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Legislative Update

Legislative Update. National Health Reform Update. Senate HELP Bill Detail missing Senate Finance Three options papers set the stage OMB scores “draft” at $1.6 billion; target <$1 Billion White House involvement House Tri-Committee Bill Productivity Offsets

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Legislative Update

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  1. Legislative Update

  2. National Health Reform Update • Senate HELP Bill • Detail missing • Senate Finance • Three options papers set the stage • OMB scores “draft” at $1.6 billion; target <$1 Billion • White House involvement • House Tri-Committee Bill • Productivity Offsets • No DSH cuts; includes physician self-referral

  3. Hospitals Reach Agreementon Health Reform • Stakeholders Involved: • White House • Senate Finance Chairman Max Baucus (D-MT) • AHA • Catholic Health Association • Federation of American Hospitals • Caps hospital spending cuts to $155 billion over 10 years • AHA estimates that hospitals would see reduced uncompensated care of at least $171 billion over 10 years

  4. Key Elements of the Agreement • Coverage • Starting in 2013, policies will be implemented to expand coverage to 95% of all Americans, and require a mandatory employer contribution and an individual mandate • Hospital Spending Reductions • $155 billion over 10 years • Market basket cuts (-1.0% per year over 10 years) • No DSH cuts for 5 years • Reductions begin in 2015 • After 10 years – 60% preserved • Reduction in payments for Hospital Readmissions • Focus on “avoidable” cases • Related to the initial admission

  5. Key Elements of the Agreement • Public “Exchange” • Details to be forthcoming • Delivery System Reforms • Value-based purchasing provisions that are budget neutral • Bundling – pilot project • Restrictions on physician self-referral • Medicare-approved slots for physician GME is increased • Tax-Exempt Status • Maintains the community benefit standard for hospital tax-exemption • No formulas or tests on the amount of charity care provided

  6. Kansas“Health Reform” Initiatives PASSED: • Increased CHIP coverage to 250 percent of the Federal Poverty Level • Dental Coverage for Pregnant Women FAILED: • Premium Assistance Program STILL AVAILABLE: • Statewide Smoking Ban, plus Tobacco Tax • Additional Assistance for Small Businesses • Health Care Transparency • Medical Home Model • Expanded Coverage for Adults

  7. Implications of the State Budget • Revenues continue to plummet • May/June 09 revenues $126 million below projections • Governor’s July 2009 Actions • $90.6 million in spending cuts (2 percent cuts) • $70 million in new revenues • $700 million in certificates (internal borrowing) • Current Environment for KHPA • Increasing backlog of Medicaid applications • Reduction in staff • Lack of resources to implement new policies • Further Reductions in KHPA Budget • Unlikely to be absorbed through Medicaid Ops • Decrease in Medicaid provider reimbursement rates?

  8. Changes to the KHPA • New Leadership • Dr. Andy Allison, Ph.D. as KHPA Executive Director • Dr. Barb Langner, Ph.D. as Medicaid Director • Agency Dilemma • Whether to focus solely on the operations of the Medicaid program OR continue providing policy recommendations on health initiatives • Legislative Changes to KHPA • Independent vs. Governor-led • Medicaid Operations vs. Health Policy

  9. Next Steps… • Meet with your Legislator • Invite to hospital • Need help, let KHA know • Find the connections • Trustees • Staff • Other community members

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