AHCCCS Update AHCCCS Tribal Consultation Meeting October 27, 2010 - - PowerPoint PPT Presentation

AHCCCS Update

AHCCCS Tribal Consultation Meeting October 27, 2010 Sells, Arizona

Topics to Cover

Tribal Consultation Policy Budget Health Care Reform

Tribal Consultation

AHCCCS Tribal Consultation Policy

AHCCCS and Indian Tribes in the State of Arizona share the common goal of decreasing health disparities and maximizing access to critical health services. In order to achieve this goal, it is essential that the AHCCCS Administration and Indian Tribes engage in open, continuous, and meaningful consultation on a government-to-government basis.

Agency has regular Tribal Consultations

9 in current Calendar Year – Second meeting on Tribal lands 7 in 2009 6 from 2006-2008

All information from previous meetings is available on web

American I ndians in AZ & AHCCCS American I ndians in AZ & AHCCCS

Arizona Residents

• Arizona population: 6,343,952
• 285,183 AI Arizona residents

AHCCCS Members

• AHCCCS members: 1,374,653
• 141,432 AI AHCCCS members

Source: U.S. Census Bureau, 2006-2008 American Community Survey Source: AHCCCS, October 1, 2010

100% Federal Indian Health Service & Tribal Facility Payments

(In Millions)

50 100 150 200 250 300 350 400 FY 2004 FY 2005FY 2006 FY 2007FY 2008FY 2009 FY 2010

AHCCCS Population as of July 1, 2010

1985 – 2010

144,450 456,385 508,917 318,383 1,047,982

• 200,000

400,000 600,000 800,000 1,000,000 1,200,000 1,400,000 1 9 8 5 1 9 8 6 1 9 8 7 1 9 8 8 1 9 8 9 1 9 9 1 9 9 1 1 9 9 2 1 9 9 3 1 9 9 4 1 9 9 5 1 9 9 6 1 9 9 7 1 9 9 8 1 9 9 9 2 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9

.

2010

1,352,908

AHCCCS/TOTAL MEDICAID STATE MATCH SFY2006-SFY2015

$0 $500,000,000 $1,000,000,000 $1,500,000,000 $2,000,000,000 $2,500,000,000 $3,000,000,000 $3,500,000,000 $4,000,000,000 $4,500,000,000 SFY06 SFY07 SFY08 SFY09 SFY10 SFY11 SFY12 SFY13 SFY14 SFY15 Stimulus Other County Tobacco General

AHCCCS/TOTAL MEDICAID STATE MATCH SFY2006-SFY2015

$0 $500,000,000 $1,000,000,000 $1,500,000,000 $2,000,000,000 $2,500,000,000 $3,000,000,000 $3,500,000,000 $4,000,000,000 $4,500,000,000 SFY06 SFY07 SFY08 SFY09 SFY10 SFY11 SFY12 SFY13 SFY14 SFY15 Other County Tobacco General

Expenditure Changes FY 2007-FY 2011

9 *Medicaid numbers assume regular FMAP

AHCCCS Budget

3 Options for Policy Makers when dealing

with AHCCCS budget reductions

Eligibility – Limit - Health Care Reform Payment Rates – Limit–Network & Access to Care Benefits – Limit – Federal Requirements

Each has limitations but to date all have been

utilized

Program today is over $800 million less as a

result of policy decisions

AHCCCS Budget changes to Date

AHCCCS Program is $800 million less as

a result of policy changes

$413 million in provider reductions $241 m in institutional rate freezes $121 m in eligibility reductions $39 m in benefit changes $29.5 m in admin reductions $28 m in increased member cost sharing

AHCCCS Benefit Changes

Federal government establishes mandatory

and optional benefits

October 1, 2010 Benefit Changes - $10 m

General Fund

Adult Emergency Dental Care Services provided by Podiatrist Select Transplants - Well Exams - Orthotics Limit Physical Therapy to 15 visits per year

State has been trying to secure benefit

waiver for IHS and 638 Pass through payments

AHCCCS Budget

FY 2012 - $1 billion shortfall for FMAP FY 2012 AHCCCS funding will be one of the

biggest issues facing new legislature

Population Growth Slowing –

CY 2008 - 65,000 CY 2009 - 210,000 CY 2010 – (18,000) – Base up 30,900 - KidsCare

(19,600) -FES (29,300)

AHCCCS Budget Cont.

AHCCCS will be implementing provider reductions on

April 1, 2011

Hospitals up to 5% Other Providers being evaluated

Looking to establish limit on number of Inpatient

Days

Cost Sharing/Copays - Agency working to maximize

Mandatory copays implemented 10-1-10 Injunction has prevented implementation for Prop 204 pop.

Provider Tax continues to be discussed by

stakeholders

Health Care Reform

PPACA expands Medicaid to 133% of the federal

poverty limit on January 1, 2014.

Nationally Medicaid is estimated to grow by 16

million lives

Create Health Exchange

provide tax credit subsidy for individuals from

133% to 400%

Nationally Exchanges are expected to cover 24

million lives by 2019

State needs to determine who will operate

Exchange

Established Individual Mandate

Health Care Reform

Several Components exist in Arizona

Population Expansion – Childless adults Appropriate Payment to ensure access Emphasize home and community

services

Develop models to meet challenges of

dual eligible population

Health Insurance Exchange

Nationally anticipated to enroll up to 24 m Provide electronic marketplace for those

receiving subsidy

Legislation establishes variety of plans Exchange is responsible for regulating plans

• ffered

Exchange is responsible for interfacing with

Medicaid to determine if eligible

Health E-Arizona Applications

50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 FY 2006 FY 2007 FY 2008 FY 2009 FY 2010 Public Subscriber

Exchange Policy Questions

Should the State Run an Exchange? If Yes where should it be housed? – Insurance –

AHCCCS – New Entity

How do we get a decision by the Spring of 2011? What is role of AHCCCS in exchange and can current

member enrollment infrastructure be leveraged?

How can product on the Exchange be established to

meet unique needs of American Indians?

With Exchange implementation on 1-1-2014 has the

purpose for HCG ended?

AHCCCS Staffing Levels

800 900 1000 1100 1200 1300 1400 1500

Jan-07 Mar-07 May-07 Jul-07 Sep-07 Nov-07 Jan-08 Mar-08 May-08 Jul-08 Sep-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09 Nov-09 Jan-10 Mar-10 May-10

Employees