[MMA News Now, Dec. 13, 2012] While supportive of much of its work, the MMA sent a letter to the governor’s Health Care Reform Task Force on Dec. 10 recommending revisions to the group’s Roadmap to a Healthier Minnesota.

In particular the MMA asked for revisions to three “strategy elements” in the Roadmap.
The MMA stated in a letter signed by MMA President Dan Maddox, M.D. that it can’t support the task force’s recommendation to “explore and remove regulatory barriers to the advancement of the nursing workforce,” which involves enacting the Advanced Practice Registered Nursing (APRN) Model Act and Rules.

Noting that the Roadmap recommendations involve improving care coordination and integration of care, the MMA feels that “implementation of the APRN Model Act would run counter to that goal and would actually erode collaborative practice that is currently part of Minnesota’s APRN law.”

The letter goes on to note: “that not all APRNs deliver primary care, particularly Certified Registered Nurse Anesthetists. The MMA urges the Task Force to specifically limit any recommendations to transform primary care specifically to those health care professionals delivering primary care.” The MMA would support regulatory changes to ensure more effective and efficient inclusion of APRNs in the delivery of care, but not if such changes mean complete independent practice.

In another strategy element, the Roadmap aims to “prepare for anticipated increased demand on safety net provider services by increasing reimbursement to safety net providers for primary care, mental health, substance abuse and community-based services provided to Minnesota Health Care Program recipients.” Concerned that this is too narrow, the MMA “urges the Task Force to expand the recommendation to increase reimbursement to all providers serving Minnesota Health Care Program recipients.”

The MMA specifically noted that as the individual mandate and other insurance coverage options take effect in 2014, the increased demand on the health care system, particularly primary care, could be significant. Yet, the state has failed to adequately invest in Medicaid physician reimbursement with only one across-the-board increase in fee-for-service rates in 20 years – back in 2000.

In a third strategy element, the Roadmap recommends use of a: “public-practice process to set performance targets, including goals for health care cost containment, health care quality, patient experience and population health.” The MMA certainly supports performance targets, but questions as to the scope of this recommendation remain. For example: the composition of the public-private partnership, the need to avoid duplication of current measurement efforts, and the feasibility and value of imposing consequences if the targets are not met.

To view the entire Roadmap, visit this link.