MINNEAPOLIS, June 4, 2009 - The MMA is providing members ongoing coverage of the key components of the 2008 Health Care Reform Act. Here the a summary of recent events.

MMA Remains Concerned about Rules for Health Care Homes
The MMA was continuing to call for improvements in the standards and rules being developed for certifying health care homes in Minnesota as the departments of Health and Human Services prepared to release the final rules at the end of May for a 30-day public comment period.
State officials had already modified the proposed rules, which spell out which providers will be eligible for care coordination payments for patients enrolled in state-sponsored health care programs, in response to physician feedback obtained at a summit sponsored by the MMA and others. However, the MMA still saw room for improvement in a later draft of the rules.
The MMA is concerned that the rules require practices to offer 24-hour access to care, ensure continuous access to patients’ medical records, and dedicate space for the care coordinator at the same location as the provider and time to perform care coordination functions. In addition, the MMA is urging officials to clarify whether care plans will be required for all patient

Pay-for-Performance Measures
The MMA commented on the final recommendations for a pay-for-performance system submitted to the Minnesota Department of Health. The MMA supported several of the recommendations but is concerned about the lack of specificity about the measures that will be included in the Statewide Standardized Quality Measure Set, from which measures will be selected for pay-for-performance programs. The MMA also is concerned that the measures selected be well-established, evidence-based, reliable, and valid, and that there be robust risk and case-mix adjustment. 

Baskets of Care
The Institute for Clinical Systems Improvement, which was under contract with the state to recommend components to be included in seven baskets of care, has completed its work on defining the components of the baskets. The recommendations are available at www.icsi.org. The seven baskets are preventive services for children, preventive services for adults, childhood asthma care, diabetes treatment, OB care, total knee replacement, and treatment of low back pain.
The MMA is participating in a work group that’s developing an educational plan and informational materials for physicians and other providers about the baskets of care. The MMA is also involved in a group developing measurements for determining the efficacy of each of the baskets. 

Peer Grouping Committee to Meet in June
The Peer Grouping Advisory Committee is scheduled to meet for the first time in June. This committee will advise the Department of Health about devising a methodology, known as peer grouping, for comparing Minnesota providers on cost and quality. The group will hold eight meetings between June and September.