Primary care coordination – policy development

As a key component of state health care reform efforts, the Department of Human Services (DHS) is working to improve primary care through clinic-based care coordination and the establishment of “health care homes” for Minnesota Health Care Programs (MHCP) clients. This page contains additional information on the development of the primary care coordination (PCC) program and its relationship to statewide health reform efforts.

Program development and criteria

Since fall 2007, DHS staff have worked with stakeholders from medical and patient communities, health plans, counties and other interested groups to develop the PCC program. The program is designed for a subset of MHCP clients in fee for service who have chronic medical conditions and complex needs.

In October 2008, the recommendations of stakeholders and workgroup members were compiled into criteria for provider participation (PDF). In February 2009, the federal Centers for Medicare and Medicaid Services approved a three-tiered payment schedule (PDF) for providers serving patients’ with varying levels of complexity. DHS worked with the University of Minnesota on the payment methodology (PDF) as well as other program components.

Relationship to health care homes

The PCC program, created under 2007 legislation, is an important precursor to health care homes statewide under the 2008 Minnesota Health Reform Act. The act calls for development of a health care home certification process and a corresponding system of risk-stratified per-person care coordination payments to certified practices. Because the PCC program shares key goals and design elements with the health care home vision, PCC’s implementation with select clients offers a working model for development of health care homes for a broader population. PCC is expected to fold in to the health care home program for MHCP clients. This means that practices that register as PCC providers will eventually be required to be certified as health care homes under the statewide process in order to continue receiving care coordination payments.

Additional information is available on the Minnesota Department of Health (MDH) health care homes Web page.

Related grants

DHS also awarded grants in January 2009 for the establishment of care delivery models in numerous Minnesota clinics to prepare providers to participate in the primary care coordination program and the state's health care home initiative.

  • • Courage Center was awarded a 12-month $200,000 grant to pilot a medical practice model designed to meet the needs of adults with disabilities who have complex medical conditions. The project will integrate primary care medical services on site with Courage Center's other specialized services.
  • • Minnesota Academy of Pediatrics Foundation was awarded an 18-month $349,462 grant to identify, recruit and assist sites to be primary care medical home clinics for children and adults with complex health care needs. The project will support at least 20 clinics statewide and will be implemented in partnership with the Minnesota Academy of Family Physicians and the Minnesota chapter of the American Academy of Pediatrics.
  • • Neighborhood Health Care Network was awarded an 18-month $312,170 grant to build infrastructure in 12 sites operated by seven of its affiliated primary care clinics in the Twin Cities area. The project is part of the Network's long range goal of converting all sites into medical homes for all patients.

  • A $202,666 grant was awarded in spring 2008 to the University of Minnesota-Fairview Children's Clinic for a medical home pilot project for children with autism.

    Funding for the grants was appropriated by the 2007 Legislature and awarded through a request for proposals process.

    Past events

    Fitting Minnesota into the National Landscape:
    A Conversation with National Experts about Implementation of Health Care Homes

    DHS and MDH sponsored a meeting in January 2009 to discuss how Minnesota's health care home efforts fit into the national landscape. Three national speakers attended: Jeanne McAllister from the Center for Medical Home Improvement, Ann O'Malley from the Center for Studying Health System Change and Sarah Scholle from the National Committee for Quality Assurance. Copies of the presentations are available on MDH’s Web site.

    Transforming Primary Care: Developing a Medical Home in Minnesota

    A November 2007 conference introduced the concepts of “medical home” and care coordination at a practice-based level and presented the integration of these concepts into the payment reform initiatives of the primary care coordination program and other grant activities enacted by the 2007 Minnesota Legislature. DHS, the Minnesota Medical Association and other health care organizations sponsored the event. The following presentations were given:


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