[MMA News Now, July 26, 2012] The MMA recently made recommendations to two work groups that are tasked with examining care integration and payment reform, and workforce issues as part of the Governor’s Health Care Reform Task Force effort.

The Task Force includes commissioners, legislators and private sector representatives and is charged with developing strategies that: improve access to health care for all Minnesotans; lower health care costs by reforming how we pay for health care and changing the incentives, so we encourage preventive care and reward healthy outcomes, not sickness; and improve the health of all Minnesotans and address the huge health disparities that plague our state.

“The MMA is somewhat concerned to see such a strong reliance on the yet-to-be-proven Accountable Care Organization (ACO) model as the central theme in the recommendations,” the MMA wrote in a letter to the Care Integration and Payment Reform Work Group. Although supportive of further testing of ACOs, the MMA is not convinced that ACOs are the only way to achieve the payment and delivery reform goals of the group. 

The MMA also urged the work group to provide greater clarification on quality measures to drive improvement and measures needed for ACO evaluation and/or oversight.

On the subject of changing care delivery, the MMA asked the care integration and payment reform committee to examine the certification and recertification criteria currently in place for health care homes. “We would urge specific attention to whether these criteria impose barriers to health care home expansion and whether the timeline for recertification should be extended,” the MMA wrote.

With the Workforce Work Group, the MMA focused on the group’s endorsement of independent practice for advance practice registered nurses as outlined in the Advance Practice Registered Nursing (APRN) Consensus Model.

“The APRN Consensus Model is a document that was created almost exclusively by nursing organizations and includes provisions that MMA believes would erode collaborative practice,” the MMA wrote in a letter to the Workforce Work Group. The MMA cited a study on Medicare spending that found it was actually the mix of the physician workforce that plays a critical role in the use of highly effective care for Medicare beneficiaries.

The MMA urged the committee to support two amendments to the Nurse Practice Act in lieu of adopting the APRN Consensus Model.  These amendments would: 1) “eliminate a written prescribing agreement as a requirement to prescribe drugs and therapeutic devices;  and 2) explicitly require the APRN to practice within a health system that has a written plan for patient-centered care for interdisciplinary consultation,  collaboration and referral as indicated to achieve optimal patient outcomes.”

The Governor’s Task Force expects to develop final recommendations for the Legislature by September 2012.