South Carolina Healthy Outcomes Plan (HOP) SCDHHS Perspective - - PowerPoint PPT Presentation

South Carolina Healthy Outcomes Plan (HOP)

SCDHHS Perspective Deirdra Singleton│ May 30, 2014

Where We’ve Been

Healthy Outcomes Plan (HOP) Hospital Transparency and DSH Graduate Medical Education (GME) OB/GYN & Telemedicine Optional State Supplementation (OSS)

Proviso 33.34

• Outcome of the General

Assembly passed FY 2014 budget

• State-based plan to improve

health while increasing value and transparency

• Health system does a poor

job prioritizing who is in need of services

• Once identified, individuals

who are poor or living with disabilities generally enter a system not designed to meet their needs

• Proviso 33.34 addresses

the root causes of these problems

Components of Proviso 33.34

Healthy Outcomes Plan

FIND

Outreach

IDENTIF Y

Prioritize people in need

ASSESS

PAM, GAIN-SS

MANAGE

Develop care plan

Healthy Outcomes Plan

0% 20% 40% 60% 80% 100% 120% 140% Enrolled PAM GAIN Care Plan

HOPs

HOP Comparative Enrollment, Assessments and Care Plans

As of April 30, 2014

Enrollment T arget

Next Year

Legislative Funding

Purpose

Proviso 33.34

FY 13/14

Proviso 33.26 Proposed

FY 14/15 Rate Increase $35M $35M Rural Hospital DSH Payment (100%) $20M $25M Primary Care Safety Net – FQHC $5M $8M FQHC – Capital Needs $2M $4M Primary Care Safety Net – Free Clinics $2M $2M Primary Care Safety Net – Innovative Care $5M $5M Rural Provider Capacity – T elemedicine $8M $10M Care Coordination – Alcohol/Drug Services n/a $2M Total $77M $91M

Note: The FY 14/15 budget is not finalized, and there is a House and Senate version.

Where We Are Going

DSH Waiver

Current DSH

• Inflexible
• Retrospective

Future DSH: DSH Waiver

• Flexible
• Less prescriptive
• More innovative
• Proactive
• Prospective
• Stakeholder input essential on

DSH waiver

• CMS approval (comprehensive)