Increased administrative burden, reduced flexibility in care and risk of patient harm are just a few of the concerns Minnesota Academy of Family Physicians (MAFP) members have raised about the Minnesota Restricted Recipient Program (MRRP). The MRRP was created to curb misuse of health care services but has unintentionally limited access to necessary care.
Adopted MAFP Resolution: A Call for Re-Evaluation
At the 2025 MAFP Resolution Forum, members passed the following resolution:
Resolution 2025-03
Increased Primary Care Burden and Risk of Patient Harm: Addressing the Problems with the Minnesota Restricted Recipient Program
BE IT RESOLVED that the MAFP partner with other stakeholders to advocate for the Minnesota Department of Human Services to re-evaluate parameters of the Minnesota Restricted Recipient Program to limit burden on primary care physicians and other providers and undue harm on patient care.
What is the MRRP?
The MRRP was developed to improve safety and care quality, while reducing costs for recipients of Minnesota Health Care Programs (MHCP) who have misused services. Authorized by federal regulation, the program is managed jointly by the Minnesota Department of Human Services (DHS) and the state’s eight Managed Care Organizations (MCOs).
Recipients are identified through data showing overuse of emergency rooms, early prescription refills or the use of multiple physicians and pharmacies. Once identified, they are placed into the MRRP and must receive care through a designated primary care physician (PCP), clinic, hospital and pharmacy for up to 36 months.
Key restrictions include:
- PCPs must practice family medicine, internal medicine or general practice (specialists are not eligible).
- PCPs must have hospital privileges at the designated hospital.
- All providers must be located within 30 miles of the patient’s home.
- PCPs are responsible for all care coordination and may deny referrals they feel are inappropriate.
What We Heard from MAFP Members
During a recent MAFP Community Conversation with DHS, family physicians across Minnesota voiced deep concerns about the program, including:
- Access Delays: Doctors shared stories of patients being unable to access care or prescriptions when their PCP was unavailable, leading to unnecessary ER visits and frustrations for patients and health care teams.
- Administrative Burden: Being assigned to one PCP does not reflect the reality of modern practice, where health care teams and partners work together to care for patients. When a family physician or the designated PCP is out of the office, there can be disruptions in patient care that other team members cannot address. One MAFP member shared how they had to call in hospice pain medications from a hiking trail while on PTO because they were the sole MRRP-designated PCP for the patient.
- Inconsistencies: Some members reported being assigned MRRP patients even though they lacked hospital privileges, contrary to program rules.
- Communication Challenges: While DHS shared contact numbers for support, members reported consistently long wait times when calling for assistance.
What’s Next?
The MAFP will continue to engage DHS and other stakeholders to push for improvements to the MRRP that reduce administrative burden and support timely, patient-centered care. Members have advocated for solutions such as:
- Implementing emergency overrides when the assigned physician is unavailable or allowing partners at the designated primary care clinic to provide backup coverage.
- Clarifying assignment criteria, including physician hospital privilege requirements.
- Improving physician support systems with faster, more responsive communication channels that are easily accessible by all members of the health care team.
Have Feedback or Experience with the MRRP?
We want to hear from you. If you have experiences—positive or negative—with the MRRP as the designated PCP or care team member, please contact us or share your story at our next member forum.
Together, we can advocate for a program that truly supports patient safety without compromising access to care or overburdening family physicians and their teams.
