Kandiyohi County officially joins PrimeWest Health after three years of consideration – West Central Tribune

Wilmar – Kandiohi County is moving forward to become a full partner in PrimeWest Health.

Nearly three years after deciding to join the regional consortium of Minnesota counties to manage publicly funded health programs for low-income populations, the board passed a resolution at its Nov. 15 meeting to complete the process. including approving financial contributions to the risk of the organization. based equity fund.

“I’m really excited that we’ve gotten to this point,” said Commissioner Corky Berg. “We’ve been talking about this for some time.”

Kandiohi County Health and Human Services Director Jenny Lippert recommended the county join PrimeWest after giving a presentation at the Nov. 15 board meeting on the 2023 health plan awards.

“We, as the Kandiohi County Board, should make that financial contribution if we choose to join PrimeWest,” Lippert said. “I think having him in our community is going to benefit in so many ways.”

jennifer lippert

Contribution/Kandiohi County

PrimeVest operates as a county-based purchasing agreement, allowing member countries to act as health plan providers, including negotiating provider contracts, coordinating health care services, and managing risk Is. Because PrimeVest is owned and held accountable by member countries, it is believed to provide a more personalized service for those countries.

“They really develop and design programs to help members enjoy healthy and fulfilling lives, and they do it with the lens of rural health care,” Lippert said.

To fully join PrimeVest, counties will need to contribute to the organization’s risk-based capital fund, which is used when health care costs exceed projections for member counties.

When Kandiohi County first decided to join, its contribution was estimated at $3.6 million, with the idea being that all 12,700 people enrolled in various health programs in the county would be added to PrimeVest.

“They need to have a reserve based on the number of people enrolled in their health plans,” Lippert said.

Now though, with only about 2,700 people estimated to have chosen PrimeVest as their plan provider, the county’s buy-in has dropped to just $258,523.

“It’s an incredible shortcoming,” said Commissioner Roger Emdyke.

Every five years, states and counties go through a process called procurement, which decides which health insurance companies can provide plans for five different publicly funded health programs – Prepaid Medical Assistance Programs , MinnesotaCare, Minnesota Senior Health Care Options, Minnesota Senior Care Plus and Special Needs Basic Care.

In January 2020, when the county first decided to join PrimeVest, it was expected that the state would allow counties to have only one health plan provider such as PrimeVest.

“We have a statute that defines that clearly,” said Commissioner Roli Nissen.

However, the state has not yet allowed this to happen. When the latest buyout took place in 2021, PrimeWest was not even selected as an option, preventing Kandiohi County from becoming a full member.

The state, in the face of pushback from the counties and threats of lawsuits, decided to halt the buyout process and keep things as they were. This still meant that Kandiohi County could not use PrimeWest, as it was not a planning provider in Kandiohi County until 2021.

The Minnesota Department of Human Services just restarted the purchase process this summer but again the state didn’t rule out the way Kandiohi County had hoped.

While PrimeWest is now an option for customers in Kandiohi County, it is not the only one. That means county staff would need to know about two to three different health plans, depending on the program, which would lead to a lot of work.

“When you have additional plans it puts a burden on local units of government,” said County Administrator Larry Kleindahl.

While the board is disappointed that the state has not allowed it to move to a single-source system, the commissioners still feel there are major benefits to joining PrimeVest at this time.

Since PrimeVest sued the state over its purchase decision, there’s always the possibility that Kandiohi County could see nearly all of its health care customers move to PrimeVest. Having the chance to gradually add customers to PrimeVest instead of all 12,700 at once could mean better change and the ability to create opportunities and programs that are tailored to the specific needs of Kandiohi County.

“I see it as a win-win situation,” Berg said. “I really like a win-win situation.”

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