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Minn. Gov: Give Access to PHRs, HRAs
August 6, 2008
Minnesota Governor Tim Pawlenty (R) has proposed offering a free personal health record to every resident of the state by 2011. Initially, his administration intends to offer a PHR to each of the state’s 50,000 employees in 2009.
The PHR initiative is part of a health reform plan that includes giving small health reimbursement accounts to state employees. The effort has been championed by Pawlenty, who is on Sen. John McCain’s short list of vice presidential candidates.
Under the plan, PHRs would be used on back-end platforms such as Google Health and Microsoft HealthVault that will support providers, with patient consent, populating the PHRs with patient data. “The state and other employer groups will contract with vendors to build the front-end systems used to access and control the data from the back-end platforms,” explains a spokesperson for Pawlenty. “Carson Companies recently launched a pilot program here in Minnesota for their 6,000 employee families using Microsoft’s HealthVault platform with a front-end system developed by a company called Avenet.”
Still, consumers won’t be able to get their records electronically from providers unless the providers use electronic health records systems. The state is encouraging EHR use by mandating all prescriptions be electronically ordered by 2011. Giving consumers access to PHRs should further accelerate the demand for EHRs, according to the spokesperson.
Along with the PHR, state employees would receive a debit-card supported health reimbursement account of up to $250 each to assist in paying out-of-pocket expenses. The HRAs, paid by excess reserves in the state’s self-insurance fund, would be available to employees that seek medical care at facilities that demonstrate efficiency.
All provider groups that are part of the state’s self-insured program are measured for quality and cost factors. Eighty-four percent of state employees presently use providers that have demonstrated higher efficiency. “The intent of the HRA is to motivate additional plan members who have not been motivated to date by the current out-of-pocket differentials,” says the Pawlenty spokesperson.
Further, only 30% of state employees presently have a flexible spending account for health care. The hope is that employees who like the features of the HRA will enroll in a FSA in future years. The FSA also is supported with a debit card. Those with an FSA and HRA would receive one card with expenses taken first from the “use it or lose it” FSA, then from the HRA, which permits users to roll over remaining funds each year.
Also as part of Pawlenty’s plan, eight private health insurers covering 98% of the private market in the state will publish price and quality data on a state Web site. The goal is to encourage consumers to become better purchasers of care.
The state’s Medicaid program will not publish its data on the site because its payment rates are about one-third of private rates, which would skew the data.
The Minnesota Department of Finance and Employee Relations soon will seek proposals for a secure and portable Web-based PHR with features that include:
* electronic access to test results,
* access to patients’ own medical records electronically,
* instant access to immunization records, and
* prescription history and automated detection of interactions.
More information will be available at doer.state.mn.us.
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