WILLMAR - Kandiyohi County took formal action Tuesday to enter into county-based purchasing and join the PrimeWest Health consortium to manage publicly funded health programs for the Medicaid and MinnesotaCare population.
It's a significant step, in essence allowing the county to go into the health plan business through PrimeWest, contract with providers and assume the risk for eligible low-income residents receiving health care services.
It also has the potential to be far-reaching. Of Kandiyohi County's 44,000 residents, about one in four are covered by Medicaid or MinnesotaCare, collectively making these the largest payers in the county for health care services.
Medicaid, also called Medical Assistance in Minnesota, is the federal-state health insurance program for the poor and disabled. MinnesotaCare is a health insurance plan for people who cannot afford private insurance but make too much to qualify for other subsidized programs.
The County Board of Commissioners already voted in July to join PrimeWest Health. Tuesday's resolution formalizes the county's intent to move forward.
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"This is another stage in that process," said Ann Stehn, director of Kandiyohi County Health and Human Services.
The county's decision comes just before the start of a new procurement process by the Minnesota Department of Human Services to seek proposals and award health plan contracts for managing Medicaid and MinnesotaCare services.
"We are quite hopeful this will be able to come to fruition by Jan. 1, 2020," Stehn said.
Joining PrimeWest Health and entering the world of county-based purchasing of health care services for certain residents will give Kandiyohi County new opportunities to improve health outcomes and increase the cost-effectiveness of publicly funded health care spending, county officials said Tuesday.
"I'm very excited about Kandiyohi County going into PrimeWest and looking forward to it," said Commissioner Jim Butterfield.
The county considered county-based purchasing on and off for the past several years. Most recently it was part of an integrated health plan known as Southern Prairie Community Care, a group of 12 counties that sought collaboratively to improve care, promote chronic disease management and lower costs for the eligible low-income population.
The group was successful in bettering health outcomes and reinvesting the savings locally, but a changing marketplace and concerns about long-term fiscal sustainability prompted a decision earlier this year to join forces with PrimeWest and give the member counties - Chippewa, Cottonwood, Jackson, Kandiyohi, Lincoln, Lyon, Murray, Nobles, Redwood, Rock, Swift and Yellow Medicine - the option of coming along.
All the counties except Nobles have chosen to join PrimeWest, Stehn said. Lac qui Parle County, which was not part of Southern Prairie Community Care, also is opting into PrimeWest, she said.
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With 12 new counties added to the consortium, PrimeWest Health will nearly double in size, from 13 counties to 25. It also will swell the number of Minnesota counties involved in county-based purchasing to nearly one-third of the state, Butterfield noted.
"It gives us a better voice at the Capitol," he said.
The resolution adopted Tuesday by the Kandiyohi County Board includes a $3.6 million contribution to the risk-based capital reserve of PrimeWest Health. Half of the money must be paid upon execution of the joint powers agreement with PrimeWest. The county will have until May 1, 2020, to pay the rest.
