What are the best practices for providing care for a specific condition? This question is not easy to answer. Further, the best practices for treating the average patient may differ from the best practice for treating certain other types of patients; particularly when a patient suffers from multiple conditions simultaneously.
Despite these challenges, this information can be used not only for quality monitoring but also to alter payment systems. Specially, once the care relevant for the treatment of a specific condition is identified, payers can use this information to for the purposes of bundled payment. In fact, the Minnesota Department of Health (MDH) has developed “Baskets of Care” to accomplish just this goal. The MPH website states that:
Baskets of care are collections of health care services designed to treat particular health conditions or episodes of care. Offering these bundled services is a major reform in the way we pay for health care…Minnesota health care providers now have the option to voluntarily use baskets of care to deliver services. State law requires providers offering a state-designated basket of care to register with the commissioner of health.
MPH has developed 7 different baskets of care. These include:
- Asthma (children) – Management of asthma as a chronic disease
- Diabetes– Without co-morbidities, does include hypertension and hyperlipidemia
- Low Back Pain – Management of acute episode of low back pain
- Obstetric Care – Prenatal, uncomplicated vaginal delivery, cesarean section delivery
- Preventive Care (adults)
- Preventive Care (children) – Well child care, preventive care, normal newborn care
- Total Knee Replacement – Inclusive management from preoperative phase through rehabilitation phase
I am not sure, however, how widely payers (or providers) use these baskets of care. Anyone from Minnesota have any feedback on this program?