AM Utah Hosp Assoc 8-18-09 [Compatibility Mode]

AM Utah Hosp Assoc 8-18-09 [Compatibility Mode] - 1 Update...

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Unformatted text preview: 1 Update From Washington: Obama Administration & Health Care Reform UHA Annual Board Retreat Sun Valley, Idaho August 18, 2009 2 Overview Overview • Recent regulatory action • Health reform update • Messages for recess…and getting ready for the Fall Medicare Inpatient PPS Rule • Sets rates for FY 2010…starting October 1, 2009 • Final rule issued July 31 • Key issues: – Behavioral offset…coding or classification changes which do not reflect real changes in case mix – Capital IME FY 2010 Market basket 2.1 % Coding - 1.9 % Outliers - 0.3 % 508- 0.2 % “Other” - 0.2 % Net update - 0.5 % 3 Medicare Inpatient PPS Rule • Sets rates for FY 2010 starting October 1, 2009 • Final rule issued July 31 • Key issues: – Behavioral offset ($2.2 billion) – Capital IME ($5 billion over ten years) FY 2010 Market basket 2.1 % Coding - 1.9 % Outliers - 0.3 % 508- 0.2 % “Other” - 0.2 % Net update + 1.6 % Medicare Inpatient PPS Rule (final) Rural Provisions Critical Access Hospitals • Make clinical labs of CAHs provider-based (35 mile) • Reimburse Method 2 at 100% for facilities Medicare-Dependent Hospitals • Apply a cumulative, retroactive budget neutrality adjustment to MDH FY 2002-based hospital-specific rates. • Expected to affect approximately 50 MDHs and cuts approximately $5 million in FY 2010. 4 Health Care Reform • “ Pay or play” for employers with individual mandate • Medicaid/CHIP expansions • Tax credits for small employers to purchase coverage • National “Exchange” • Payment reform… “coordinated care” General Direction General Direction • What will be the role of government? • How will we pay for it? • What is the legislative process? Health Care Reform Health Care Reform Threshold Political Issues Threshold Political Issues 5 • Organizing the “market” – Should the exchange/connector have a “public” program? – “Crowd out” – Payment adequacy Role of Government Role of Government • Organizing the “market”: – Should the exchange/connector have a “public program? – How should the private plans be regulated? – Public program “alternatives” h Backup approach h Narrow eligibility h Not linked to Medicare rates h Separate from CMS and self-sustaining Role of Government Role of Government Sen. Conrad 6 • Organizing the “market”: – Should the exchange/connector have a “public program? – How should the private plans be regulated? – Public program features: h Backup approach h Narrow eligibility h Not linked to Medicare rates h Separate from CMS and self-sustaining- Should there be a federal health board? (Super MedPAC/IMAC) Role of Government Role of Government • What will be the role of government?...
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This note was uploaded on 09/16/2010 for the course NUTS 1123 taught by Professor Long during the Spring '10 term at École Normale Supérieure.

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AM Utah Hosp Assoc 8-18-09 [Compatibility Mode] - 1 Update...

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