]
Legislation passed
Pick your moral hazard ,[object Object],[object Object],[object Object],[object Object]
Implementation challenges ,[object Object],[object Object],[object Object],[object Object]
Defining clinics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Where does care coordination live? Provider Provider Directed Care Coordination Community based Case management Negotiated coordination
Community Fair Process – current work ,[object Object],[object Object],[object Object]
PDCC clinic criteria workgroup ,[object Object],[object Object],[object Object],[object Object],[object Object]
Workgroup membership ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patient selection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Evaluation ,[object Object],[object Object],[object Object]
Additional tools and products ,[object Object],[object Object],[object Object],[object Object]
Medicaid Transformation Grant ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ICC predictive modeling ,[object Object],[object Object],[object Object],[object Object],[object Object]
MN HIVE – Minnesota’s development of a value exchange ,[object Object],[object Object],[object Object],[object Object]
DIAMOND project ,[object Object],[object Object],[object Object],[object Object]

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Payment Reform for Primary Care – Minnesota DHS efforts

  • 1. Payment Reform for Primary Care – Minnesota DHS efforts Jeff Schiff, MD MBA Medical Director Minnesota Health Care Programs Minnesota Department of Human Services
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  • 12. Breakthrough Series (9-12 month time frame) Select Topic Planning Group Develop Framework & Changes Participants Prework Supports E-mail Visits Phone Assessments Senior Leader Reports LS 1 LS 3 LS 2 Summits, Guides, Publications, etc. A D P S A D P S
  • 13. Which system is the unit of health care practice, intervention, measurement, focus? (Batalden) Self-care system Geopolitical, market system Macrosystem Mesosystem Microsystem Individual care-giver & patient system
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  • 26. Where does care coordination live? Provider Provider Directed Care Coordination Community based Case management Negotiated coordination
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