Minnesota Accountable Health Model

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Accountable Care Organizations

Accountable Care Baseline Assessment

The Minnesota Department of Health commissioned a baseline assessment as part of the $45 million federal State Innovation Model (SIM) grant to implement the Minnesota Accountable Health Model. The assessment was designed to guide the development of tools and resources for providers and communities, and inform future monitoring efforts. Accountable Care Organizations (ACOs) are central to the Minnesota Accountable Health Model, which seeks to improve health in communities, provide better care and lower health costs.

The study included both qualitative and quantitative analyses, and drew on responses from more than 70 health plans and providers representing a majority of public and private health care markets.

A comprehensive report, Baseline Assessment of ACO Payment and Performance Methodologies in Minnesota for the State Innovation Model (SIM), is available.

  • • Baseline Assessment of ACO Payment and Performance Methodologies in Minnesota for the State Innovation Model (SIM)
  • • Appendix A, Survey Participation
  • • Appendix B, Survey Questions
  • • Appendix C, Detailed Results
  • • Fact sheet: report summary and key findings
  • • Press Release

    • Minnesota All Payer Claims Database (MN APCD)

  • • Minnesota All Payer Claims Database (MN APCD): High Value Reports for Employers (PDF)
  • • CommercialCase Price Variation among High-Volume Inpatient Treatments in Minnesota Hospitals (PDF) (this links to the MDH site, http://www.health.state.mn.us/healthreform/allpayer/pricevariation.pdf)

    • Overview

    An Accountable Care Organization (ACO) is a group of health care providers, with collective responsibility for patient care that helps coordinate services – delivering high quality care while holding down costs*. The ACO model creates an incentive for providers to efficiently and effectively manage the health of their patients regardless of where the patient receives care. Innovation lies in the flexibility of their structure, payments and risk assumption (i.e., how much “skin in the game” they have in terms of controlling costs and improving quality). That structure is likely to include Primary Care Providers (PCPs), specialists, a hospital, and other provider and community agreements/partnerships.

    *Robert Wood Johnson Foundation

    Examples of National ACO Models

  • • Medicare Shared Savings Program (MSSP),
  • Center for Medicare and Medicaid Services (CMS)
  • Eligible providers, hospitals, and suppliers participate in ACOs to improve the quality of care for Medicare Fee-For-Service (FFS) beneficiaries and reduce unnecessary costs. Advance Payment ACO Models provide supplemental support from the Center for Medicare and Medicaid Innovation (CMMI) to physician-owned and rural providers for start-up resources to build the infrastructure (staff, information technology systems, etc.). Minnesota MSSP sites include Essentia Health, HealthEast Care System and Entira Family Clinics.
  • • Pioneer ACO Model - For early adopters of ACOs,
  • CMMI
  • Designed to support organizations with experience operating as ACOs - or in similar arrangements - in providing more coordinated care to beneficiaries at a lower cost to Medicare. The Pioneer ACO Model will test the impact of different payment arrangements in helping these organizations achieve the goals of providing better care to patients and reducing Medicare costs. Minnesota Pioneer ACO sites include Fairview Health Services, Park Nicollet, and Allina Health.

    • Minnesota Medicaid ACO Models

  • • Integrated Health Partnerships (IHPs)
  • Includes 145,000 total enrollees
  • • Hennepin Health
  • A safety-net ACO integrating social services and behavioral health
  • • Integrated Care System Partnerships (ICSP)
  • MCO-Provider partnerships for seniors and people with disabilities

    • Commercial ACO/Total Cost of Care (TCOC) Arrangements

    With commercial ACO/TCOC agreements, health care providers and systems participate in a range of different delivery and payment arrangements aimed at achieving the Triple Aim. Agreements may include performance based on outcomes/quality and cost; varying levels of financial risk from shared savings to sub-capitation. Arrangements can be across multiple populations (self-insured, commercial and government) for some models.