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CHASE Board MeetingOctober 22, 2019
Nancy DolsonDepartment of Health Care Policy & Financing
Hospital Transformation Program
2
• Timeline
• Community Advisory Council
• Proposed Rural Support Fund
HTP Timeline
3
*assuming 3/31/20 SPA approval by CMS
Stakeholder Engagement
Final Reports from Hospitals
Public Notice of SPA
Draft of SPA (9/30)
Draft of 1115 Waiver (10/30)
Stakeholder Engagement
Medical Services Board (MSB) public rule review meeting
Waiver public comment period ends
Final draft of SPA submitted to CMS
Section 1115 waiver submitted to CMS
MSB Initial approval (1/10/20)
MSB final adoption (2/14/20)
Rule effective date (3/30/20)
Hospitals begin application* (4/15/20)
31 Jul
Sept-
Oct
30
Sep
31 Dec
1 Apr
2019
Aug
Nov
Dec
Jan
2020
–
Apr
2020
Stakeholder Engagement
Public Comments
Scoring Methodology
Measures Specifications
Collection of Baseline Data
Participating hospital application
Stakeholder Engagement
SPA Feedback & Comments
Public Notice of 1115 Waiver
Hospital Reporting Milestones
1115 waiver budget neutrality completed
1115 waiver special terms and conditions finalized
SPA
Effective Date
10/1/19
HTP Waiver Timeline
4
• Public Notice November 10
• Public hearings
➢ CHASE
➢ Medical Care Advisory Committee
➢ Webinar
• Waiver submission to CMS December 31
• Federal public notice 30 days
• Federal decision making minimum 45 days
HTP Community Advisory Council
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• https://www.colorado.gov/pacific/hcpf/HTP-
Community-Advisory-Council
HTP Proposed Rural Support Fund
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• See handout
• Funding to support hospitals to prepare for future
value-based payment environments
• $12 million per year, each of five years of waiver
• Critical Access and non-resort rural hospitals
• Funds to hospitals with most financial distress
based on evaluation of financial and utilization
information
HTP Proposed Rural Support Fund
7
• Questions
➢ Determining which hospitals will receive funds
➢ Amount of funds to hospitals
➢ Other?
• Stakeholder feedback
➢ CHASE Board
➢ Rural Health Center Conference, HTP Rural Hospital
Workgroup, Western Healthcare Alliance, Eastern Plains
Healthcare Consortium, others
Hospital Expenditure Report
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The hospital expenditure report must include, but not be limited to:
(a) A description of the methods of analysis and definitions of report components;
(b) Uncompensated care costs by major payer group; and
(c) The percentage that each of the following categories contributes to overall expenses of
hospitals:
(I) Delivery of inpatient health care and services by major payer group;
(II) Delivery of outpatient health care and services by major payer group and site location;
(III) Administrative costs;
(IV) Capital construction costs and associated bond liabilities;
(V) Maintenance;
(VI) Capital expenditures;
(VII) Personnel services;
(VIII) Uncompensated care by major payer group; and
(IX) Other expenditure categories, as determined by the state department.
Hospital Expenditure Report
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• January 15, 2020 report
➢ Current activities and implementation progress
➢ No individual hospital data
• Subsequent annual reports beginning January 2021
➢ Include all required information
➢ Hospitals have 15 days to review the report and underlying data
prior to publication
➢ Also, data to be used for cost shift analysis in CHASE annual
report
Hospital Expenditure Report
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• Executive Summary with Overview and Key Findings
• Introduction with Purpose and Background
• Methodology
➢ Statement of methods, Peer Groups, Regionality, and Limitations
• Uncompensated Care
➢ Bad Debt and Charity Care
• Expenditure Categories
• Appendix
➢ Compiled hospital data and definitions of the report’s components
Hospital Expenditure Report
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• Peer groups
➢ 25 and fewer licensed beds
➢ 26 to 90 licensed beds
➢ 91 and more licensed beds
• Regionality
➢ Division of Insurance rating areas
DOI Insurance Rating Areas
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Hospital Expenditure Report
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Thank You
Nancy DolsonSpecial Financing Division DirectorDepartment of Health Care Policy & [email protected]
