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Ten Federally Qualified Health Centers Collaborate with State to Improve Health Outcomes, Reduce Costs in Minnesota Medicaid Program

UNH
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:

  • 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.
  • 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.
  • 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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