Goodhue County Health and Human Services DATE: August 5, 2015 TO: FROM: Goodhue County Board Nina Arneson, Goodhue County Health and Human Services Director RE: Approve Resolution to object to Minnesota Department of Human Services (DHS) selection of participating health plans for Goodhue County and to seek mediation BACKGROUND: The Department of Human Services (DHS) has conducted a statewide (87 counties) health care services procurement in 2015. This included publishing a Request for Proposals (RFP) to provide health care services to recipients of Medical Assistance and MinnesotaCare in Goodhue County beginning January 1, 2016. Goodhue County Health and Human Services Department reviewed proposals and recommended South Country Health Alliance (SCHA) for Goodhue County as the Managed Care Organization. In addition to the department s recommendation, on June 2, 2015, the Goodhue County Board also recommended South Country Health Alliance (SCHA) to provide managed care services in Goodhue County beginning January 1, 2016. On July 28, 2015 Goodhue County Health and Human Services was informed by Nathan Moracco, DHS Assistant Commissioner that the State has selected two different health plans to enter into contract negotiations to provide health care services to recipients of Medical Assistance and MinnesotaCare in Goodhue County beginning January 1, 2016. RECOMMENDATION: Approval and signature of the attached Board Resolution for Goodhue County to object the State s selection of participating health plans for Goodhue County and to request for mediation.
GOODHUE COUNTY Resolution RESOLUTION APPROVING AND AUTHORIZING TO OBJECT TO MINNESOTA DEPARTMENT OF HUMAN SERVICES SELECTION OF PARTICIPATING HEALTH PLANS FOR GOODHUE COUNTY AND TO SEEK MEDIATION WHEREAS, the Minnesota Department of Human Services published a Request For Proposals to provide health care services to recipients of Medical Assistance and MinnesotaCare in 87 Minnesota counties including Goodhue County; and WHEREAS, the Minnesota Department of Human Services requested that counties evaluate and make a recommendation regarding these proposals; and WHEREAS, after evaluation of these proposals the Goodhue County Board recommended the approval of South County Health Alliance to provide health care services in Goodhue County as their proposal both met the needs of our citizens and their organization has a demonstrated history of being a valuable, responsive partner in providing affordable and effective health care services in our community; and WHEREAS, the Minnesota Department of Human Services disregarded Goodhue County Board s recommendation and chose alternate plans for Goodhue County; NOW, THEREFORE, BE IT RESOLVED by the Goodhue County Board of Commissioners that, it hereby objects to Minnesota Department of Human Services selection of participating health plans for Goodhue County and, specifically, the Department s decision to reject South County Health Alliance s proposal to provide healthcare through the Prepaid Medical Assistance and MinnesotaCare programs. Goodhue County hereby authorizes the submission of a request for mediation with the Department pursuant to Minn. Stat. 256B, both on behalf of Goodhue County individually and through South Country Health Alliance. Dated this August 13, 2015 SIGNATURE: Ted Seifert, Goodhue County Board Chair
2300 Park Drive, Suite 100, Owatonna, MN 55060 Reprocurement Impact on GOODHUE COUNTY As a result of the 2016 Families and Children reprocurement, South Country Health Alliance (SCHA) has received notification that we will be offered the ability to contract with the state for only one of our 11 service area counties. Below are the impacts to your county resulting from the potential loss of SCHA s Medical Assistance (MA) and MinnesotaCare business, effective January 1, 2016. There will be no change to SCHA s services or coverage through the end of 2015. Affected members will be contacted directly by SCHA and the state. SCHA continues to rate high in member satisfaction and maintain excellent quality in services: Rated a 4-star health plan. Rated #1 among Minnesota health plans in Overall Customer Service for MA and in Getting Needed Care, Getting Care Quickly and Shared Decision Making for MinnesotaCare. Rated #2 among Minnesota health plans in Rating of Personal Doctor, How Well Doctors Communicate and Overall Customer Service for MinnesotaCare. Rated above state average among Minnesota health plans in Rating of All Health Care, Rating of Personal Doctor and Shared Decision Making for MA. Impact on Members Disruption of care for more than 31,000 SCHA members enrolled in MA and MinnesotaCare. Affects 4,403 Goodhue County members Loss of the local connection with SCHA and the coordination of care between SCHA, local providers, public health, social services and other community resources. Loss of programming and initiatives unique to SCHA that improve and increase access to dental, mental health and child welfare services. Examples include: SCHA s Community Reinvestment Grant program, which put nearly $3 million back into our communities in 2014 Extra preventive dental visits Healthy Pathways, a mental health prevention and early intervention service Impact on Providers Upsets 14 years of relationship building with local providers. Providers acknowledge that SCHA sets itself apart from other health plans in our responsiveness, our clear understanding of the need to support rural health care delivery and our process of recognizing and rewarding the quality and outcomes delivered to our members. Loss of value-based contracting opportunities of over $3 million including SCHA s Pay for Performance program in 2014, which rewards providers for quality care delivery to our members. South Country is a leader in moving toward value-based care. Unlike the fee-for-service system that drives providers to do more to increase income, value-based reimbursement rewards providers for quality of care over quantity of care care with enduring results at a reasonable Last Updated: 8/6/2015 1
cost, improving the value of care that is in best interest of our members, the providers and our health plan. Providers participating in P4P contracts: New Ulm Medical Center Tri-County Health Care Unity Family Health Care Mayo Clinic Health System Lakewood Health System Benedictine Living Community of Mora First Light Health System Loss of SCHA reimbursement in our 11 counties at 200% of the standard Medicaid payment to improve member access to local dental providers. Threatens future initiatives. Current initiatives active in Goodhue County: Goodhue County Health and Human Services Parent Support Outreach Program Case Manager ($274,920 grant) SEMAAA Evidence-based Health Promotion programs ($41,000 grant) Threatens the development of Diamond View, a health information exchange spearheaded by SCHA and leading the state in innovation. Diamond View achieves health data interoperability between providers, county partners and health plans, facilitating secure and instant sharing of members medical information that can improve patient care and health outcomes. Other Impacts Loss of influence in the development and delivery of Medicaid services: Members through the Member Advisory Committee County and provider partners through close collaboration and committees Other county citizens through the Joint Powers Board Loss of $43,582 in SCHA funding for Goodhue County s Community Care Connector position. Unique to SCHA, the Connector is employed by the county and acts as a local SCHA expert for both members and county workers, helping to improve the efficiency and quality of service for members. Loss of member incentives for preventive care and safety programs in Goodhue County (figures from 2014) that may in turn be spent in the community: $22,525 for preventive care incentives $3,130 in free car seats and training to use them $2,717 to local independent health clubs for fitness program discounts $4,236 to local school districts for Community Education & ECFE classes Loss of enhanced payment for county family home visiting services. If SCHA cannot sustain the loss of 85% of our membership, other functions will be threatened: Non-renewal of the Medicare Advantage contracts for SeniorCare Complete (MSHO) and AbilityCare (SNBC) Ends SCHA Care Coordination contracts, totaling $212,151 to Goodhue County ($1,544,194 for all SCHA counties): Senior members: 2,375 total across all counties enrolled SNBC members: 2,335 total across all counties enrolled Because SCHA is county-owned, profits generated from health plan efficiency and health care savings go toward either the equity of the county owners (taxpayers) or are reinvested into the communities through initiatives and grants that address needed services. This will be lost if SCHA closes. The dissolution of the health plan itself, displacing nearly 100 employees with annual payroll and benefits of over $8 million Last Updated: 8/6/2015 2
BOARD OF COUNTY COMMISSIONERS GOODHUE COUNTY, MINNESOTA June 2, 2015 Moved by C/Anderson, seconded by C/Majerus, and carried to approve the following resolution on the consent agenda: WHEREAS, the Minnesota Department of Human Services has published a Request For Proposals to provide health care services to recipients of Medical Assistance and MinnesotaCare in 87 Minnesota counties including Goodhue County; and WHEREAS, the Minnesota Department of Human Services has requested County evaluations and recommendations regarding the RFP proposals from each respective county; and WHEREAS, Blue Plus, Medica, UCare and South Country Health Alliance (SCHA) submitted proposals to provide managed health care services in Goodhue County; and WHEREAS, representatives of Goodhue County Health and Human Services have reviewed and evaluated the proposals; and WHEREAS, South Country Health Alliance (SCHA) have submitted proposals suitable to meet our needs. THEREFORE, BE IT RESOLVED that the Goodhue County Board of Commissioners supports the recommendation of Goodhue County Health and Human Services approving South Country Health Alliance (SCHA) as Managed Care Organization (MCO) providing managed health care services in Goodhue County. State of Minnesota County of Goodhue Majerus Allen Seifert Rechtzigel Anderson Yes I, Scott O. Arneson, duly appointed, County Administrator of the County of Goodhue, State of Minnesota, do hereby certify that I have compared the foregoing copy of a resolution with the original minutes of the proceedings of the Board of County Commissioners, Goodhue County, Minnesota at their session held on the 2 nd day of June, 2015, now on file in my office, and have found the same to be a true and correct copy thereof. Witness my hand and official seal at Red Wing, Minnesota, this 2 nd day of June, 2015. Scott O. Arneson County Administrator