Feature

Medical Alley Association testifies against bill that would revoke approved research funding earmarked for the University of Minnesota

MAA testified in opposition to a bill that would remove critical research funding from the University of Minnesota’s budget in 2016.  The bill ties the University’s use of fetal tissue for research to their Medical Discovery Teams, an initiative that the legislature voted to fund $30M last session.  MAA focused on Minnesota’s rich history of pioneering health and medical breakthroughs and the huge economic impact our health technology ecosystem has on the state.  Additionally, we stressed how important the U of M is to the future competitiveness of the state as we only have one R1 research university in Minnesota.  Stripping nearly $14M in research funding would have a direct impact on research and programs at the medical school and could jeopardize our legacy as an innovation hub.  Defunding research, which will compromise the strength of biomedical research in the future, is not the message Minnesota lawmakers should be sending to our community.

Our testimony and letter can be found here: /library/news/maa-testifies-against-bill-that-would-revoke-approved-research-funding-earmarked-for-the-university-of-minnesota/

State Policy News

Second Deadline Week

April 8^th marked the end of the second deadline week at the legislature.  Policy committees met around the clock to meet the deadline that requires the legislature to act favorably on a bill or companion bill that has already met first deadline in the other house.  The third and final deadline is Thursday April 21st, when the House Ways and Means and the Senate Finance Committees must act favorably on major appropriation and finance bills.  Session is set to conclude on May 23.

Health and Human Services Omnibus Bill

The Governor’s Supplemental Budget Recommendations were included in SF 3332 (Lourey). The Health and Human Services Budget Division heard the bill on Tuesday. The hearing also included extensive public testimony both in support and opposition of various provisions in the bill.

Article 1 of the bill focuses specifically on Health Care. Below is a snapshot of the provisions contained therein.

• Section 1 contains language to increase transfers from the health care access fund to the general fund in order to reflect the current value of medical assistance and MinnesotaCare revenue.
• Section 2 directs the expansion of MinnesotaCare eligibility by requiring the Commissioner of Human Services to seek the necessary federal waivers.
• Sections 3, 9 and 11 relate to asthma-related services coverage under medical assistance and authorizes the commissioner to utilize volume purchases and competitive bids for allergy reduction products.
• Sections 4-8 modify spousal benefits to require that all marital assets are considered under the law when a spouse is receiving, or requesting to receive, medical assistance services.
• Sections 10, 12 and 13 increase the payment rate for medical assistance services, rates for preventative medical visits, and payment rates for outpatient mental health services by 5%.

Here is a link for a complete look at SF 3332.

House leadership unveils budget adjustment targets

House leadership released their budget adjustment targets on Thursday morning. The February Budget and Economic Forecast lowered the state’s projected surplus at the end of the current biennium to $900 million, down from an estimated $1.2 billion forecast last December.

Of note, the target has a $0 change to higher education, K-12 education, and Health and Human Services. The Republican House did allocate some money for use in Broadband expansion, but not as significant as requested by the Governor.  It should be noted that the House did not set targets for either Transportation or Taxes because both of these bills are sitting in conference committee already. They did say however, that they expect to split the $900 million surplus between these areas though they did not say how.

MNsure Open Enrollment Performance Evaluation

HF 3228 (Murphy) / SF 2902 (Lourey) – The bill is a result of the Health Care Financing Task Force recommendations. It requires an evaluation of enrollment trends in qualified health plans, the consumer experience, MNsure’s progress and the extent of which subsidies have reduced market churn. The evaluation would be completed by an outside vender determined by the Department of Management and Budget and a report would be due to the legislature by January 15, 2017.

The bill was heard in Health and Human Services Reform committee on Tuesday, passed as amended, and re-referred to Health and Human Services Finance committee.

Legislative retirements

Senator Alice Johnson announced her retirement at the beginning of the week.  Rep. Jerry Newton will be seeking her Senate seat in November.  Below is a full list of those legislators that have retired this year.  Rep. Yvonne Selcer also announced late in the week.

Current legislators who will not seek re-election in 2016

Current House members seeking Senate seats in 2016

Press release of interest

New measures help quantify improvement patients experienced following knee and spine surgery

New data from the Minnesota Department of Health (MDH) and Minnesota Community Measurement (MNCM) indicate most Minnesota patients enjoyed increased mobility following knee and spine surgeries, but the degree of improvement varied across medical groups.

Minnesota is the first state in the nation to collect and publicly release outcome data for three orthopedic surgeries: total knee replacement, lumbar fusion surgery and herniated disk surgery. The data are collected as part of Minnesota’s Statewide Quality Reporting and Measurement System.

The results from providers who submitted data to MNCM show most patients improve in their ability to complete activities such as sitting, walking and getting in and out of bed after surgery. MNCM publicly reports these results at www.MNHealthScores.org.

Spine surgeries were measured on a 100-point scale. Patients on average saw a 16.7-point change after lumbar fusion surgeries and a 22-point change after herniated disk surgery. A higher number of points indicated greater improvement in a patient’s pain, function and mobility after surgery.

Knee replacement outcomes were measured on a 48-point scale, on which the top score represented a fully functioning knee. The statewide average change in score after knee surgery was 17.1 points. Again, a higher number of points indicated greater improvement after surgery.

According to Minnesota Health Commissioner Dr. Ed Ehlinger, getting Minnesotans quality information about the outcomes associated with common medical procedures helps empower them to increase ownership of their health care. Given the aging of the state’s population, he said it will become even more important in the years ahead to have solid data about the outcomes associated with knee and spine surgeries.

“It is important to understand the effectiveness of these surgeries because the demand for them is growing,” Commissioner Ehlinger said. “I am pleased that Minnesota has taken the lead by providing patients with quality information about the degree to which these procedures have helped to alleviate pain and to improve mobility and function.”

More than 700,000 knee replacements are performed each year in the United States, and with an aging population staying active and working longer, that number is expected to rise above 3 million by 2030. Meanwhile, the number of spine surgeries in patients older than 65 is expected to rise 59 percent by the year 2025.

For the spine and knee procedures, Minnesota’s statewide quality reporting system uses measures based on Patient Reported Outcome (PRO) tools. The measures, developed by MNCM, are unique in that they are based on the patients’ own accounts of changes in their physical and mental health status before and after the surgeries, including their ability to do normal household and job-related activities.

“These measures are an ideal way for clinics to measure function, pain and quality of life from the best source of the information – their patients,” said Jim Chase, MNCM President. “Measures based on PROs are an increasingly sought-after type of health care performance measure.”

A total of 31 medical groups submitted data for total knee replacements; 13 medical groups for lumbar fusion surgeries; and 16 medical groups for herniated disk surgeries.

“We are very excited about these first-year results and are a believer in transparency,” said Dr. Paul Huddleston, a consultant with the Department of Orthopedic Surgery at Mayo Clinic, which had better than average results for the total knee replacement measure. “We can’t get these type of results without the proper protocols, standardization and teamwork in place. As patients get older and sicker, the challenge will be to maintain our level of results.”

Chase thanked the providers who participated for helping to advance patient knowledge and acknowledged the process was new for many of the specialists involved.

“We understand that sharing this information on outcomes with the public is a relatively new concept to specialties like orthopedics,” said Chase. “The primary care community has been measured for over a decade and has come to value the measures and indicate extensive use of the results to improve care.”

About Us
The goals of the MDH Statewide Quality Reporting and Measurement System are to enhance market transparency by creating a uniform approach to quality measurement, improve health outcomes and reduce acute care spending.

Minnesota Community Measurement (MNCM) is a non-profit organization dedicated to accelerating the improvement of health by publicly reporting health care information. A trusted source of health care data and public reporting on quality, cost and patient experience for more than a decade, MNCM works with varied stakeholders to spur quality improvement, reduce costs and maximize value in health care.

Federal Policy News

Klobuchar introduces Improving Medical Innovation Act

Senator Amy Klobuchar introduced the Improving Medical Innovation Act, which seeks to streamline FDA processes to improve the regulatory climate for health technology in the country.  The bill has four significant provisions that will help foster innovation and drive consensus between the FDA and our member companies.  Senator Klobuchar has been working tirelessly on behalf of our health technology industry and is a strong advocate for our state at the national level.  “Minnesota is home to more than 700 medical device companies that employ approximately 35,000 people who work each day to improve patients’ health and well-being. My bipartisan bill will help improve efficiency and transparency at the Food and Drug Administration to ensure patients have timely access to safe, effective, and innovative medical breakthroughs.”

Below is a breakdown of the proposals found in the legislation:

Allow FDA to consider recognizing international consensus standards for medical devices. The FDA, medical device companies and regulators worldwide participate in many standard setting organizations. The consensus standards developed by these organizations help increase efficiency for medical device innovators and for the regulators evaluating their products.

Allow FDA to remove certain products from the device reserved list. Most Class I medical devices and some Class II devices are so low-risk that they are not required to undergo premarket review. Some of these products have possible risk so they are placed on a reserved list. The list has not been updated in nearly 20 years because there is no mechanism for the FDA to remove products that no longer need premarket review. In 2015 the FDA identified at least 120 types of devices that should be removed from the list.

Improve the Advisory Committee process. The FDA can convene an advisory committee to review a medical device premarket submission if the submission is of significant public interest or highly controversial. This provision would increase the transparency of the committee member selection process and allow the sponsor to nominate candidates with adequate expertise.

Establish a Post-market Surveillance Pilot Program. Medical device manufacturers, importers and user facilities are required to submit Medical Device Reports (MDR) to the FDA for certain device-related adverse events and product problems. Over-reporting imposes a heavy resource burden on the FDA and diminishes the value of MDRs. This provision would allow the FDA to establish a pilot program to test alternative reporting methods that would provide more accurate and meaningful assessments of device safety.

Hearings of Interest

For hearings of interest, learn more at the Minnesota State Legislature Combined Calendar.