Legislative Commission on Health Care Access Work Group Meetings

August 20, 2007

The Legislative Commission on Health Care Access and a number of its workgroups also met this week at the Capitol. All of the work groups are still in the information gathering state, and to that tone, heard a number of presentations from various groups on cost savings initiatives.

Carolyn Pare with the Buyers Health Care Action Group testified before the Cost Containment Work Group focused on restructuring the health care system through savings identified by its sister work groups, giving a presentation on assumptions on cost savings in the private sector due to pay for performance. David Godfrey, fiscal analyst with the Minnesota Senate, provided the work group with a presentation comparing enrollee premiums for state subsidized insurance programs in other states.

Dr. Jeff Schiff, medical director with the Minnesota Department of Health,gave a presentation on the elimination of unnecessary services. During Schiff's presentation, Rep. Jim Abeler (R-48B) asked about the implementation of a law passed in 2005 requiring providers to seek prior authorization from a payer for any imaging procedure for public program enrollees. Schiff conceded that the Department did not implement the law in part because some private plans had just rolled out their programs requiring preauthorization for imaging procedures.

Abeler promptly responded, saying, "When the legislature passes a bill, it is generally not a suggestion. We expect the [Department of Health] to act."

The Cost Containment Work Group focused on Identifying Health Care Costs and Savings received a presentation from Doctors George Schoephoerster and Douglas Wood on a "medical home" approach to caring for patients. The physicians' presentation closed with recommending that legislators look at ways to attract and retain providers in under served areas and consider regulatory or legislative changes increasing reimbursement for preventative services.

The Cost Containment Work Group focused on identifying new cost savings mechanisms heard presentations on a number of legislative proposals introduced in the 2007 legislative session. Work Group members also discussed the need to continue moving toward integrating mental health services into the services a patient is receiving when applicable.

The Public Health Work Group met to continue its discussions on seeing what role the legislature can play in addressing the current obesity epidemic in Minnesota. Work group members heard presentations on current actions the Governor and the Minnesota Department of Health are already taking as well as an overview on some of the federal programs that are currently underway. Rep. Mary Ellen Otremba (DFL-11A), who chairs the Agriculture, Rural Economies and Veteran Affairs Committee, noted that all policy items regulating the food industry fall under the jurisdiction of her committee, and it might be appropriate for work group members to hear a presentation from the Department of Agriculture.

Work Group chair Rep. Steve Gottwalt (R-15A) questioned whether parents are doing their part on preventing the obesity epidemic especially in light of multiple actions schools have taken, and expressed an interest in knowing what could be done to help educate parents. Otremba noted that some low income families don't even know how to prepare healthy meals, and there might be a need to educate parents.

Rep. Kim Norton (DFL-29B) expressed concern that the work group was going to focus exclusively on child obesity while the entire public health system might be in need for review and potential reform as well. However, most other work group members expressed support for sticking with obesity. As deliberations continue, it will be interesting to observe whether the purview of the work group evolves.

The Insurance Reform work group also met for the first time, during which group members received overviews on the insurance market in Minnesota from Tom Pender with the House Research Office and Deputy Commissioner of the Commerce Department Patrick Nelson. Pender's overview focused on the types of insurance available in Minnesota and detailed the percentages of people on public versus private programs.

Nelson's presentation focused on the regulatory aspect of insurance, explaining the jurisdictions between the health and commerce departments with respect to who is responsible for regulating which aspects of the health insurance industry. It is unclear when the work group will meet again as workgroup co-chair Rep. Diane Loeffler (DFL-59A) will be serving on jury duty for a portion of the month.

"Portions of the information contained herein was provided by the Minnesota House of Representatives and Senate websites, found at http://www.house.leg.state.mn.us/ http://www.senate.leg.state.mn.us/, for additional materials on the topicsdiscussed above please consult these sources."