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Successes at a Minn. Medicaid-managed-care ACO


The Hennepin County Government Center,  in Minneapolis. Its stylized letter “H” shape serves as the logo for Hennepin County.

This Commonwealth Fund report looks at the successes of Minnesota’s Hennepin Health, a safety-net Accountable Care Organization (ACO) launched in 2012 as a Medicaid demonstration project meant to be a new model of care for Medicaid beneficiaries, many of whom suffer from serious behavioral-and-mental health issues as well as poverty, trauma and social isolation. The ACO’s territory includes Minneapolis and environs.

The Commonwealth Fund reported these results:

“Hennepin Health’s efforts have improved access to primary care for its members and reduced use of acute care. Emergency department visits decreased by 9.1 percent between 2012 and 2013, while hospital admissions remained stable. Over the same period, outpatient visits increased by 3.3 percent….”

“Hennepin Health also has provided better care for members with chronic conditions. Growing percentages of its members receive recommended diabetes, vascular, and asthma care—though the numbers are still low. Hennepin Health’s leaders are encouraged by members’ increasing use of primary care, but say it will likely take longer before this yields appreciable improvements in health.”

To read the entire Commonwealth Fund report, please hit this link.


Looking for payment models for community health


Because Cambridge Management Group has done considerable work in community/population health, including in addressing the social determinants of health, especially in the Pacific Northwest, this article in The New England Journal of Medicine caught our eyes.

The authors  of the article, headlined “Accountable Health Communities — Addressing Social Needs through Medicare and Medicaid,” write:

“As health systems are increasingly being held accountable for health outcomes and reducing the cost of care, they need tools and interventions that address patient and community factors contributing to excess utilization. Effective partnerships among medical care, social services, public health, and community-based organizations could improve population health outcomes, but developing sustainable payment models to support such partnerships has proved challenging.

“Some encouraging innovations have emerged. Catalyzed in part by statewide all-payer delivery-system reform and the growth of value-based or shared-risk payment models, some purchasers and providers of medical care have found innovative ways to support high-value community-focused interventions. For example, Hennepin Health, a county-based Medicaid managed-care organization in Minnesota, has reduced emergency department visits by 9% by using housing and community service specialists who are part of a tightly integrated medical and social service system.”

“To accelerate the development of a scalable delivery model for addressing upstream determinants of health for Medicare and Medicaid beneficiaries, CMS recently announced a 5-year, $157 million program to test a model called Accountable Health Communities (AHC). …{T}he test will assess whether systematically identifying and addressing health-related social needs can reduce health care costs and utilization among community-dwelling Medicare and Medicaid beneficiaries.”

“The AHC model reflects a growing emphasis on population health in CMS payment policy, which aims to support a transition from a health care delivery system to a true health system. The AHC test will improve our understanding of whether savings can materialize when upstream factors are addressed through collaboration among stakeholders who are accountable for the health and health care of their community.”

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