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Health and Human Services: Blue Cross care coordination to move to Lutheran Social Services; lawmakers approve payment and program changes
Summary
County staff outlined an October transition of care coordination for about 157 local clients from a Blue Cross Blue Shield contract to Lutheran Social Services, and reviewed recent state legislative changes affecting MNChoices assessments, reimbursement methodology and disability waiver services.
Pine County Health & Human Services staff told commissioners that care coordination work performed under a contract with Blue Cross Blue Shield will transition to Lutheran Social Services, with new clients served by Lutheran Social Services beginning Sept. 1 and the county’s active contract ending Oct. 1 to allow a month for handoffs.
Ryan (Health & Human Services unit lead) told the board the county has 157 individuals currently receiving care coordination under the Blue Cross contract who will move to Lutheran Social Services. Staff are cross‑training during September to support continuity; Blue Cross requested limited assistance during the first two weeks of October and the county expects to accommodate that. The county completed a desk audit of records in July and the contracted files were 100% compliant in the sample review.
Commissioners asked whether clients would lose coverage during the handoff. HHS staff said services already authorized for the year remain in place and that Blue Cross is coordinating closely; the county’s role will include outreach if family members or providers raise concerns after the transition.
Ryan also summarized state legislative changes affecting MNChoices assessments and disability waiver payments. Notable items raised in the update: - Expanded remote MNChoices assessment options and a new option for individuals or guardians to waive an annual reassessment by attestation if conditions are unchanged; counties will not force waivers. The county noted staff prefer in‑person assessments but view waivers as a possible time‑saver for routine cases. - A shift toward a flat reimbursement methodology for MNChoices assessments starting in 2027, part of legislation the presenter said seeks roughly $18 million in savings statewide; exact unit definitions were not yet published. - Caps tying some provider inflation adjustments to CPI and reductions in day‑ and unit‑based services for disability waivers, including cuts to maximum daily in‑home hours in some cases (the presenter cited examples where 16 hours/day services were reduced to a 6‑hour maximum). - A nursing‑facility payment modification that includes a new surcharge and language that could result in county cost shifts in future biennia if statewide savings targets are not met.
Staff warned the board about an embedded fiscal risk: if the state’s expected savings do not materialize, a statutory backstop could impose $72.5 million in county cost shifts statewide beginning July 1, 2027. The presenter said Pine County’s waiver budget is about $31 million and that legislative changes could produce significant county impacts.
Ending: Staff said they applied to an Advisory Council/working group through AMC to represent smaller and Greater Minnesota counties in statewide discussions and will keep the board apprised as rulemaking and payment methodology details are released.
