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State budget, Upl , and HCAP update

State budget, Upl , and HCAP update. Southwestern Ohio HFMA Event. May 11, 2017. State Budget. Medicaid expansion reauthorized 100-138% FPL will pay premium of $20/mo. Able-bodied expansion population will need to be employed or in a training program Legislature wants to control spending

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State budget, Upl , and HCAP update

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  1. State budget, Upl, and HCAP update • Southwestern Ohio HFMA Event May 11, 2017

  2. State Budget Medicaid expansion reauthorized • 100-138% FPL will pay premium of $20/mo. • Able-bodied expansion population will need to be employed or in a training program • Legislature wants to control spending Cuts to hospitals eliminated • However, payments to hospitals cannot exceed $6.9 billion in either of the next two fiscal years State Budget, UPL, and HCAP Update│ Southwestern Ohio HFMA Event

  3. State Budget New transparency law same as the old • This is the same law OHA and other provider groups are suing over • Must give out-of-pocket expense, insurance payment to provider, and total charges regardless of request • Previously eliminated by Governor Kasich Stay tuned to Senate • We expect spending to go down Insert Presentation Title │ Insert Audience/Group

  4. UPL Ohio Medicaid Overview & Update │ Mercy Health Finance

  5. 2016 HCAP Refresher Insert Presentation Title │ Insert Audience/Group

  6. 2017 HCAP Program size gets inflationary increase • Scheduled DSH cuts start next year Currently in final 30-day window for cost report changes • “Cover charge” of .03% of adjusted total facility costs OBRA Caps about even with 2016 model • FFS shortfall & UC costs down, MCO shortfall up Insert Presentation Title │ Insert Audience/Group

  7. 2017 HCAP Elimination of Pot 3A for 2017 model • Funds moved to Pot 2, completing transition • Now almost entirely OBRA-based Can estimate 2017 payments from OBRA cap • Unless hospital qualified for Pot1 last year and will not this year, or Pot 3A payment was large Pots 5 (closed hospital) and 7 (statewide residual) are back Insert Presentation Title │ Insert Audience/Group

  8. Daniel Vielhabeer Manager, Health Economics and Policy Daniel.Vielhaber@ohiohospitals.org

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