Managed care reporting

Minnesotans are entitled to clear information on how public dollars are spent on public health care programs, Medical Assistance (MA) and MinnesotaCare DHS-4932 (PDF). In an effort to provide this information, Gov. Mark Dayton directed the Department of Human Services (DHS) to establish these webpages, under a 2011 Executive Order (PDF). It is a single source for all publicly available state information and reports on managed care plans under contract with DHS for publicly funded health care programs.

These pages provide information on managed care plans' quality of care delivered, financials, contracting and related reports by state agencies. This information is collected by DHS—the purchaser of health care services for public program enrollees—and the Minnesota Department of Health (MDH)—the state agency that regulates managed care plans including health maintenance organizations (HMOs) and county-based purchasing plans. DHS launched the site in April 2011.

Contracts
Enrollment
View reports on how many people are enrolled in each plan, as well as maps showing public program enrollees' plan choices by counties.
- Managed care public program enrollment figures by plan, county, program and eligibility type, DHS
  This monthly report has the number of people enrolled in managed care public programs in each plan and each county.
- Maps of plan choices by county, DHS
  Public program enrollees can choose which managed care plan they want from those available in their county. These maps show the choices available for each program.
- Health plan enrollment across all business, MDH
  This is detailed information about all people enrolled in Minnesota managed care plans.
Financial information and data
View annual financial reports from the plans with data on revenue, expenses and net income for all their health care business.
- Health plan annual financial reports, MDH
  These are the annual statement of revenues, expenses and net income by all Minnesota HMOs and county-based purchasing organizations for all their business. It includes the IRS 990 filings and annual financial examination reports.
- Minnesota Health Care Markets Chartbook, MDH
  - Section 5 of the chartbook provides information on key enrollment and spending trends in publicly financed health insurance programs that cover Minnesotans.
  - Section 7 of the chartbook contains information on the structure of the private health insurance market in Minnesota, including market shares, financial statistics and enrollment numbers by health plan.
Quality, outcomes and performance measures
Reports and audits
- Accreditation Status (PDF) Four of the nine managed care organizations (MCOs) with which Minnesota contracts are accredited by the National Committee for Quality Assurance (NCQA) (updated Oct. 4, 2023).
- View reports and audits related to managed care plans required by the governor and Legislature.
- Managed care organizations must annually submit documentation of compliance with the mental health parity rule. The Mental Health Parity and Addiction Equity Act of 2008 requires health plans to provide benefits for mental health and substance use disorder treatment and services at a comparable level and no more restrictive than those offered for medical care. The Mental Health Parity Rule Report (PDF) displays a cumulative compliance summary.
- DHS must annually submit the Managed Care Program Annual Report (MCPAR) to CMS as required by the Code of Federal Regulations, title 42, section 438.66(e). This annual report reflects the performance of each MCO in the following areas: administration and management, appeals and grievances, claims management, materials and customer service, finance, information systems, marketing, medical and utilization management, program integrity, provider network management, quality improvement, the delivery of long-term services and supports, and other items of the contract.
- Ownership and controlling interest reports
  Managed care organizations must annually report individuals within their organization that have ownership or a controlling interest in the organization. The following report includes names and titles of the individuals.
- Delegation to subcontractors reports
  Managed care organizations must annually identify subcontractors they delegate work to and submit a report.
Reports on initiatives to improve screening, diagnosis and treatment of children with autism spectrum disorder and other developmental conditions
Managed care plans and county-based purchasing plans are required to implement strategies that facilitate access for young children to periodic developmental and social-emotional screenings, allowing access to appropriate evaluation and assessment, including treatment recommendations to improve the child’s functioning, with the goal of meeting milestones.

2015
- Report on Barriers, Strategies and Effectiveness of Practices for Children with Symptoms of Autism Spectrum Disorder (PDF)
- Children with Autism Spectrum Disorder Managed Care Data (PDF)
2014
- Report on Barriers, Strategies and Effectiveness of Practices for Children with Symptoms of Autism Spectrum Disorder (PDF)
- Children with Autism Spectrum Disorder Managed Care Data (PDF)