In a recent meeting of the North Dakota Senate Appropriations - Human Resources Division, state officials gathered to discuss the performance of healthcare measures and the implementation of value-based care strategies aimed at improving health outcomes for Medicaid members. The session, held on March 12, 2025, highlighted both successes and challenges within the state's healthcare system.

The meeting opened with a review of North Dakota's performance in key health measures. Notably, the state ranked third nationally for the asthma medication ratio, indicating a high percentage of adults and children with asthma receiving necessary medications. Additionally, North Dakota secured the second position for adolescent immunizations among 13-year-olds, both metrics significantly above the national median.

However, the discussion also revealed areas needing improvement. North Dakota's performance in well-child visits for children aged 15 to 30 months was concerning, ranking sixth from the bottom with only 40.8% compliance, far below the national median of 64.8%. Similarly, the state struggled with oral evaluations for dental services among Medicaid children, underscoring the need for targeted interventions.

To address these challenges, officials emphasized the importance of transitioning to value-based care. This approach aims to enhance accountability in healthcare delivery, improve patient experiences, and ultimately lower long-term costs. The strategy involves collaborative partnerships with healthcare providers to ensure that the measures implemented are tailored to the unique needs of North Dakota's healthcare landscape.

One significant initiative discussed was the health system value-based purchasing program, which began with the state's six largest hospitals. This program incentivizes hospitals to report on quality measures and improve their performance over time. The first year focused on establishing reporting habits, with plans to shift towards performance-based incentives in the coming year.

Senator Davison raised concerns about the obstacles hospitals face in meeting these new standards, particularly regarding data reporting and the integration of electronic health records. The officials acknowledged that while data collection has been a challenge, they are optimistic that improvements will emerge as providers adapt to the new system.

Looking ahead, the state is seeking an additional $2 million to continue refining and expanding its value-based care programs. This funding will support the administration of these initiatives and help ensure that rural healthcare providers can participate effectively. The overarching goal remains clear: to enhance the quality of care for North Dakota's Medicaid members while managing costs more effectively.

As the meeting concluded, the sense of urgency and commitment to improving healthcare outcomes was palpable. With a focus on collaboration and innovation, North Dakota is poised to make significant strides in its healthcare system, addressing both successes and shortcomings in the months and years to come.