title: Hennepin Health: a safety-net accountable care organization for the expanded Medicaid population.
abstract: Health care payment and delivery models that challenge providers to be accountable for outcomes have fueled interest in community-level partnerships that address the behavioral, social, and economic determinants of health. We describe how Hennepin Health--a county-based safety-net accountable care organization in Minnesota--has forged such a partnership to redesign the health care workforce and improve the coordination of the physical, behavioral, social, and economic dimensions of care for an expanded community of Medicaid beneficiaries. Early outcomes suggest that the program has had an impact in shifting care from hospitals to outpatient settings. For example, emergency department visits decreased 9.1 percent between 2012 and 2013, while outpatient visits increased 3.3 percent. An increasing percentage of patients have received diabetes, vascular, and asthma care at optimal levels. At the same time, Hennepin Health has realized savings and reinvested them in future improvements. Hennepin Health offers lessons for counties, states, and public hospitals grappling with the problem of how to make the best use of public funds in serving expanded Medicaid populations and other communities with high needs.
authors.affiliation: Shana F. Sandberg (ssandberg@aamc.org) is a research specialist in the Center for Workforce Studies, Association of American Medical Colleges (AAMC), in Washington, D.C.
authors.forename: Shana F
authors.initials: SF
authors.lastname: Sandberg
authors.affiliation: Clese Erikson is senior director of the AAMC Center for Workforce Studies.
authors.forename: Clese
authors.initials: C
authors.lastname: Erikson
authors.affiliation: Ross Owen is deputy director of Hennepin Health, in Minneapolis, Minnesota.
authors.forename: Ross
authors.initials: R
authors.lastname: Owen
authors.affiliation: Katherine D. Vickery is a clinician investigator in the Division of General Internal Medicine and Department of Family Medicine, Hennepin County Medical Center, in Minneapolis.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Vickery
authors.affiliation: Scott T. Shimotsu is a senior health care analyst in the Analytics Center of Excellence, Hennepin County Medical Center.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Shimotsu
authors.affiliation: Mark Linzer is director of the Division of General Internal Medicine, Hennepin County Medical Center.
authors.forename: Mark
authors.initials: M
authors.lastname: Linzer
authors.affiliation: Nancy A. Garrett is chief analytics officer at Hennepin County Medical Center.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Garrett
authors.affiliation: Kimry A. Johnsrud is chief operations officer at NorthPoint Health and Wellness Center, in Minneapolis.
authors.forename: Kimry A
authors.initials: KA
authors.lastname: Johnsrud
authors.affiliation: Dana M. Soderlund is a senior data analyst in the Analytics Center of Excellence, Hennepin County Medical Center.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Soderlund
authors.affiliation: Jennifer DeCubellis is assistant county administrator for health in Hennepin County, in Minneapolis.
authors.forename: Jennifer
authors.initials: J
authors.lastname: DeCubellis
mesh_terms: D060866:Accountable Care Organizations / Q000458:organization & administration*; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D006297:Health Services Accessibility; D006801:Humans; D008484:Medicaid; D008910:Minnesota; D019982:Organizational Case Studies; D064876:Safety-net Providers / Q000458:organization & administration*; D014481:United States
keywords: Access To Care; Medicaid; Organization and Delivery of Care; Safety-Net Systems; Workforce Issues