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Larry E. Tisdale Vice-President of Finance. Medicaid Redesign. Better for Idaho’s taxpayers, businesses, and patients. \=. Where we stand. Community Health Centers. Who are the “medically indigent”?. Working Idahoans Self-employed & Small Business Employees

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Presentation Transcript
slide1

Larry E. Tisdale

Vice-President of Finance

medicaid redesign

Medicaid Redesign

Better for Idaho’s taxpayers, businesses, and patients

where we stand
Where we stand
  • Community Health Centers
who are the medically indigent
Who are the “medically indigent”?
  • Working Idahoans
  • Self-employed & Small Business Employees

Idaho’s minimum wage = $15,080/year

Idaho average salary = $38,000/year

Annual Cost of Living *

* U.S. Bureau of Labor Statistics - averages are based on 2.6 person households

slide7

Status Quo

High cost

Forecast

Spent

County Indigent Fund – supported entirely by property taxes

slide8

Status Quo

High cost

Forecast

Appropriated

State Catastrophic Fund – supported entirely by income taxes

low value
Low Value
  • Status Quo
financial risk
Financial Risk
  • Status Quo
financial risk1
Financial Risk
  • Status Quo
slide14

MedicaidRedesign

Eliminate Waste

Over $1 billion

in tax dollars from

2014 - 2024

Half fiscal year

slide15

Coverage for Working Idahoans

MedicaidRedesign

68% of those who qualify have at least one full-time worker in the household;

16% have one or more part-time workers

slide16

Provide Coverage for Working Idahoans

Medicaid Redesign

  • Provides coverage to adults earning <138% of FPL or a family of four must have income less than $32,500
  • Adults age 19-64
  • Must be legal Idaho residents

Idaho minimum wage = $7.25/hr or $15,080/yr

slide17

Redesign the System

  • Medicaid Redesign
  • Personal responsibility and accountability
  • Coordinated Care
  • Managed Care for chronic conditions
  • Reduce waste through technology and electronic health records
for idaho s economy

Far Reaching Effects…..

for Idaho’s Economy

  • Status
  • Quo

Medicaid Redesign

$12.3-18.5 million in federal penalties for businesses

Healthier Workforce

Rising taxes or budget cuts to critical programs

16,000 new jobs

Not attractive to new businesses

Bringing Idaho taxes back to Idaho

slide20

Status

  • Quo

Medicaid Redesign

$1.5 Billion

$85 Million

only one choice
Only one choice

www.TheRightMedicineForIdaho.org

potential legislative activity
Potential Legislative Activity
  • Medicaid Expansion ?
  • Insurance Exchange
  • Time Sensitive Emergencies
  • Hospital Tax Exemptions
  • Managed Care for Dual Eligibles HB351
  • Battery of Health Care Workers
  • Medically Indigent Statute changes
  • Idaho Physician Shield Act (IMA)
  • Transparency
  • State Health Innovation Plan (SHIP)
medicaid expansion
Medicaid Expansion
  • Not a current initiative for the 2014 Legislative Session
  • Governor Otter “current Medicaid system is broken”
  • Currently exploring 1115 waiver possibilities
insurance exchange
Insurance Exchange
  • Passed by last year’s Legislature
  • Current exchange is federally supported
  • This is mostly a political fight
time sensitive emergencies
Time Sensitive Emergencies
  • TSE is a statewide system for the coordinating and delivering evidence based care
  • Includes trauma, strokes and heart attacks (STEMI)
  • Hospital designation and participation is voluntary
  • Allows billing for trauma team activation
    • Certified by American College of Surgeons
    • Designated by the State
hospital tax exemptions
Hospital Tax Exemptions
  • Largely a political misinformation campaign
    • CEO Compensation
    • Physician Employment
    • Profit Margins
  • Increasing taxes on community hospitals will not lower the cost of health care
managed care for medicaid medicare
Managed Care for Medicaid/Medicare
  • HB351 Manditory or Voluntary enrollment?
  • In response to HB260 from 2011
  • Largest issue may be with nursing facility payments
    • UPL
    • Quality Incentives
battery of health care workers
Battery of Health Care Workers
  • Carryover from last year
  • Makes it a felony to assault hospital workers
  • New version includes non-licensed workers
  • Lesser punishment than first responder assault
  • Tough sell with the Legislature
medically indigent statute changes
Medically Indigent Statute Changes

Two potential Proposals:

  • Eliminate funding over 100% of federal poverty level
  • Remove money to fund “community clinics”
idaho physician shield act
Idaho Physician Shield Act
  • Ensures that no guideline or metrics established by the PPACA shall be used as a basis for establishing community standards of care
  • IHA has no formal position at this time
transparency
Transparency
  • Again?
  • IHA opposes transparency based solely on pricing data
  • States’ websites that have pricing information go largely unused
  • IHA would support transparency of quality data
state health innovation plan ship
State Health Innovation Plan (SHIP)
  • There is potential for a resolution supporting the design model
  • The design grant ended in December 2013
  • The Department of Health and Welfare is in the process of applying for a testing grant