Evaluating the Preferred Integrated Network program in Minnesota

Testing a framework to address whole health needs

Research shows that people with serious mental illness (SMI) die an average of 25 years earlier than people in the general population, due mainly to preventable and treatable conditions. The Minnesota Department of Human Services established a pilot program, the Minnesota Medicaid Preferred Integrated Network (PIN) program, that used an innovative public-private partnership model to provide integrated physical and mental health services and coordination with county social services to improve the health and well-being of people with SMI. 

A key element of the PIN program was a Wellness Navigator, assigned to each program participant. The Navigator coordinated services across a range of providers and case managers for the participant. Participants also had access to expanded wellness benefits and supports—like educational groups, specific treatment groups, transportation, and nutritional counseling.

The program also aimed to improve access to services, improve the quality and capacity of the workforce and service systems, and improve accountability for service quality.

Determining program effectiveness to inform statewide implementation

The Minnesota Department of Human Services selected HSRI to lead an independent evaluation of the PIN program. 

We used both qualitative and quantitative methods to examine whether program goals were achieved, evaluating 1) program operations and effectiveness, 2) access to services, and 3) cost-related service utilization. In a second phase, we provided expanded analyses of service utilization and costs for PIN program participants versus those for comparison groups: Medicaid recipients receiving Targeted Case Management under fee-for-service (FFS) and Medicaid recipients receiving regular case management under a managed care arrangement. 

To produce a comprehensive picture of the PIN pilot program and its effectiveness, we synthesized and triangulated data from a variety of sources:

• Key informant interviews
• Leadership surveys
• Consumer focus groups
• Document reviews
• Chart reviews
• Logs of health referrals
• Medicaid claims 
• Level of Care Utilization 

The results

When compared to comparison groups, our research showed that PIN program participants were more likely to use routine outpatient care services after program enrollment, and they showed greater reductions in their use of high-cost intensive treatments.  

Our recommendations

Based on the evaluation findings, our recommendations focused on: 

• Model improvements
• Infrastructure to support the shift from volume- to value-based care 
• Training requirements 
• Data collection and reporting requirements