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A Proposal for Medicaid Reform: Preserving and Improving Access to Care

A Proposal for Medicaid Reform: Preserving and Improving Access to Care. Prepared by The Mississippi Hospital Association Madison, Mississippi. Why Reform?. Mississippi Healthcare Providers and Hospitals. Mississippi Leadership. Mississippians. $624,134,531 uncompensated care cost

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A Proposal for Medicaid Reform: Preserving and Improving Access to Care

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  1. A Proposal for Medicaid Reform:Preserving and Improving Access to Care Prepared by The Mississippi Hospital Association Madison, Mississippi

  2. Why Reform? Mississippi Healthcare Providers and Hospitals Mississippi Leadership Mississippians • $624,134,531 uncompensated care cost • Reduced services • Reduced work force • Bankruptcy • Five facilities closed since 2010 • NO to ObamaCare!!! • State can’t afford it! • What if the Feds stop funding the program?? • Don’t want to expand a broken program • A Texas court ruled “expansion” unconstitutional • Non-disabled; without coverage • Limited access to care • Age 19-64 • Below 138% federal poverty • 163,000-300,000 Mississippians • Two-thirds working • Looking for a better life

  3. What not “Traditional MEDICAID EXPANSION”? Managed Care Organizations

  4. Based on historical performance, Do we want - More of the Same? According to Medicaid, here are the results…. Mississippi ranks #1 in medical debt, yet we rank 34th in medical spending, and 49th in overall national health ranking. Emphasizing the high need for care and the inability to pay for that care.

  5. What should Reform look like? Mississippi Healthcare Providers and Hospitals Mississippians State of Mississippi • Improved access to quality care • Individuals below 138% federal poverty • 163,000-300,000 Mississippians • Two-thirds are currently working to support their families • Provide job training and work skills • A transitional coverage model • Decrease in uncompensated care cost • Higher quality standards • True reform of the healthcare delivery system demonstrated • Ensures access to care to all • Patient and provider accountable for appropriate care • Economic stimulus • Job creation • General Revenue Fund increase • Increase in personal income • Healthier more marketable workforce • NO additional cost to state or tax payers

  6. What does Medicaid Reform look like? • Providers and patients work more collaboratively • Shared resource utilization • Medicaid certifies the premium • Participants and Hospitals fund the 10% state share in order to receive the 90% Federal Matching Funds • Meaningful quality measures are determined by providers and Division of Medicaid • Premiums are paid to MississippiTrue a Provider Sponsored Health Plan (PSHP) • Governed and operated by Mississippi providers MississippiTrue administers the plan

  7. Funding Has Been Modeled

  8. How is the program funded if there is no cost to the State?

  9. For example, 300,000 participants….. In our proposal, $5,000 is used as the target annual individual premium. This number will be certified by the Mississippi Division of Medicaid. …..generates $1,500,000,000. The State Share is 10% and would equal $150,000,000. How is it funded?

  10. Resulting in a 9 to 1 Federal Match for $1,350,000,000

  11. What has to happen? MDOM requests a 1115 Demonstration Waiver from CMMS • You should understand the • Plan • Benefits • Funding • Help share the message with • Friends • Family • Co-workers • Make sure the Candidates you support know how important this issue is to you and confirm your position. The Waiver will describe a Public-Private partnership and the program plan The Legislature will amend Sections 43-13-145 (Hospital Assessment) and 43-13-115 (Eligibility) of the Mississippi code CMMS approves 1115 Demonstration waiver

  12. What is the Result? Mississippi Healthcare Providers and Hospitals State of Mississippi Mississippians • Improved access to care • Essential benefits similar to those offered by Medicaid • Focus on wellness; Physician visits and prescription drugs • Job training /Skill building • Personal responsibility & consumerism • Projected $52.6 million reduction in private insurance premiums • Net economic benefit of $36.4b over 11 years • New job creation of 20k-30k • $200m increase in state revenue (tax receipts) • $600m Personal Income growth • Healthier, more marketable workforce • NO additional cost to State or Tax Payers • $251.6 million decrease in uncompensated care cost • Additional healthcare jobs • Revenue available to invest back into facility operations • Improved financial stability for rural and urban hospitals • Healthier patient population • Potential for new services development

  13. Look us up @ MississippiCares.com

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