PrimeWest History
Since 1985, Minnesota has purchased health care for an increasing number of Medicaid recipients through its Prepaid Medical Assistance Program (PMAP). PMAP permits the State to purchase health care by contracting with managed care organizations on a prepaid, capitated basis. But rural counties were concerned this approach did not adequately address the needs or unique characteristics of rural areas. As a result, in 1997 Minnesota's legislature enacted a County-Based Purchasing (CBP) law to preserve access to care for Medicaid beneficiaries participating in PMAP.
The CBP legislation enables counties to directly purchase health care services for their local beneficiaries rather than relying upon non-local proprietary HMOs for such provisions. This legislation also provides counties with the ability to include local input when making decisions that can greatly impact local health care. The CBP law acknowledges counties' inherent sensitivity and accountability to local needs that cannot be duplicated by non-local HMOs. Counties are uniquely positioned—geographically, culturally, and organizationally—to best integrate public and private resources for improving access to care and continuity and quality of care; preserving fragile rural health systems; and maximizing the Medicaid resource locally.
In 1998 the county boards of Big Stone, Douglas, Grant, McLeod, Meeker, Pipestone, Pope, Renville, Stevens, and Traverse counties entered into a joint powers agreement under Minnesota law to form PrimeWest Health System. PrimeWest was intended to perform the CBP function on behalf of the counties for the following reasons:
1. To assure low income residents have geographic and economic access to quality local health care providers and services
2. To improve integration of county, state, and federally funded services
3. To reduce fragmentation of service delivery through increased integration and coordination of public and private health care services
4. To develop alternative methods to provide essential services that are unable to satisfactorily meet local demand
5. To effectively manage tax dollars and public resources, including eliminating private sector cost shifting to government-funded programs and preventing leakage of public health care dollars intended for local use to non-local interests