Hennepin Health—An Accountable Care Model for Vulnerable Medicaid Populations

Hennepin Health is an accountable care organization serving complex Medicaid enrollees in Minneapolis, Minnesota and surrounding communities. Through its County-operated health plan, Hennepin County assumes fully-capitated risk for a subset of the geography's Medicaid enrollees. Within this Medicaid managed care structure, Hennepin Health has created a defined provider network that is linked by a shared electronic health record, a risk sharing funding arrangement, and a collaborative governance structure. Bringing together a County-operated managed care organization, hospital and clinics, and human services and public health functions, Hennepin Health aims to reduce avoidable acute care and capture those savings to improve the local delivery system.

Hennepin Health's members are disproportionately impacted by social determinants of health. Nearly one third are believed to be homeless at any given time [1]. The majority of Hennepin Health's members are eligible for Medicaid under the Affordable Care Act's Medicaid expansion. These individuals are disproportionately men of color, are affected by mental health and chemical dependency, and are involved in the justice and corrections systems. Through intensive care coordination and the integration of social services with the delivery of health care, Hennepin Health has been able to reinvest annual savings into further care delivery reforms [2]. Hennepin Health is actively extending its model to serve complex families and children in addition to the Medicaid expansion population.

Through a return on investment model, Hennepin Health is leveraging health care dollars to address social determinants of health, and values purchasing social services as a means to reduce overall costs and improve wellness in its patient population. Through investments in housing, employment supports, intensive harm reduction efforts for chronic inebriates, and other social supports to improve health, Hennepin Health has realized significant cost reductions and has annually been able to reinvest in new system innovations for continuous population improvements.

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