Minn. Stat. § 62U.04. Payment reform; health care costs; quality outcomes: Health Care Payment and Pricing Reform – Minnesota

Status: Enacted
Year Enacted: 2008
Year Amended: 2018
File: Download

Authorizes the state’s All Payer Claims Database (implemented in Minn. R. 4653.0100 through .0600). An APCD is a database for aggregating health care claims data from payer sources in order to compare costs among physicians and health care systems;
 1: Directs the Commissioner of Health to “develop a plan to create transparent prices, encourage greater provider innovation and collaboration across points on the health continuum in cost-effective, high-quality care delivery, reduce the administrative burden on providers and health plans associated with submitting and processing claims, and provide comparative information to consumers on variation in health care cost and quality across providers.”
 2 to 3d, Subd. 10: Directs the Commissioner of Health to develop a uniform method of calculating provider’s relative cost of care, adjusted for quality. The Commissioner must establish provider peer groups and disseminate information to providers on their total cost of care, total resource use, total quality of care, and the total care results of the groupings. Data that cannot be linked to the identity of an individual provider or hospital may be disseminated to the public. Data collection under the foregoing subdivisions has been suspended by the legislature indefinitely.
 4: All health plan companies must submit de-identified encounter data to the Commissioner of health.
 5: All health plan companies must submit data on their contracted prices with health care providers for the purpose of performing analyses. Such data is treated as nonpublic.
 7: The Commissioner must convene a workgroup to develop strategies for engaging consumers on understanding health care cost and quality.
 11: Respecting the state’s APCD, applies data collected by subdivisions 4 and 5 above for studies to evaluate the efficacy of home health care programs; hospital readmissions trends; variations in costs, quality, and utilization based on geography; and to evaluate the state innovation model testing.
 12: As of 2014, creates a workgroup within the Department of Health to develop a framework for the expanded use of the state’s APCD. A report with findings from the workgroup is expected to be issued to the legislature by Feb. 2015.


Return to Database Search

© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

Associated Litigation:

No items found