12 Minn. Communities Receive $4M in Accountable Health Awards

Twelve Minnesota Accountable Communities for Health (ACH) are poised to demonstrate how healthcare and community organizations can work together to create profound change in population health. Minnesota's Commissioner of Health and Commissioner of Human Services selected these Accountable Communities for Health to each receive a $370,000 grant, out of a total grant amount of $4.4 million.

Minnesota is testing the ACH model as part of its $45 million State Innovation Model grant from the federal government. Researchers estimate that healthcare accounts for only about 20 percent of a population's health, while modifiable community, social and economic factors contribute 80 percent. Keeping a person healthy, especially a person with complex chronic conditions, often requires a dedicated team of clinical and community providers. The awards will support these ACHs' efforts to promote health and improve healthcare by strengthening clinical and community partnerships.

"By integrating different kinds of care, the Accountable Communities for Health model holds significant promise," said Lucinda Jesson, commissioner of the Minnesota Department of Human Services. "A broad range of community partners—primary care, behavioral health, social services, long-term care and public health—work together to improve the quality and effectiveness of care for those who need it. This can transform how we are delivering care in Minnesota."

To test the model, the commissioners selected communities with different experiences providing accountable care. Key components of accountable care include value-based payment arrangements, community and provider collaboration, care coordination, population health measurement, management and evaluation and integration across provider settings.

"It is exciting to see public health, communities, health and human service providers and so many others step forward to form these partnerships in an effort to improve the health of Minnesotans," said Minnesota Commissioner of Health Dr. Ed Ehlinger.

The participating ACH sites represent population and geographic diversity:

• UCare/Federally Qualified Health Center Urban Health Network (FUHN), Minneapolis.
• Vail Place/North Memorial, Hopkins.
• Hennepin County/Hennepin Health, Minneapolis.
• Generations Health Care Initiatives, Duluth.
• New Ulm Medical Center, New Ulm.
• Otter Tail County Public Health, Fergus Falls.
• Allina Health Systems/Northwest Metro Alliance, Minneapolis.
• CentraCare Health Foundation, St. Cloud.
• Southern Prairie Community Care, Marshall.
• Lutheran Social Service of Minnesota/Bluestone Physician Services, St. Paul.
• Unity Family Health Care, Little Falls.
• North Country Community Health Services, Bagley.

Shelly Zuzek, Clinical Services Director at Vail Place, a leader in mental health services, says their model for this partnership is rooted in team-based care and involves the collaboration of a diverse set of professionals who will work to engage patients in multiple ways. "Part of our funding will cover costs associated with a community paramedic who will work directly with our care team to support patients in their homes and in community-based settings," Zuzek said. "This is an example of the potential we have to impact people as they transition across the health care system and into the community. We look forward to seeing how this collaboration improves the overall health of the populations we are targeting."

Otter Tail County Public Health has been working with partners in their community to develop a "Rural Health Model that Works." This model of care embeds public health practices of prevention, promotion and protection working in partnership with consumers, health care providers, and community organizations. County Public Health Director and CHS Administrator Diane Thorson, said they have used community conversations to learn what is important to their communities. "Our community values choice rather than mandates. Choices allow for engagement and empowerment of individuals to select treatment plans based upon evidence-based practices, community resources, and personal lifestyle," Thorson said. "We will hold our community and provider systems accountable for improving health outcomes."

The Center for Medicare and Medicaid Innovation (CMMI) awarded Minnesota a State Innovation Model (SIM) testing grant of over $45 million to use across a three-year period ending in December 2016. As a joint effort between the Minnesota Department of Health and the Minnesota Department of Human Services with support from Governor Mark Dayton's office, Minnesota is using the grant money to test new ways of delivering and paying for health care using the Minnesota Accountable Health Model framework. The goal of this model is to improve health in communities, provide better care and lower healthcare costs.