Agenda - 10-12-2010 - Board of Health Meeting

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19 How does the health reform law affect Medicaid disproportionate share hospital (DSIIJ payments? The health reform law does implement Medicaid DSH reductions-from 2014 to 2019, the law contains a total of $14.1 billion in Medicaid DSH cuts. Does the health reform law contain any new requirements for nonprofit hospitals? Yes-in 2010, there are additional requirements for nonprofit hospitals to provide charity care, as well as conduct and implement a community health needs assessment in coordination with public health experts and community leaders. These new requirements will be enforced through a $50,000 annual fee for noncompliance. Delivery Systems, Health Care Access and Ouality Improvement Does the health reform law contain measures that may help improve health care access, delivery and quality? Yes there are a number of provisions within the law that are designed to improve access to quality health Gaze. Medicaid, Medicare & CHIP Delivery System, Access and Quality Improvement Measures Does the health reform law contain initiatives that are designed to improve Medicare, Medicaid and the Children's Health Insurance Program (CHIP)? Yes-the health reform law authorizes the creation of a Center for Medicaze and Medicaid Innovation. This unit within the Centers for Medicaze and Medicaid Services will be responsible for coordinating pilot and demonstration projects for payment and service delivery models to improve the efficiency and quality of Medicaze, Medicaid and CHIP. What types of provisions within the health reform law may help improve care for individuals who are eligible for both Medicare and Medicaid? For individuals who aze eligible for both Medicare and Medicaid (often referred to as "dual eligibles"), the law creates the Federal Coordinated Health Care Office within the Centers for Medicare and Medicaid Services. This office, to be created in 2010, will be charged with improving Gaze coordination for dually eligible individuals to increase their access to quality health caze. What other Medicaid program innovations designed to improve care are in the health reform law? The health reform law contains a number of new Medicaid demonstration projects: • Bundled payments for episodes of care involving hospitalization (effective January 1, 2012-December 31, 2016) • Global capitated payments to safety net hospital systems (effective FY2010-FY2012) • Allow pediatric medical providers to share in cost-savings if they are organized as accountable Gaze organizations (effective January 1, 2012-December 31, 2016) • Provide Medicaid payments to institutions of mental disease for adult enrollees who require stabilization of an emergency condition (effective October 1, 2011-December 31, 2015) Also, the law extends the Medicaid Money Follows the Person Rebalancing Demonstration program through September 2016. Additionally, in 2011, there will be a new state plan option to permit certain Medicaid enrollees to designate a provider as a health home. Eligible enrollees would be individuals with at least two chronic conditions, one condition and the risk of developing another, or at least one serious and persistent mental health condition. Participating states would be given a 90 percent FMAP for two years. 13