Alaska Primary Care Association December 3, 2015 THE HEALTHY ALASKA PLAN

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1 Alaska Primary Care Association December 3, 2015 THE HEALTHY ALASKA PLAN

2 Healthy Alaskans Medicaid Expansion Update Catalyst for Reform HEALTHY ALASKA PLAN AGENDA Medicaid Redesign & Expansion Technical Assistance Contract 1915 (i) and (k) Contract Provider Tax Contract The Healthy Alaska Plan 2

Expansion Technical Assistance Contract 1915 (i) and

3 HEALTHY ALASKANS Who is covered by expansion? Adults Ages Not otherwise eligible for Medicaid or Medicare Earning up to 138% of the Federal Poverty Level (FPL) Single adults earning up to $20,328 per year $1,694 per month Two-person family earning up to $27,492 per year $2,291 per month The Healthy Alaska Plan 3

138% of the Federal Poverty Level (FPL) Single adults earning up to $20,328 per

4 HEALTHY ALASKANS How many have signed up? Estimates for year one = 20,666 As of November 30th: 5,685 determined eligible for Medicaid Expansion Chronic & Acute Medical Assistance enrollees transitioned to Medicaid CAMA is fully funded by general funds The Healthy Alaska Plan 4

eligible for Medicaid Expansion Chronic & Acute Medical Assistance

5 HEALTHY ALASKANS Where can people apply? Apply one of the following ways: No Wrong Door ARIES Self Service Portal Uses your myalaska Account Paper application 12/8/2015 The Healthy Alaska Plan: Medicaid Expansion in Alaska 5

gov No Wrong Door ARIES Self Service Portal Uses your

7 Medicaid Redesign & Expansion Technical Assistance Contract Contract Awarded to Agnew::Beck Subcontractors: Health Management Associates (HMA) and Milliman (actuarial firm) Contract Amendment: Additional Stakeholder Process Sector engagement sessions Alaska State Hospital & Nursing Home Association; Alaska Primary Care Association; Long Term Service & Supporters Providers; Alaska Behavioral Health Association; Physicians; Tribal Health Organizations; Change Agent Conference Webinars follow each Key Partners Work Session Contract and Amendment are posted online dhss.alaska.gov/healthyalaska/pages/medicaid_redesign.aspx The Healthy Alaska Plan 7

Care Association; Long Term Service & Supporters Providers; Alaska Behavioral Health Association; Physicians; Tribal Health Organizations; Change Agent Conference

8 Key Partner Organizations Alaska Association on Developmental Disabilities Alaska Behavioral Health Association Alaska Commission on Aging Alaska Dental Society Alaska Geriatric Exchange Network (AGENet) Alaska Legislature: House of Representatives Alaska Legislature: State Senate Alaska Mental Health Trust Authority Alaska Native Health Board Alaska Native Tribal Health Consortium Alaska Nurse Practitioner Association Alaska Nurses Association Alaska Osteopathic Medical Association (invited) Alaska PCA Association Alaska Pharmacists Association Alaska Primary Care Association Alaska Psychological Association Alaska State Hospital & Nursing Home Association Alaska State Medical Association American Academy of Family Physicians American Academy of Pediatrics (invited) American College of Physicians American College of Emergency Physicians Community Care Coalition Governor's Office Governor's Council on Disabilities and Special Education Lt. Governor's Office Mat-Su Health Foundation Statewide Independent Living Council of Alaska The Healthy Alaska Plan 8

Nurse Practitioner Association Alaska Nurses Association Alaska Osteopathic Medical Association (invited) Alaska PCA Association Alaska Pharmacists Association Alaska Primary Care Association Alaska

9 Meetings Held: 1 st Session July 27: Kick-Off Webinar August 18: Key Partners Work Session September 2: Project Update Webinar Draft Environmental Assessment Alaska s current system Models of care; provider reimbursement Medicaid financing mechanisms to support systems change Brainstormed shared vision and priorities for Medicaid redesign The Healthy Alaska Plan 9

Models of care; provider reimbursement Medicaid financing mechanisms to support systems

10 The Healthy Alaska Plan 10

11 Meetings Held: Round 2 October 9: Key Partners Work Session October 21: Project Update Webinar Review of Initiatives Alternative Models for the Expansion Population Medicaid Reform Initiative Options Evolving working document Description; key features; federal requirements; IT needs; rate structure and/or payment mechanism; statutory and/or regulatory changes; actuarial analysis The Healthy Alaska Plan 11

Evolving working document Description; key features; federal requirements; IT needs; rate structure

12 Reform Initiatives: All Presented The Healthy Alaska Plan 12

13 Meetings Held: Round 3 November 10: Key Partners Work Session Presentation on Actuarial Analysis Overview of the Approach Review of Medicaid Reform Initiatives Potential alternative coverage models for expansion population November 19: Project Update Webinar Review of Preliminary Package of Reforms The Healthy Alaska Plan 13

Potential alternative coverage models for expansion population November 19:

14 Reform Initiative: 2 nd Review The Healthy Alaska Plan 14

15 Preliminary Package of Reforms The Healthy Alaska Plan 15

16 Remaining Work Actuarial Analysis and drafting the Final Report DHSS will continue presentations as requested January 15: Final Report due to DHSS Contractors will be available for four legislative hearings January 21: Final Report Webinar The Healthy Alaska Plan 16

Report due to DHSS Contractors will be available for four

17 Building Reform. Continuing the Dialogue. The Healthy Alaska Plan 17

18 More reforms to come 1915 i/k Implementation Contract Contract Awarded to Health Management Associates Alaska currently provides HCBS to 4,000 individuals under four 1915(c) Medicaid waiver programs: Children with Complex Medical Conditions (CCMC) Adults with Physical and Developmental Disabilities (APDD) Alaskans Living Independently (ALI) Individuals with Intellectual and Developmental Disabilities (IDD) The Healthy Alaska Plan 18

with Complex Medical Conditions (CCMC) Adults with Physical and Developmental Disabilities (APDD) Alaskans

19 More reforms to come 1915 i/k Implementation Contract 1915(i): For people who do not meet nursing level of care, but meet other criteria Alzheimer s, traumatic brain injury, severe mental illness, or individuals with developmental or intellectual disabilities Section 1915(k) improve savings on home and communitybased services Implementation: July 1, 2017 Stakeholder Process Development and Implementation Council In person forums: Anchorage, Barrow, Bethel, Fairbanks, Mat- Su Valley, Juneau, Kenai, Ketchikan, Nome The Healthy Alaska Plan 19

1915(k) improve savings on home and communitybased services Implementation: July 1, 2017 Stakeholder Process Development and

20 More reforms to come Provider Tax Study Feasibility Study & Recommendation Contract Awarded to Myers & Stauffer No tax can be imposed without legislation Every state in the union, except Alaska, has one or more health care provider taxes 19 classes of health care services and providers can be taxed Nursing facility services and inpatient hospital services are most common taxed classes The Healthy Alaska Plan 20

more health care provider taxes 19 classes of health care services and providers can be taxed Nursing

21 Provider Classes Currently Under Study (As of December 1 st ) 1. Inpatient hospital 2. Outpatient hospital 3. Nursing facility 4. Intermediate care facility services for individuals with intellectual disabilities 5. Physician services 6. Home health services 7. Outpatient prescription drugs 8. Services of managed care organizations 9. Ambulatory surgical center services 10. Dental services 11. Podiatric services 12. Chiropractic services 13. Optometric/Optician 14. Psychological services 15. Therapist services 16. Nursing services 17. Lab and x-ray services 18. Emergency ambulance services 19. Other: RPTCs PCAs HCBS Waiver Behavioral Health The Healthy Alaska Plan 21

22 How can you stay informed? Healthy Alaska Plan dhss.alaska.gov/healthyalaska 1915 i/k Implementation dhss.alaska.gov/dsds/pages/cfccouncil/cfcdic.aspx Sign up for Updates Request a presentation Medicaid.redesign@alaska.gov The Healthy Alaska Plan 22

23 Questions? Thank you! Monique Martin

New Hampshire Department of Health and Human Services. Medicaid Care Management Program Step 2 Design Concept

New Hampshire Department of Health and Human Services Medicaid Care Management Program Step 2 Design Concept Redesign of New Hampshire s Long Term Services and Supports Delivery System: A Concept Paper