Medicaid Reform 2020: Pathways to Independence

Creating a simpler, more sustainable Medical Assistance system is the goal of a proposed redesign. Now Minnesotans affected are being […]

Creating a simpler, more sustainable Medical Assistance system is the goal of a proposed redesign. Now Minnesotans affected are being asked to weigh in. The Department of Human Services’ plan to reform significant portions of Medical Assistance or MA, Minnesota’s Medicaid program, is in the midst of a 30-day comment period. The period ends July 17 and Minnesotans who would be affected by the proposed reform plan are urged to contribute their thoughts.

The plan and comment links are available at http://mn.gov/dhs/about-dhs/public-participation.jsp  DHS regularly invites client, stakeholder and citizen involvement in its initiatives and proposed program changes.

The plan encompasses three broad reform efforts. First, it broadens supports to serve people in their homes and communities, increasing independence and avoiding reliance on more intensive, expensive services. Second, it engages consumers in their care by providing more choice and opportunities for self-direction. Third, it furthers DHS’s health reform agenda through integration of primary and behavioral health and direct contracting with providers for better health outcomes.

The plan is a result of bipartisan legislation and part of the 2011 budget agreement. It is designed to be budget neutral in the short term and to produce savings in the long term.

“This plan will give people more choice, get them services earlier and in less costly settings and help secure the stability of our programs for years to come,” said Commissioner Lucinda Jesson. “We thank the many stakeholders included in the development and will need their continued involvement in finalizing the plan for submission.”

A major portion of the plan seeks to revamp Minnesota’s home and community-based services for seniors and people with disabilities. Currently, many participants with complex conditions are on a waiting list or are not eligible for certain services. Making more flexible community supports accessible to a broader group of people are a key part of this reform package. Individual assessments will result in personal budgets that fit the individual person, rather than a set list of predetermined services. Enrollees will then be able to participate in directing those budgeted dollars, enabling more choice of services and caregivers. Other services in the proposal include employment supports and housing assistance to keep people connected to work and community.

“Minnesota is justifiably proud of our No. 1 national ranking for quality, access and affordability in our current home and community-based Medicaid services,” said Jesson. “But given the demographics of our state, we need to begin the next wave of change to be ready for 2020.”

Many of the proposals in the plan require new federal approval, including a provision that would allow the state to contract directly with providers to care for people on publicly-funded health care programs. DHS is providing opportunities for public comment on the plan before mid-July, with the request for approval for certain policies from the federal Centers for Medicare and Medicaid Services (CMS) to be officially submitted July 31. It is expected that negotiations with CMS on the terms and conditions of this request would be completed in December and be reflected in Gov. Mark Dayton’s 2013 budget proposal to the Legislature.

A copy of the reform proposal and information on submitting comments is available on the DHS website.

In addition, two public hearings were held to provide stakeholders and other interested parties the opportunity to comment on the waiver request.