Taking Action Express: Cutting Low-value Care and Mental Health Stigma; Specialty Drug Dilemmas…and More!

JUNE 6, 2017

Discovering Solutions: Reducing Low-value Care in MN 

Diagnostic imaging for uncomplicated headaches is the most common — and most costly — low-value service in Minnesota, accounting for 40 percent of overall costs. Total spending on 18 low-value services measured was $54.9M. 

These and other findings by the Health Economics Program (HEP) of the Minnesota Department of Health (MDH) are newly available, the result of an analysis of low-value services in Minnesota in 2014. This issue brief used the Minnesota All Payer Claims Database (MN APCD), a comprehensive community data asset that includes public and private insurance claims for nearly all Minnesotans.

Action Group members from leading Minnesota employers have participated in MN APCD key informant interviews and focus groups, and are guiding development of proposed reports to deliver on goals for expanding health care coverage, reducing costs, and improving quality of care.

Our next member meeting on July 26 will focus on how employers can optimize use of a valuable community asset: Health care data. Non-members may also attend by contacting Sue Jesseman for a complimentary pass.

Related and interesting: 

 Improving Overall Health by Addressing Mental Health 

Imagine if 60 percent of people with diabetes, or heart disease, or cancer did not not seek treatment. It’s unthinkable. Yet, of the 44 million Americans living with mental illness, 60 percent receive no treatment in a given year, despite a growing body of evidence directly linking behavioral and physical health.

In a special report, Modern Healthcare examines national and local efforts aimed at fixing the problem, and exploring the link between chronic disease and behavioral health.

Minnesota Health Action Group Mental Health Learning Network members are identifying opportunities to improve access to quality care, and helping reduce the stigma that often accompanies mental illness. They recommend the following resources for employers:

  1. Working Well: Leading a Mentally Healthy Business (note: first page of PDF is blank)
  2. Issue Brief: Fixing Behavioral Health Care in America
  3. National Alliance on Mental Illness’ (NAMI) partnership to create stigma-free workplaces

Member Only Meetings:
Not yet a member and see something of interest? Contact us for a complimentary meeting pass (excludes Summit):

Join the Movement to Create a Better Health Care System

With health care spending now accounting for nearly 18 percent of the GDP, the explosion and endless pipeline of costly specialty drugs, and growing health care complexity that perplexes even the savviest health care consumer, it has never been more important for employers to collaborate through member-led coalitions like the Minnesota Health Action Group.

We are growing and welcoming newcomers to become part of our movement to build a better health care system. Action Group members know from experience that we accomplish more together than any of us can alone. We draw strength from our collective voice, and progress through our united efforts. Learn more about us through our new overview, attend a meeting as our guest, talk to members or board members, or contact Deb Krause.


Summit Advances Health Care Affordability Debate

Transitioning our health care system from one that is expensive and inequitable to one affordable and equitable requires keeping people healthy and providing consistent and outstanding patient care. This was the overarching message from 2017’s sold-out Annual Employer Leadership Summit.

A new blog by Carolyn Pare, Action Group president and CEO, summarizes the vision for how member organizations have committed to the movement to improve health care access and affordability.

Deluge of New Specialty Drugs Brings Greater Complexity

“The pipeline for new drugs is bursting, and new devices and tools in the rapidly emerging digital health space will come to market more quickly.”

According to QuintilesIMS, more than 2,000 drugs are in the late-stage approval process, and they will yield an estimated 45 new active substances annually over the next five years. This deluge will make decision making more complex for clinicians, and for payers, who must choose which treatments to favor through preferred pricing.

Members of The Action Group’s multi-stakeholder Specialty Drug Guiding Coalition are actively pursuing specific action items, deliverables, and a timeline to address high costs and variability in Minnesota and nationally. Additionally, The National Alliance of Healthcare Purchaser Coaltions has launched a new vision to align the private sector in support of a high-value specialty drug marketplace. Minnesota employers and The Action Group played a key role in developing the framework. To view the vision, click here.



Lawmakers Work Tirelessly to Tackle Spending and Policies 

Minnesota lawmakers used every last minute available to them to try and complete their work prior to the May 23 deadline for the 2017 legislative session, but it was not enough. At 12:01 a.m. the next day, Governor Mark Dayton declared a special session to give lawmakers more time to complete their work. The “informal agreement” Dayton had with each of the four legislative caucus leaders called for a narrow special session and a self-imposed 7 a.m. Wednesday, May 24, deadline to complete the legislature’s unfinished business.

That new deadline passed without agreement between legislative leaders and the Governor on major spending and policy bills. Working and negotiating nearly around the clock, a deal was struck late Thursday evening May 25, on all of the outstanding issues. The final bills were processed over the course of about six hours, and the 2017 Special Session adjourned after 3 a.m. on Friday, May 26.

The funding bills being sent to Dayton add up to a record $46 billion budget, a tax bill that includes $660 million in tax cuts and a host of policy provisions favored by the Republican-controlled legislature. In the end this budget makes $463 million in Health and Human Services (HHS) cuts over the next biennium, and uses a great deal of Health Care Access Fund money to fund most of that spending, including MA costs.

Below is a list of the provisions of interest to The Action Group from the HHS omnibus budget bill. Stay tuned over the summer as we watch the activity in Washington D.C., to see how it will impact Minnesota’s health care landscape.

Article 4, Section 2, Line 152.31: Audits of MCOs to ensure contract compliance in the public programs.

Article 4, Section 3, Line 153.13: Payment restructuring/quality incentive payment reforms, including input from health care purchasers.

Article 4, Section 39, Line 194.26: Changes to performance measures for providers serving public program recipients. Please note paragraphs (f), (g), and Subdivision 2 beginning on Line 195.30.

Article 5, Line 221.10: Deals with various health insurance provisions, including transitions of non-profit HMOs to a for-profit organization on Line 226.8.

Article 10, Section 57 (Line 379.28) and Section 146 (Line 454.25): Creation of a Palliative Care Advisory Council.

“Today we are at a crossroads. Not since the turn of the century have we fundamentally reexamined our overall strategies to managing health-care costs and supporting the health and well-being of our people.”

Michael Thompson,
CEO of the National Alliance of Healthcare Purchaser Coalitions, featured in the May 24, 2017, edition of CFO. Click to view “Health Care Purchasers Take the Wheel.” The Action Group is a proud member of the National Alliance.

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