MINNEAPOLIS, January 17, 2008 - The MMA has sent a letter to Governor Tim Pawlenty’s Health Care Transformation Task Force identifying some issues of concern related to some of their draft proposals that would significantly change health care payment. 

Since the recommendations are still in a draft form, and some of the recommendations are not fully explained, it is not entirely clear what the Health Care Transformation Task Force will actually put forward when it releases its final report in late January.  The five major themes of recommendations that are being developed are as follows:

• improving public health,
• improving the quality, cost, and patient-centeredness of the health care system,
• restructuring the payment system, 
• reducing the overall size and cost of the health care system, and
• health insurance access and affordability.

Upon initial review, many of the draft recommendations emerging from the task force seem consistent with the MMA’s own proposals as outlined in the Physicians’ Plan for a Healthy Minnesota, including promotion of a medical home, individual mandate for coverage and the associated insurance reforms, public health investment, and greater cost and quality transparency.  There are, however, some recommendations that the MMA believes merit far more explanation and development.

In particular, the MMA has identified a key recommendation included in the “restructuring the payment system” section of the report that seeks to “establish provider accountability for the total cost and quality of care.”

In its letter to the task force, the MMA noted that it is unreasonable to imply that “providers” can, or should, be held solely responsible for total costs and quality. In addition, the recommendation, suggests creating a capitated payment model – a model that previously failed locally and across the country.

“We’re not jumping to any conclusions yet,” said Michael Ainslie, M.D., chair of the MMA Board of Trustees who signed the letter. “But we’re concerned about some of the language in the report, so we sent a letter to the task force to let them know that their recommendations require greater explanation.”

The MMA is also concerned that the draft proposal, if implemented, would have the effect of increasing provider consolidation, since the plan calls for provider groups to put forward bids for providing care for groups of patients, which is an activity only large groups would likely be able to do.  

“The draft proposal has many good ideas, but the MMA wants to make sure we don’t make the mistakes of the past and try to pound a square, capitated peg, into a round health care hole,” Ainslie said.