Agenda - 02-29-2000-8i - Laserfiche WebLink

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s .~: ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: February 29, 2000 Action Agenda Item No. „$. 1. SUBJECT: Contract With DMG-Maximus, Inc. to Conduct a Cost Study for Personal Health Services DEPARTMENT: Health PUBLIC HEARING: (Y!N) No ATTACHMENT(S): INFORMATION CONTACT: Contract Rosemary Summers, ext 2411 TELEPHONE NUMBERS: Hillsb6rough 732-8181 Chapel Hill 9fi8~501 Durham 688-7331 Mebane 336-227-2031 PURPOSE: Contract between DMG-Maximus, Inc. and Health Department to conduct a cost study for the purpose of setting fees for personal health services. BACKGROUND: Traditionally the Orange County Health Department has charged very minimal fees for only a few of the personal health care services it provides. The Department has billed the Medicaid program for services provided to Medicaid-eligible clients, which has comprised approximately 13% of the department's total budget and 19% of the personal health services budget. These bills have been submitted in a "bundled" format. For example, a patient might be seen for a well child check-up that would include a physical exam, an immunization, and perhaps some laboratory tests, and all of those services would have been "bundled" and submitted to Medicaid as a single bill. Beginning July 1, 2000 the North Carolina Medicaid program is requiring all health departments to submit "unbundled" bills for all services eligible for Medicaid reimbursement. The cost for each individual service rendered must be submitted to Medicaid. The department must be able to show actual costs for each service to justify the amount billed. This then requires the health department to establish cost figures for each individual personat health service provided. A cost study will also allow the department to establish fees and thereby bill third party payors such as Blue Cross and Blue Shield for Health Choice clients and others who have private insurance. There are approximately 40-50 procedure codes for which the department needs to establish cost figures. Due to current workloads, staff in the health department do not have time to conduct the study internally. The department conducted some preliminary work in this regard last spring through the use of students from the School of Public Health, however, students cannot meet the July 1 time frame that the_department must meet. In addition, the establishment of fees is expected to impact budget projections for the fiscal year 2000-2001. In consultation with the Finance Director, the department contacted DMG-Maximus, Inc. They