South Carolina Healthy Outcomes Plan (HOP) SCDHHS Perspective Deirdra Singleton│ May 30, 2014
Where We’ve Been
Components of Proviso 33.34 • Health system does a poor Healthy Outcomes Plan (HOP) job prioritizing who is in need of services Hospital Transparency and DSH Graduate Medical Education (GME) • Once identified, individuals OB/GYN & Telemedicine who are poor or living with Optional State Supplementation disabilities generally enter (OSS) a system not designed to meet their needs • Proviso 33.34 addresses the root causes of these problems Proviso 33.34 Outcome of the General • Assembly passed FY 2014 budget State-based plan to improve • health while increasing value and transparency
Healthy Outcomes Plan IDENTIF FIND ASSESS MANAGE Outreach PAM, GAIN-SS Develop care Y plan Prioritize people in need
Healthy Outcomes Plan HOP Comparative Enrollment, Assessments and Care Plans 140% As of April 30, 2014 120% 100% Enrollment T arget 80% 60% 40% 20% 0% Enrolled PAM GAIN Care Plan HOPs
Next Year
Legislative Funding Proviso 33.26 Proviso 33.34 Purpose Proposed FY 13/14 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 $2M $2M Clinics Primary Care Safety Net – Innovative $5M $5M Care Rural Provider Capacity – $8M $10M T elemedicine Care Coordination – Alcohol/Drug n/a $2M Services Note: The FY 14/15 budget is not finalized, and there is a House and Senate version. Total $77M $91M
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)
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