Community Paramedics Part of Big Medicaid Savings in Minnesota
As community paramedic programs have proliferated, one of the biggest questions has concerned whether they’ll actually save money. Data from Minnesota may represent some of the confirmation many have hoped for.
In a release this week, the state announced its Integrated Health Partnerships (IHP) initiative, launched in 2013, had led to six Medicaid providers who cumulatively serve 100,000 Minnesotans spending $10.5 million less than projected. The initiative includes North Memorial’s pioneering CP program.
“Some people talk about reform. We do it,” Gov. Mark Dayton said in the release. “Minnesota is the first state in the nation to implement these cost-saving reforms—and we have proven that this new approach delivers results. I thank the health providers who have partnered with us.”
North Memorial uses community paramedics to visit high-risk patients at home and help coordinate their care to prevent trips to the hospital.
The IHP initiative is built around a payment model that prioritizes preventive care and rewards providers for achieving defined health goals. Generally it rewards quality of care rather than volume; participating providers get financial incentives for reducing total care costs for Medicaid enrollees while maintaining or improving quality. Those who meet a threshold for savings are eligible to receive a share—but also, starting next year, share the risk if costs overrun.
Based on early calculations, North Memorial is in line for some of those funds, as are two other providers, Children’s Hospitals and Clinics of Minnesota and the Northwest Metro Alliance (Allina Health and HealthPartners).
“Delivering healthcare at a lower cost is critical, and our efforts are paying off,” said Human Services Commissioner Lucinda Jesson. “Because of the commonsense approaches these providers are taking, the people we serve in the Medical Assistance [Medicaid] program are getting better, more coordinated care.”
The Northwest Metro Alliance has opened urgent-care sites with evening and weekend hours, has pharmacists follow up with patients who haven’t picked up their medications, fights obesity among children, and has case management services for hundreds of patients with complex conditions. At Children’s Hospitals and Clinics, families with children with complex, high-risk needs are matched with a care coordinator to help shepherd their medical care.
Minnesota was the first state to implement a Medicaid payment and delivery demonstration that shares savings and risk directly with provider organizations. Similar programs have started or will in Vermont, New Jersey and Maine.
Three more providers joined Minnesota’s IHP in 2014, bringing the total number of enrollees covered in the demonstration to 145,000. More providers are expected to join in 2015. The IHP is a key component of a $45 million federal State Innovation Model (SIM) grant Minnesota received for healthcare reforms.