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Managed Care Reporting
Minnesotans need full disclosure and greater accountability of how public dollars are spent for health care services for people enrolled in Medical Assistance (MA) and MinnesotaCare (PDF) (DHS-4932). In an effort to provide this information, Gov. Mark Dayton directed the Department of Human Services (DHS) to establish this website under an executive order (PDF). It is a single source for all publicly available state information and reports on managed care plans under contract with DHS for publicly funded health care programs.
About this website
Minnesota spent about $3.7 billion in state fiscal year 2012 purchasing health care through managed care plans for more than 700,000 people enrolled in public health care programs. These links provide information on managed care plan quality of care, financials, contracting and reports by state agencies. This information is collected by DHS as the purchaser of health care services for public program enrollees and the Minnesota Department of Health (MDH), the state agency that regulates managed care plans including health maintenance organizations and county-based purchasing plans. DHS launched the site in April 2011. The site is a work in progress and additional information will be posted.
DHS contracts with each managed care plan for the various groups of people, such as families with children and seniors, covered by MA and MinnesotaCare are listed here. Model contacts and the contracting schedules are also included.
This includes information on how many people are enrolled in each plan and county. A series of maps show which plans are contracted to provide services to public program enrollees in each county for each program.
This is information about payments made by DHS to managed care plans. It also includes annual financial reports from the plans with data on revenues, expenses and net income for all their health care business.
This is information about health care services provided to people through managed care plans. It includes information about quality of care, efforts to improve services, incentives for providers to improve care and customer surveys.
These are reports and audits related to managed care plans required by the Governor and/or Legislature.
Managed care plans and county-based purchasing plans are required to implement strategies that facilitate access for young children to periodic developmental and social-emotional screenings, allowing access to appropriate evaluation and assessment, including treatment recommendations to improve the child’s functioning, with the goal of meeting milestones.
Report on the Value of Minnesota Health Care Programs (MHCP) Managed Care, as Compared to Fee-for-Service
DHS contracted with Public Consulting Group (PCG) to author a report on the value of managed care for state public health care programs required by Minnesota Sessions Laws 2012, Chapter 247, Article 1, Section 31. Specifically, PCG was tasked with determining the value of managed care for Minnesota Health Care Programs (MHCP) in comparison with a fee-for-service (FFS) delivery system. This is their report.
MCOs’ Quality Improvement Program Websites
Minnesota managed care organizations (MCOs) submit annual quality program updates to demonstrate how their quality improvement programs identify, monitor and work to improve service and clinical quality issues relevant to the Minnesota Health Care Programs (MHCP) enrollees. The MCOs’ quality program website URLs, linking to a public webpage, are posted here. Each MCO’s quality program website describes quality improvement activities resulted in measurable, meaningful, and sustained improved healthcare outcomes for the contracted populations.
Public comments will be accepted at this email address: DHS.HealthCare.Research&Quality@state.mn.us (Please include MCO’s name or the URL in the subject line.)
Self-reported MCO quality improvement initiatives
Minnesota managed care organizations (MCO) submit annual summaries of how their Quality Improvement Program identifies, monitors and works to improve service and clinical quality issues relevant to the Minnesota Health Care Program (MHCP) enrollees. The second set of reports is included here. Each MCO summary highlights what each MCO considers significant quality improvement activities that have resulted in measurable, meaningful and sustained improvement.
Feedback on this site
DHS welcomes feedback and suggestions to make this a useful and user-friendly tool. Click on the “Report/Rate this page” link below to send comments.
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