Green Mountain Care Board FY 2019 Budget June 27, 2018 The Role of - - PowerPoint PPT Presentation

Green Mountain Care Board FY 2019 Budget June 27, 2018

The Role of GMCB

Health insurer rate review (including the Exchange) Hospital Budgets ACO Budgets VITL Budget Major capital expenditures (Certificate of Need) Health Resource Allocation Plan (HRAP) Implementation of APM ACO Oversight, Certification, Rule 5.0 (Act 113) Review/modify/approve plan designs for Vermont Health Connect Data and Analytics (VHCURES, VUHHDS and APM Analytics) Primary Care Advisory Group Billback Fund Management Expenditure Analysis Cost Shift Report Outreach and Education/ OML Approve State HIT and Health Care Workforce Plan Prescription Drug List Per Act 165

2

The Green Mountain Care Board is charged with reducing the rate of health care cost growth in Vermont while ensuring that the State of Vermont maintains a high quality, accessible health care system.

Green Mountain Care Board FY 2019 Budget

MISSION: The mission of the Green Mountain Care Board (GMCB) to regulate, innovate, and evaluate Vermont's changing health care system to improve the health of the population, provide access to high quality health services for all residents of the state, and ensure the affordability

• f health care by reducing the rate of growth in

health care costs.

FY 2019 SUMMARY & HIGHLIGHTS

• $211k base, ongoing reduction in contracts
• Requested by House Appropriations in

lieu of eliminating three limited service positions from our base

• 4.1% General Fund reduction
• 5 Board, 5 Exempt, 22 Classified positions
• Performance Year 1 All-Payer Model
• Alignment of regulatory responsibilities
• Process Updates: Rate review, hospital budget
• Updated, more robust data analytics initiatives
• Health Care Advocate increased by House

Appropriations to level fund with FY18

General Fund , 2,032,469 , 25% HIT Fund , 60,000 , 1% Global Commitment , 2,495,518 , 31% Federal Funds , 70,000 , 1% Billback , 3,386,789 , 42%

GMCB FY19

FY18 As Passed to FY19 As Passed

4

Total Appropriations

5

$5,000,000 $5,500,000 $6,000,000 $6,500,000 $7,000,000 $7,500,000 $8,000,000 $8,500,000 $9,000,000 $9,500,000 $10,000,000 FY15 FY16 FY17 FY18 FY19

Appropriation by Fund Source

6

• 500,000

1,000,000 1,500,000 2,000,000 2,500,000 3,000,000 3,500,000 4,000,000 4,500,000 FY14 FY15 FY16 FY17 FY18 FY19 General Fund Global Commitment Federal Fund Interdepartmental Funds Special Funds

RBA: Rates for VT Health Connect Products

BCBS – FY18 $14.4M savings to VHC insured population MVP – FY18 $1.8M savings to VHC insured population

7

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 2015 2016 2017 2018 Approved Proposed 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 2015 2016 2017 2018 Approved Proposed

RBA: Hospital Budget Review

All 14 Hospital Systems in Vermont Proposed & Approved Hospital Budget Rate (price & utilization) Proposed & Approved Annual Price Increases

8

• 0.5%

0.5% 1.5% 2.5% 3.5% 4.5% 5.5% 2015 2016 2017 2018 Proj Approved Proposed Target 0.0% 1.0% 2.0% 3.0% 4.0% 5.0% 6.0% 7.0% 2015 2016 2017 2018 Proj Approved Proposed

9

Pre-GMCB Average % Increase 7.3%