Minnesota

ORIGIN AND MISSION
In November 2008, five Minnesota organizations signed an accord to form an alliance called The Minnesota Health Care Value Exchange. The alliance was established to support HIT; quality improvement and measurement; price transparency and public reporting; incentives to promote high-quality, efficient care; and consumer engagement and education. The five partner organizations comprising the Minnesota Health Care Value Exchange are:

•    Buyers Health Care Action Group (BHCAG), a non-profit coalition of large private and public employers working to redirect the focus of the health care system to optimal health and value;
•    Institute for Clinical Systems Improvement (ICSI), a non-profit organization that brings together medical groups, hospitals, health plans, employers, and other groups to provide patient-centered and value-driven care to patients in Minnesota and surrounding states;
•    MN Community Measurement (MNCM), a community-based, non-profit organization that works to accelerate the improvement of health through measurement and public reporting of health care performance;
•    Smart Buy Alliance, an affiliation of private, public, group, union, and individual health care purchasers working to ensure that health care reforms focus on improving health and health care delivery for all Minnesotans. It includes Minnesota Management & Budget (state employees) and Human Services (Medicaid, SCHIP, and MinnesotaCare); and
•    Stratis Health, a non-profit organization that leads collaboration and innovation in health care quality and safety, serves as a trusted expert in facilitating improvement for people and communities, and is the state’s Quality Improvement Organization (QIO).

GOVERNANCE
Although each of the five member organizations has its own separate governance structure, the Minnesota Health Care Value Exchange has a board with one representative from each organization. The Minnesota Health Care Value Exchange elects members to fulfill specific responsibilities, including convener of meetings and logistics (Buyers Health Care Action Group), AHRQ contactor (Smart Buy), finance representative (to be determined), and Medicare data steward (Stratis).

ACTIVITIES AND ACCOMPLISHMENTS
The Minnesota Health Care Value Exchange is working to coordinate health reform activities and build upon the quality improvement, performance measurement, and public reporting activities already occurring in the community. Priority areas include care model redesign, purchasing redesign, payment reform, consumer engagement initiatives, and electronic medical record and personal health record implementation. The Minnesota Health Care Value Exchange received Chartered Value Exchange designation from Department of Health and Human Services Secretary Mike Leavitt in March 2008.

The alliance’s activities directly relate to state health care reform legislation signed into law in May 2008 (Senate File 3780, Senate File 2942, House File 3149, and House File 1812). The goal is to move toward achieving quality, affordable, accessible health care for all Minnesotans. The legislation includes “health care home” criteria; e-prescribing; the use of encounter data to establish peer groupings of providers based on quality and efficiency; as well as payment reform, quality measurement, and cost/quality transparency. Minnesota Health Care Value Exchange is the coordinating body for members’ work on state health reform legislation, including:

•    The Minnesota Quality Reporting and Incentive Payment System,
•    Health care home support and development,
•    Bundles of care measurement and payment, and
•    Provider peer grouping by cost and quality.

The value exchange also is developing funding and other support for care re-design projects (e.g. Depression Care Improvement).

Member organizations have partnered in the past for Quality Care and Rewarding Excellence (QCare), an initiative created by the governor’s executive order in 2006. QCare aims to gather, analyze, and distribute data on health and health care in Minnesota to guide health care reform in the state. QCare identified certain focus areas (diabetic care, public health, hospital “never events”) in which to improve care, in addition to consensus goals for the state to achieve by certain dates. The QCare group included physicians, hospital leaders, members of the legislature, and businesses, as well as state agencies.