Matt Dean must’ve done something very right last week. For those not keeping score at home, Matt Dean spearheaded the House GOP team that brokered last Friday’s GAMC reform agreement. That’s my conclusion after reading Lori Sturdevant’s column, a column in which she rightly praises Matt Dean and Erin Murphy:

A commendable thing happened last week after the Minnesota House failed to override Gov. Tim Pawlenty’s veto of the bill preserving General Assistance Medical Care (GAMC) for the very poor: The two House members leading their respective parties’ efforts on the matter, DFL Rep. Erin Murphy and GOP Rep. Matt Dean, just kept working.

Constructively, too. On Friday, a deal was struck that has the blessing of the Legislature’s top leaders in both parties. It’s expected to go to the full House and Senate this week.

For that turnaround to be accomplished so soon after a veto and failed override scoured the veneer of bipartisan good feeling off of this session is remarkable.

This reform is proof of the Republicans’ commitment to reforming Minnesota’s health care safety net while saving Minnesota’s taxpayers millions of dollars. Most importantly, the agreed upon reform brings heightened accountability to the system to guarantee better outcomes for the people currently enrolled in GAMC. Here are some of the basics of the agreement:

Coordinated Care Organizations (CCOs), Accountable Care Organizations (ACOs) and Medical Homes are terms for a care model we are moving toward for this patient population. Despite technical differences, people use these terms interchangeably. Basically it is a way to connect unconnected providers to make sure people are getting care that gets them back on their feet instead of racking up revenue.

The agreement reached stops auto enrollment for two additional months. In that time period, 17 hospitals set up coordinated care systems. In agreeing to this, hospitals assume the cost of caring for GAMC patients for an intensive coordinated care delivery model for six months. They will have the incentive to find the most appropriate program (VA, MA, MNCare etc) the patient qualifies for and get them there quickly. Hospitals will have a disincentive to admit patients, and an incentive to keep them on their medications and get them healthy and stable.

Giving hospitals and clinics the affirmative responsibility and the global budget to care for the poorest of the poor means greater accountability. It also gives each hospital an incentive to experiment on what works best. If a CCO, ACO or medical home does a great job, we’ll know. Ditto if they don’t do such a great job.

The fact that this legislation establishes an accountability framework proof that Matt Dean, Erin Murphy and the GOP team of Dean, Steve Gottwalt, Laura Brod and Jim Abeler had the right priorities. They set as their top priorities improving life for the people currently on GAMC while improving accountability to Minnesota’s taxpayers.

I can’t stress that enough because only a week ago, DFL legislators were making dire predictions about GAMC:

Less than two weeks ago, the Legislature approved a veto-override majority GAMC solution that created a reformed GAMC program at a lower cost to taxpayers. Minnesotans, taxpayers, and hospitals expected better than they got today from elected leaders who chose to uphold the Governor’s veto rather than give immediate attention to those in need.

Larry Haws wasn’t the only DFL politician who painted a doomsday picture of what would happen after the House GOP upheld Gov. Pawlenty’s veto of the original bill.

This is another important point to consider:

Hospitals in particular pushed the need for a fix. 70% of GAMC patients are seen in the Metro, and the majority of those at Regions and Hennepin. The vast majority are seen at 12 hospitals around the state. Put another way, 99.5% of Minnesota is not on GAMC.

The turnover rate of people using GAMC is high, with turnover of 90 percent being the ‘norm’. That the legislators worked with hospitals is additional testimony to their commitment to improving outcomes for the patients. That should be applauded all across Minnesota.

Prior to this, Matt Dean wasn’t a high profile GOP politician, though he was always a highly competent legislator. The fact that Lori Sturdevant has written glowingly of his efforts means that Matt Dean will no longer work in anonymity. Talking with various GOP team members, each point to Matt as the leader of the team in the GAMC negotiations.

Well done, Matt. On behalf of Minnesota’s taxpayers, I’ll say thank you.

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