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Health plan collaboration plans

Regional public health / health plan collaboration groups
Key resources

The recommendations and advice in earlier chapters of this section on public health and the community certainly apply to health plans and health care providers. There is an additional legal requirement that applies specifically to health plans, which requires them to have conversations with public health.

The early 1990s saw significant discussions of health reform that included the public health system. During that time, the Department of Human Services was restructuring its public programs for health care, looking to managed care organizations to provide capitated services under the new Prepaid Medical Assistance Program, or "PMAP." The Minnesota Department of Health and local public health departments raised important concerns about how the transfer of Medical Assistance dollars (including administration) from counties to private organizations—organizations typically focused primarily on individual health care—would undermine the ability of counties to maintain important population-level public health activities. Managed care organizations taking funds for public health care programs should also be expected to take some responsibility for population health.

A key response to this concern was the development of a law in 2001 (Minn. Stat. § 62Q.075) that requires licensed Health Maintenance Organizations (HMOs) and Community Integrated Service Networks to submit a plan to the state health commissioner. This "collaboration plan" would describe how the organization would collaborate with community health boards and other community health-related organizations to achieve high-priority public health goals in the communities they served. Health plans were (and are) required to develop their collaboration plans in concert with local public health departments and other community organizations providing health services within the same health plan service area.

The stated purposes of collaboration plans are to:

• Promote an exchange of information that allows the public and private sectors to begin to identify areas of mutual interest
• Focus the collective efforts of the public and private sectors on a few, high-priority health problems in a community

According to statute, collaboration plans must address the following:

• Specific measurement strategies and a description of any activities which contribute to one or more high priority public health goals
• A description of the process by which the health plan will coordinate its activities with the community health boards, and other relevant community organizations servicing the same areas
• Documentation indicating that local public health units and local government unit designees were involved in the development of the plan
• Documentation of compliance with the plan filed previously, including data on the previously identified progress measures

In 1995, the first legislatively mandated Collaboration Plans formalized dialogues among public health and organized systems of health care. As a result, these groups started to develop a common language and to identify and undertake common efforts to achieve goals that prevent disease and improve the health of the people of Minnesota. They began to build collaborative relationships, and have learned to appreciate and understand each other's language, strengths, and positions. Today, health plans engage in many collaborative activities to achieve public health goals with many community partners.

Collaboration Plans today take the form of a combined plan, prepared by the Minnesota Council of Health Plans (MCHP). The plan combines into one document an extensive list of committees and regional groups that health plans participate on together with local health departments. The plan also describes the public health work that these committees accomplish and the public health goals that they are addressing.

Private organizations, especially health plan companies and health systems, can play a strong role, through collaboration with public health professionals, in achieving shared public health goals. Through the collaboration planning process, local public health departments and local public health departments have the opportunity to exchange information with the health care sector about the specific goals they are pursuing, and to discuss (and potentially collaborate on) their respective activities.

As of 2013, three regional groups comprised of local public health departments and health plan representatives are actively discussing public health goals, strategies, and health plan/public health collaboration. These are:

• The Northeast Public Health Cooperative
• The Collaborative for a Healthy Population in southeast Minnesota
• The Prairie Regional Health Alliance in southwest Minnesota

You can find more information about health plan collaboration plans online: MDH: Health plan collaboration plans.

• Health plan collaboration plans
• Minn. Stat. § 62Q.075 (2001): Local public health accountability and collaboration plan

Next: Public health powers and duties of local government