The HCH program is jointly operated by the Minnesota Department of Health (MDH) and the Minnesota Department of Human Services (DHS), which oversees the state's Medicaid and CHIP programs. Although the HCH program is a multi-payer initiative and includes several other payers (Medicare, state employee insurance, private insurance) in addition to Medicaid, Medicaid is the only payer required to make HCH payments. A statewide Advisory Committee guides the HCH program by developing strategic goals, supporting the delivery of quality care, addressing priorities such as practice transformation and financial sustainability, and exploring opportunities for community partnerships. The Advisory Committee is comprised of researchers, health plan representatives, HCH-certified clinics, state agencies, and health care providers, including pediatric providers.
Primary care clinics can undergo a voluntary certification process to become designated as a HCH and the criteria to become certified are designed to allow for flexibility and innovation for practices. The certification process includes a site visit to the clinic conducted by HCH program staff and an evaluation by community site evaluators to ensure that the criteria have been met. To be certified as a HCH, clinics must meet standards in the following five areas:
- Access and communication
- Patient tracking and registry
- Care coordination
- Care planning
- Performance reporting and quality improvement
Clinics are required to be recertified every three years and recertification is focused on quality outcomes. For 2017, the performance measures on which clinics were evaluated included the following: depression care, diabetes care, vascular care, colorectal cancer screening, and asthma care (for children and adults). Clinics with HCH certification are also required to measure, track, and analyze at least one quality indicator of patient experience and can use different survey tools or questions to assess patient experience. The MDH annually updates the set of quality measures (referred to as the Minnesota Statewide Quality Reporting and Measurement System) that HCHs are required to report on.