Ten Federally Qualified Health Centers Collaborate with State to Improve Health Outcomes, Reduce Costs in Minnesota Medicaid Program
Ten federally qualified health centers (FQHCs) in the Twin Cities area
have formed a coalition to collaborate with the state to improve care
and reduce costs for nearly 22,000 Medicaid beneficiaries in Minnesota.
Under terms of the contract with the Minnesota Department of Human
Services (DHS), the Federally Qualified Health Center Urban Health
Network (FUHN) will be responsible for meeting DHS-established quality
and cost benchmarks for Medicaid patients, and will be eligible to share
in cost-savings it achieves during a three-year contract period.
Known as an accountable care organization (ACO), the FUHN model – one of
the nation’s first “safety net” ACOs – is one component in Minnesota’s
Medicaid Health Care Delivery System (HCDS) demonstration project, a
payment reform effort aimed at improving Medicaid outcomes and reducing
costs by focusing on integrated and coordinated patient care.
To help achieve its goals, FUHN has partnered with Optum, an Eden
Prairie-based health care services and technology company. FUHN and
Optum have invested time and resources to develop a care coordination
model that emphasizes population health management and increased patient
engagement. The model relies on data analytics and the deployment of
predictive modeling software, which Optum is providing to FUHN as a
component of the collaboration.
“This contract represents a fundamental shift in our relationship with
the state, and in our relationship with each other, to better serve
Medicaid beneficiaries,” said Dr. Jaeson Fournier, chief executive
officer of West Side Community Health Services in St. Paul and
chairperson of FUHN. “These 10 FQHCs have come together as FUHN to
deliver better, more integrated care to those we serve. Optum’s
financial commitment to our project, its health care and Medicaid
knowledge, and its technical expertise will support FUHN in achieving
its goals of increasing patient satisfaction, improving patient health
care outcomes, and reducing the total cost of care for patients served
under our HCDS agreement with DHS.”
FUHN acknowledged that the in-kind support provided by Optum during the
planning and model development phases has been invaluable in moving the
project forward, as were several grant awards provided by The Greater
Twin Cities United Way, which supported the coalition’s start-up legal
and administrative costs.
FUHN’s delivery system consists of nearly 40 service sites across seven
counties in the Twin Cities. The population served by the 10 FQHCs is
culturally diverse and economically disadvantaged; 94 percent have
incomes below 200 percent of the federal poverty line. Patients seeking
care from these safety net providers often experience higher rates of
multiple chronic conditions, including asthma, diabetes, hypertension,
and depression or other serious mental illnesses. Many have low levels
of health literacy or face medical complications due to poverty,
homelessness, or cultural and language barriers.
FUHN leaders have identified three components of their care delivery
model that they expect will enable them to develop an integrated network
able to manage total patient care, which, in turn, will help them
achieve their goals of improving quality and reducing costs:
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Data Analytics and Technology:
FUHN will use Optum technology and health analytics tools to provide
reports on claims data that will assist in monitoring cost,
utilization and quality trends for individual patients, as well as for
care providers and clinics. These reports will help drive improvement
activities across clinics and measure the impact of resulting process
changes.
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Performance Improvement Specialists:
At each of the 10 FQHCs, performance improvement specialists will work
with medical directors and clinic staffs to analyze site performance,
identify improvement strategies and monitor the implementation of new
techniques. These clinical specialists will support the FQHCs in
designing follow-up care processes that will reduce emergency
department and inpatient utilization by targeting care coordination
efforts on high-risk populations.
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Patient-Centered Medical Home
Certification: As part of the project, FUHN plans to
strengthen primary care for Medicaid beneficiaries through each
clinic’s attainment of Health Care Home certification, Minnesota’s
version of the patient-centered medical homes. This is a rigorous
process that requires effective team care delivery, participant
registries that identify gaps in care, pre-visit planning, care plans
to track a patient’s progress over time, patient experience surveys,
and ongoing partnerships with community resources. Four of the 10
participating FQHCs have already obtained MN Health Care Home
certification.
The 10 FUHN member organizations are: Axis Medical Center,
Community-University Health Care Center, Indian Health Board of
Minneapolis, Native American Community Clinic, Neighborhood
HealthSource, Open Cities Health Center, People’s Center Health
Services, Southside Community Health Services, United Family Medicine,
and West Side Community Health Services.
“Minnesota has long been a leader in population health and health care
issues, and the state’s contract with FUHN to improve outcomes and
reduce costs in its Medicaid program is another example of this
approach,” said Steve Larsen, executive vice president of Optum
Government Solutions. “We are grateful for the opportunity to work with
the state and FUHN to provide more cost-effective, high-quality health
services to the community.”
Note to Editors: Journalists wishing to obtain information from Optum
should contact Steve Puleo at 781-419-8553 or steve.puleo@optum.com
About Optum
Optum (www.optum.com)
is a leading information and technology-enabled health services business
dedicated to helping make the health system work better for everyone.
Optum comprises three companies – OptumHealth, OptumInsight and OptumRx
– representing more than 35,000 employees worldwide who collaborate to
deliver integrated, intelligent solutions that work to modernize the
health system and improve overall population health.
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