CentraCare joins Medicaid model
ST. PAUL, Feb 02, 2013 (St. Cloud Times - McClatchy-Tribune Information Services via COMTEX) --
Gov. Mark Dayton announced Friday his administration is partnering with six Minnesota health providers, including CentraCare Health System, in testing a new Medicaid payment model.
The model is aimed at reducing the cost of treatment for 100,000 medical assistance enrollees, primarily through a greater emphasis on preventive care.
"The way this works is that it gives CentraCare additional information to help us try and better help the patients locally," said Kathy Parsons, director of managed care for
St. Cloud Hospital.
"It will potentially help us see that we have somebody who is using the emergency room for their primary care, and we can identify them and get them into one of the clinics for less expensive and more comprehensive care," she said.
Under the new
approach, the state Department of Human Services will shift from paying primarily based on volume of patients served to financial incentives for lowering health care costs for those patients.
Each year, the cost of care per patient will be compared with mutually set targets for cost and quality; any savings will be shared by the state and health care providers, under the new approach. The state and providers would jointly make up losses in cases where cost savings are not achieved.
"It's a three-year contract that's actually already begun," Parsons said. "But of course between now and then, we could decide to make adjustments, redo the contract, make it longer, that type of thing."
The contract will expire at the end of 2015.
The administration is forecasting the payment system will save taxpayers about $90 million over three years.
Human Services Commissioner Lucinda Jesson says her agency already is working to expand the model to more of the roughly 800,000 Minnesotans on Medicaid or MinnesotaCare.
"The biggest part to it is that focus on trying to get patients more timely care and a better setting. The way the current Medicaid system is set up, there isn't really a way to do it," Parsons said. "It's very episodic; you are here for this visit, and that's the end of it. There isn't a good way to try and better coordinate that care."
The other providers are: Children's Hospitals and Clinics of Minnesota, Essentia Health, North Memorial Health Care, Federally Qualified Health Center Urban Health Network, and Northwest Metro Alliance (a partnership between Allina Health and HealthPartners).
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