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Health Care Quality Measures

Minnesota’s 2008 Health Reform Law requires the Commissioner of Health to establish a standardized set of quality measures for health care providers across the state. The goal is to create a uniform approach to quality measurement in order to enhance market transparency. The Minnesota Department of Health seeks to build on community standards and input in developing the measures.

After January 1, 2010, health plans may not require providers to submit data on any measure outside this standardized set. Physician clinics and hospitals must begin to submit data on those measures to be publicly reported starting January 1, 2010.

The quality measures must be based on medical evidence, must be developed through a process in which health care providers participate, and must be reviewed on at least an annual basis. In addition, the measures must:

  • Include uniform definitions, measures, and forms for submission of data, to the extent possible;
  • Seek to avoid increasing the administrative burden on health care providers;
  • Be initially based on existing quality indicators for physician and hospital services, which are measured and reported publicly by quality measurement organizations including, but not limited to, Minnesota Community Measurement and specialty societies;
  • Place a priority on measures of health care outcomes rather than processes where possible; and
  • Incorporate measures for primary care, including preventive services, coronary artery and heart disease, diabetes, asthma, depression, and other measures as determined by the Commissioner.

Quality Reports

Using these measures, the Commissioner of Health is also charged with establishing a system for risk-adjusting quality measures and publishing annual reports on provider quality.

The 2010 Minnesota Health Care Quality Report is now available.

Adopted Rules and Appendices Available

The Commissioner of Health is required to annually evaluate the measures included in the standardized set of quality measures. These rules were adopted in December 2009 and amended in November 2010, 2011, 2012 and 2013. The 2013 amendments to Minnesota Rules, Chapter 4654, Permanent Rules Relating to Health Care Quality Measures, were approved by the Office of Administrative Hearings on October 25, 2013, and published in the December 9, 2013, edition of the State Register. The adopted rule, technical appendices and additional information are available at Health Care Quality Measures – Adopted Rule.

Risk Adjustment of Physician Clinic Quality Measures

In May 2008, Minnesota enacted a sweeping bipartisan health reform law.  Part of this comprehensive health care reform package included Minnesota Statutes 62U.02, which directs the Commissioner of Health to develop a standardized set of quality measures and a system for collecting and publicly reporting data on a subset of the standardized measures.  The law also requires the Commissioner of Health to establish a methodology for risk adjusting the results of those quality measures to be publicly reported and create a quality incentive payment system that, to the extent possible, adjusts for variations in patient population.

The Proposed Risk Adjustment Methodology for Physician Clinic Quality Measures (PDF: 116KB/7 pages) is now available. 

 

 

Updated Wednesday, 04-Dec-2013 10:59:05 CST