September 2019, Volume XXXIII, No 6
UCare caps monthly patient costs for insulin
UCare’s final 2020 MNsure Individual and Family plan benefits and rates, filed with the Minnesota Department of Commerce, provides members who have diabetes with financial relief through a $25 cap on monthly insulin costs, effective Jan. 1, 2020. Rounding out UCare’s suite of diabetes services, the cap applies to all insulin covered by the member’s plan and is available with UCare’s current plans and new HSA plans.
“As the health plan with the largest enrollment through MNsure, we felt a special responsibility to be part of a solution to this important public health issue,” said Mark Traynor, UCare’s president and chief executive officer.
The pharmacy benefit completes UCare’s full slate of diabetes programs supporting optimal health for its members living with diabetes.
The cost relief is made possible by recent IRS guidance allowing coverage for insulin benefits outside of a deductible for certain high-deductible health plans. UCare partnered with its pharmacy benefit manager and insulin manufacturers on a plan to bring down the monthly cost of insulin for members.
MNsure awards 2019-20 navigator outreach and enrollment grants
MNsure has announced recipients for the Fiscal Year 2020 Navigator Outreach and Enrollment Grant Program. This year’s 24 grants totaled $4.2 million and will fund 43 organizations across the state. These grants will support targeted outreach to uninsured populations and sustain a robust statewide navigator network to provide application, enrollment, and renewal assistance to Minnesotans who need help.
Over the last year, with the help of a navigator from one of MNsure’s grantee organizations, more than 42,000 Minnesotans found coverage and tens of thousands were helped with other important steps, like reporting changes or renewing coverage.
Grantees work to assist communities with all aspects of the application, enrollment, and renewal process, and utilize established relationships with populations facing barriers to coverage.
The 24 MNsure grants are split into two funding areas:
Geographic Focus Grants totaling $2.9 million to support highly skilled navigator organizations working collaboratively with MNsure to reach the uninsured and support Minnesotans in obtaining and maintaining health insurance coverage. The focus on this grant area is on ensuring statewide access to in-person assistance.
Population Focus Grants totaling $1.3 million to support organizations that have identified populations that face barriers to enrolling in coverage and/or high levels of uninsurance and can demonstrate an ability to effectively reach, enroll, and help renew coverage for the population.
Allina Health introduces star ratings for primary care physicians
Allina Health now provides star ratings for its primary care physicians, nurse practitioners, and physician’s assistants. The ratings are compiled by an independent organization from surveys sent to patients who receive care from an Allina Health provider. The star ratings, one to five, show on each provider’s web page, along with written comments survey respondents make. Allina Health is the first health system in the Twin Cities to publish these kinds of ratings.
The star ratings are based on responses from patients who are randomly invited to complete a Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS) survey. The CGCAHPS survey is a standardized tool developed by the federal Agency for Healthcare Research and Quality (AHRQ) to measure patients’ perception of care provided by physicians in a clinic or office setting.
The ratings are based on six questions assessing how well providers explain matters, listen carefully, provide understandable information, know important medical history, show respect, and spend sufficient time during the visit.
Not all providers on the Allina Health website will have a star rating or comments. The system displays ratings for specific primary care providers who have a minimum of 30 completed surveys within a 12-month period. Stars and comments for specialty providers will be added in October 2019. In addition, some providers on the Allina Health website may not have ratings and reviews because they participate in a different survey than CGCAHPS, or they are not surveyed by Allina Health.
Health system uses advanced real-time blood flow imaging system
Hennepin Healthcare’s Center for Wound Healing and its Center for Hyperbaric Medicine are now using fluorescence microangiography, a new technology that can assess blood flow in chronic, non-healing wounds and diabetic foot ulcers. Hennepin Healthcare is the first in Minnesota to use the LUNA Imaging System during wound assessment.
Healthy blood flow or microcirculation is essential to healing wounds that can result from diabetes, a complication from a recent surgery, or even frostbite. Fluorescence microangiography with the LUNA system enables doctors to assess blood flow to the wound, utilizing real-time information to define treatment plans, optimize patient recovery, and reduce the frequency of complications such as necrosis, infection, partial or total limb amputation, and the need for repeat surgery.
“We already know that some diabetic and radiation wounds greatly improve when treated with hyperbaric oxygen therapy,” said emergency physician Thomas Masters, MD. “Having the LUNA diagnostic tool to visualize the results allows us to measure the successful healing process during treatment. Likewise, it can indicate when there’s irrevocable tissue death so unnecessary limb preservation efforts can be avoided.”
Procedures with the LUNA System do not involve the potential safety hazards associated with X-ray procedures and traditional contrast agents. Because the dye that’s used is processed in the liver, kidney function is not affected. This is significant for patients diagnosed with diabetes whose kidney function may be at risk.
U of M recognized for achievements and impact in field of microbiology
The University of Minnesota was recognized as a Milestones in Microbiology site by the American Society for Microbiology (ASM) for its achievements in the microbial sciences and lasting impact on the field. The microbiology research at the U of M is distinguished by its ground-breaking discoveries of a broad range of microorganisms and their interactions with animal and plant hosts.
This year marks the Department of Microbiology and Immunology’s Centennial. Originally known as the Department of Bacteriology and Immunology when it was implemented in 1919, the department has been integral to the medical school ever since. Decades ago, scientists at the University of Minnesota discovered that the size and shape of bacterial cells varies with the rate and stage of growth, and that changes occur with great regularity and are governed by simple laws. These insights shook the foundations of bacterial classification and are just one example from an extensive list of accomplishments.
Housing support approved as new Medicaid benefit
Minnesota seniors and people with disabilities soon will have more help finding and keeping housing, thanks to new services coming to the state’s Medicaid program next year.
On Aug. 1, Minnesota received federal approval of housing stabilization services as a basic Medicaid benefit. The new services will be available to seniors and people with disabilities—including mental illness and substance use disorder—who are homeless, living in institutions, or at risk of becoming homeless or institutionalized. The benefit will start in July 2020. When fully implemented, an estimated 7,600 people will receive these services.
In 2017, the Minnesota Department of Human Services asked the federal Centers for Medicare and Medicaid Services to add Housing Stabilization Services to the state Medicaid plan.
Most current housing services provide short-term assistance only during a crisis or transition. The new services will increase long-term stability by supporting people to plan for, find, and move into their own homes, while also helping people stay in their own homes in the community.
“Far too many people are experiencing homelessness, and there is a lack of housing that’s affordable,” said Minnesota Housing Commissioner Jennifer Leimaile Ho. “This new benefit will help build a stronger link between where people want to live and the services they need to have stability in their lives.”
Advocates will help people with disabilities and seniors find and keep housing, addressing potential challenges such as budgeting, interacting with landlords and neighbors, and understanding leases.
Minnesota identifies severe lung injury cases among teens who vape
The Minnesota Department of Health (MDH) is encouraging Minnesota health care providers to be on alert for novel cases of severe lung disease potentially related to vaping and e-cigarette use among teens and young adults.
Children’s Minnesota has reported finding four cases of severe lung injury in the metro area potentially related to vaping. These cases are similar to lung disease cases recently reported in Wisconsin and Illinois, though it is too early to say whether they are connected.
“There are still many unanswered questions, but the health harms emerging from the current epidemic of youth vaping in Minnesota continue to increase,” said Dr. Ruth Lynfield, state epidemiologist and MDH medical director. “We are encouraging providers and parents to be on the look-out for vaping as a cause for unexplained breathing problems and lung injury and disease.”
In Minnesota, symptoms have resulted in hospitalizations lasting multiple weeks, with some patients being admitted to the intensive care unit. Product names are unknown.
© Minnesota Physician Publishing · All Rights Reserved. 2019
Clinical presentation among Minnesota cases included shortness of breath, fever, cough, vomiting, and diarrhea. Other symptoms reported by some patients included headache, dizziness, and chest pain.
James Pacala, MD, MS, head of the University of Minnesota Medical School’s Department of Family Medicine and Community Health, has received a five-year, $3.74 million Health Resources and Services Administration (HRSA) Geriatrics Workforce Enhancement Program (GWEP) award to improve the health care and health of older adults.
Minnesota Oncology has named two of its physicians to key leadership positions. John Schwerkoske, MD, will serve a three-year term as practice president, succeeding Dean Gesme, MD, FACP, FACPE. Dr. Schwerkoske is board-certified in medical oncology, hematology, and internal medicine, and has been actively involved in clinical research programs. Paul Thurmes, MD, will serve as medical director. Board-certified in internal medicine, medical oncology, and hematology, Dr. Thurmes previously served as site medical director for the Edina Clinic as well as quality medical director for the practice, and is active in providing patients access to clinical trials.
Joshua Kropko, DO, has joined St. Luke’s P.S. Rudie Medical Clinic in Duluth. Dr. Kropko received his medical degree from Lake Erie College of Osteopathic Medicine in Erie, PA, and completed his residency in family medicine at the Duluth Family Medicine Residency Program. He is certified in family medicine. Also joining the clinic is Christine Ripp, MD. She received her medical degree from the University of Wisconsin School of Medicine and Public Health and completed her residency in family medicine at the Allina Health United Family Medicine Residency Program in St. Paul. Dr. Ripp is certified in family medicine.
Kirsten Indrelie, MD, an obstetrician and gynecologist, has joined the Essentia Health–Duluth Clinic. Dr. Indrelie earned a medical degree from the University of Minnesota Medical School in Minneapolis. She completed a residency in obstetrics and gynecology at Tulane University in New Orleans, LA. Nicholas Lesmeister, MD, an orthopedic surgeon, has joined Essentia Health St. Joseph’s–Orthopedics Clinic in Brainerd. Dr. Lesmeister earned a medical degree from the University of Minnesota Medical School in Minneapolis, where he also completed a residency in orthopedics.