CHASE Board Meeting October 22, 2019 Nancy Dolson Department of Health Care Policy & Financing
Hospital Transformation Program • Timeline • Community Advisory Council • Proposed Rural Support Fund 2
HTP Timeline Stakeholder Engagement Stakeholder Engagement Final Reports from Hospitals Sept- Public Comments Public Notice of SPA Aug Scoring Methodology Oct 31 Jul Draft of SPA (9/30) Stakeholder Engagement Measures Specifications 30 Draft of 1115 Waiver (10/30) Nov SPA Feedback & Comments Collection of Baseline Data Sep Public Notice of 1115 Waiver Participating hospital application SPA Hospital Reporting Milestones Effective Date 1115 waiver budget neutrality completed 2019 10/1/19 1115 waiver special terms and conditions finalized Jan 2020 MSB Initial approval (1/10/20) 1 Apr – MSB final adoption (2/14/20) Apr 31 Dec Dec Rule effective date (3/30/20) 2020 Hospitals begin application* (4/15/20) Stakeholder Engagement Medical Services Board (MSB) public rule review meeting Waiver public comment period ends Final draft of SPA submitted to CMS Section 1115 waiver submitted to CMS *assuming 3/31/20 SPA approval by CMS 3
HTP Waiver Timeline • Public Notice November 10 • Public hearings ➢ CHASE ➢ Medical Care Advisory Committee ➢ Webinar • Waiver submission to CMS December 31 • Federal public notice 30 days • Federal decision making minimum 45 days 4
HTP Community Advisory Council • https://www.colorado.gov/pacific/hcpf/HTP- Community-Advisory-Council 5
HTP Proposed Rural Support Fund • See handout • Funding to support hospitals to prepare for future value-based payment environments • $12 million per year, each of five years of waiver • Critical Access and non-resort rural hospitals • Funds to hospitals with most financial distress based on evaluation of financial and utilization information 6
HTP Proposed Rural Support Fund • Questions ➢ Determining which hospitals will receive funds ➢ Amount of funds to hospitals ➢ Other? • Stakeholder feedback ➢ CHASE Board ➢ Rural Health Center Conference, HTP Rural Hospital Workgroup, Western Healthcare Alliance, Eastern Plains Healthcare Consortium, others 7
Hospital Expenditure Report The hospital expenditure report must include, but not be limited to: (a) A description of the methods of analysis and definitions of report components; (b) Uncompensated care costs by major payer group; and (c) The percentage that each of the following categories contributes to overall expenses of hospitals: (I) Delivery of inpatient health care and services by major payer group; (II) Delivery of outpatient health care and services by major payer group and site location; (III) Administrative costs; (IV) Capital construction costs and associated bond liabilities; (V) Maintenance; (VI) Capital expenditures; (VII) Personnel services; (VIII) Uncompensated care by major payer group; and (IX) Other expenditure categories, as determined by the state department. 8
Hospital Expenditure Report • January 15, 2020 report Current activities and implementation progress ➢ No individual hospital data ➢ • Subsequent annual reports beginning January 2021 Include all required information ➢ Hospitals have 15 days to review the report and underlying data ➢ prior to publication Also, data to be used for cost shift analysis in CHASE annual ➢ report 9
Hospital Expenditure Report • Executive Summary with Overview and Key Findings • Introduction with Purpose and Background • Methodology Statement of methods, Peer Groups, Regionality, and Limitations ➢ • Uncompensated Care Bad Debt and Charity Care ➢ • Expenditure Categories • Appendix Compiled hospital data and definitions of the report’s components ➢ 10
Hospital Expenditure Report • Peer groups ➢ 25 and fewer licensed beds ➢ 26 to 90 licensed beds ➢ 91 and more licensed beds • Regionality ➢ Division of Insurance rating areas 11
DOI Insurance Rating Areas 12
Hospital Expenditure Report 13
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Thank You Nancy Dolson Special Financing Division Director Department of Health Care Policy & Financing nancy.dolson@state.co.us
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