Can Healthcare Reform Learn from Minnesota? You Betcha!

Posted Tue, 2009/12/22 - 20:29 by Amer Kaissi

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In a previous post, I discussed the 2006 healthcare reform law passed by Massachusetts and commented on its cost, quality and access implications. In 2008, Minnesota passed a landmark legislation that promised to overhaul healthcare delivery in the state. While the Minnesota law did not mandate universal coverage per se, it included several advancements and provisions that can make it a model to follow.

The major highlights of the Minnesota healthcare reform bill included the establishment of medical homes, focus on public health, move towards universal coverage, and “baskets of care.”

Medical homes is a concept based on the premise that healthcare delivery — especially for patients with chronic diseases — should be provided and coordinated by a team of doctors, nurses, nurse educators and pharmacists, that communicate using a secure computer platform. At the center of the medical home is the family/primary care doctor who works with others to provide patients with a broad spectrum of preventive and curative services. In the Minnesota legislation, medical homes will be developed and evaluated over a five-year period, based on cost savings and health improvements.

Another main aspect of the bill was the allocation of $47 million in grants to fight the top three causes of illnesses in the US: tobacco use, physical inactivity, and poor nutrition. The focus is on making work, school, healthcare and community environments healthier. The projected potential savings from this investment is around $1.9 billion by 2015.

While Minnesota is one of the leading states in terms of its healthcare coverage (93% of Minnesotans had some kind of health insurance before the law was passed), the bill included provisions to improve coverage even more. An estimated 12,000 additional people would obtain coverage either by extending public programs for people without children or by providing additional tax incentives to buy private insurance plans.

The idea behind “baskets of care” is that for a set of common services, all the costs associated with the service (from consultation to surgery to anesthesiology to medications to follow-up) would be calculated. Hospitals would attach price tags for each service, so patients can compare costs across the market. The services included in the baskets are child asthma care, low-back pain, obstetrics, total knee replacement, diabetes, heart disease and depression.

As the national healthcare reform debate seems to reach its last stages, legislators will continue to look for successful models to follow. The “land of 10,000 lakes” can provide several examples of programs that will improve quality and access while reducing costs.

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