62J.2917 Repealed, 1997 c 237 s 22 

*   NOTE:  Subdivision 2 was also amended by Laws 1997, chapter 
*225, article 2, section 27, to read as follows:  

*   "Subd. 2.    Factors.  (a)    Generally applicable 
*factors.  In making a determination about cost, access, and 
*quality, the commissioner may consider the following factors, to 
*the extent relevant: 

*   (1) whether the proposal is compatible with the applicable 
*regional plans of the regional coordinating boards; 

*   (2) market structure: 

*   (i) actual and potential sellers and buyers, or providers 
*and purchasers; 

*   (ii) actual and potential consumers; 

*   (iii) geographic market area; and 

*   (iv) entry conditions; 

*   (3) current market conditions; 

*   (4) the historical behavior of the market; 

*   (5) performance of other, similar arrangements; 

*   (6) whether the proposal unnecessarily restrains 
*competition or restrains competition in ways not reasonably 
*related to the purposes of this chapter; and 

*   (7) the financial condition of the applicant. 

*   (b)    Cost.  The commissioner's analysis of cost must 
*focus on the individual consumer of health care.  Cost savings 
*to be realized by providers, health carriers, group purchasers, 
*or other participants in the health care system are relevant 
*only to the extent that the savings are likely to be passed on 
*to the consumer.  However, where an application is submitted by 
*providers or purchasers who are paid primarily by third party 
*payers unaffiliated with the applicant, it is sufficient for the 
*applicant to show that cost savings are likely to be passed on 
*to the unaffiliated third party payers; the applicants do not 
*have the burden of proving that third party payers with whom the 
*applicants are not affiliated will pass on cost savings to 
*individuals receiving coverage through the third party payers.  
*In making determinations as to costs, the commissioner may 
*consider: 

*   (1) the cost savings likely to result to the applicant; 

*   (2) the extent to which the cost savings are likely to be 
*passed on to the consumer and in what form; 

*   (3) the extent to which the proposed arrangement is likely 
*to result in cost shifting by the applicant onto other payers or 
*purchasers of other products or services; 

*   (4) the extent to which the cost shifting by the applicant 
*is likely to be followed by other persons in the market; 

*   (5) the current and anticipated supply and demand for any 
*products or services at issue; 

*   (6) the representations and guarantees of the applicant and 
*their enforceability; 

*   (7) likely effectiveness of regulation by the commissioner; 

*   (8) inferences to be drawn from market structure; 

*   (9) the cost of regulation, both for the state and for the 
*applicant; and 

*   (10) any other factors tending to show that the proposed 
*arrangement is or is not likely to reduce cost. 

*   (c)    Access.  In making determinations as to access, 
*the commissioner may consider: 

*   (1) the extent to which the utilization of needed health 
*care services or products by the intended targeted population is 
*likely to increase or decrease.  When a proposed arrangement is 
*likely to increase access in one geographic area, by lowering 
*prices or otherwise expanding supply, but limits access in 
*another geographic area by removing service capabilities from 
*that second area, the commissioner shall articulate the criteria 
*employed to balance these effects; 

*   (2) the extent to which the proposed arrangement is likely 
*to make available a new and needed service or product to a 
*certain geographic area; and 

*   (3) the extent to which the proposed arrangement is likely 
*to otherwise make health care services or products more 
*financially or geographically available to persons who need them.

*   If the commissioner determines that the proposed 
*arrangement is likely to increase access and bases that 
*determination on a projected increase in utilization, the 
*commissioner shall also determine and make a specific finding 
*that the increased utilization does not reflect overutilization. 

*   (d)    Quality.  In making determinations as to quality, 
*the commissioner may consider the extent to which the proposed 
*arrangement is likely to: 

*   (1) decrease morbidity and mortality; 

*   (2) result in faster convalescence; 

*   (3) result in fewer hospital days; 

*   (4) permit providers to attain needed experience or 
*frequency of treatment, likely to lead to better outcomes; 

*   (5) increase patient satisfaction; and 

*   (6) have any other features likely to improve or reduce the 
*quality of health care."