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S.F. No. 501 - Quality Measures and Payment Method Adjustments to Recognize Health Disparities (First Engrossment)
 
Author: Senator Melissa H. Wiklund
 
Prepared By: Katie Cavanor, Senate Counsel (651/296-3801)
 
Date: April 7, 2015



 

SF 501 requires quality measures and quality incentive payments risk adjustment systems developed by the Commissioner of Health to take into account socio-demographic factors such as race, ethnicity, preferred language, county of origin, and patient characteristics that are correlated with health disparities.  Requires the Commissioner of Human Services to develop a health disparities payment enhancement to pay a higher rate to providers, and for services that takes into account patients and populations who experience greater health disparities.

Section 1 (62U.02, subd. 1) requires that the standardized set of quality measures that the Commissioner of Health is required to develop to assess the quality of health care services offered by health care providers that are to be used for the quality incentive payment system be stratified by race, ethnicity, preferred language, and country of origin effective July 1, 2016. Permits the commissioner to require that other socio-demographics that are correlated with health disparities and have an impact on performance, quality, and cost indicators be considered after voluntary pilot projects are completed.  Requires the commissioner to consult with the communities impacted by health disparities through culturally appropriate community engagement principles and methods.  Specifies that the commissioner does not have the authority to collect or analyze patient-level or patient-specific data of the patient's characteristics.

Section 2 (62U.02, subd. 2) requires that the quality incentive payment system developed by the commissioner under this section adjust for variations in patient population to reduce incentives for providers to avoid patients with risk factors related to race, ethnicity, language, country of origin, and socio-demographic factors.

Section 3 (62U.02, subd. 3) requires that the risk adjustment system that the commissioner is developing under this section take into account patient characteristics that are correlated with health disparities and have an impact on performance, cost, and quality measures. Permits the risk adjustment method to be based on reporting based on an actual to expected comparison that reflects the characteristics of the patient population served by the clinic or hospital.

Section 4 (62U.02, subd. 4) specifies that if the commissioner contracts with a private entity to complete the requirements of this section that the entity has a governance that includes representatives of providers serving high concentration of patients and communities impacted by health disparities, and consumers who represent groups who experience health disparities.

Section 5  (256B.072) requires that the measures used in the performance reporting system established by the Commissioner of Human Services for health care providers who provide services to public program recipients must be stratified by race, ethnicity, preferred language, and country of origin and risk-adjusted as specified in section 62U.02, subdivision 3, paragraph (b).

Section 6 requires the Commissioner of Human Services to develop a methodology to pay a higher payment rate for providers and services that takes into account the higher cost, complexity, and resources needed to serve patients and populations who experience the greatest health disparities.  The commissioner must submit a report to the legislature by December 15, 2015, that includes recommendations and a proposed methodology for providing a health disparities payment adjustment.

Section 7 appropriates money to the Commissioners of Health and Human Services.

 
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