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Saint Alphonsus Medical Group Strategic Assessment and Creative Recommendations November 30, 2010

Saint Alphonsus Medical Group Strategic Assessment and Creative Recommendations November 30, 2010. Right for Idaho: Medicaid Transformation & Expansion Corey Surber I March 2013. Governor Appoints Workgroup to Study Options.

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Saint Alphonsus Medical Group Strategic Assessment and Creative Recommendations November 30, 2010

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  1. Saint Alphonsus Medical Group Strategic Assessment and Creative Recommendations November30, 2010 Right for Idaho: Medicaid Transformation & Expansion Corey Surber I March 2013

  2. Governor Appoints Workgroup to Study Options • June 2012 U.S. Supreme Court decision makes Medicaid expansion under Affordable Care Act (ACA) optional. • Gov. Otter appoints 15 member workgroup in July to collect data, analyze and provide recommendations. • Workgroup engaged national consultants and experts to collect data. • Report/recommendations delivered to Gov. Otter in December.

  3. Current Idaho Medicaid • 240,000 participants, with 70% being children from low-income families • Also provides coverage for people with disabilities, low-income elderly and low-income women who are pregnant. • Federal government pays 70% of program; $1.2 b. of $1.9 b. cost. • 96.4% of $1.9 b. budget pays medical claims; less than 3% administration costs.

  4. ACA Impacts Without Optional Expansion • Mandatory ACA changes to income and asset calculation for eligibility determination take effect. • People currently eligible, but who have not applied, will enroll with mandatory coverage requirement • Together, these mandatory requirements will add 46,000 Idahoans to Medicaid w/o optional expansion!

  5. ACA Impacts of Optional Expansion Provides coverage to adults earning <138% of poverty Family of 4 must have income less than $31,810 64% are working and employed 83% white citizens Most do not have children in household Estimated 104,200 people would become eligible on January 1, 2014.

  6. Expansion Population: Current Healthcare Options • Higher rates of obesity, diabetes, and tobacco use. • Little preventive care. • Access highest cost care through emergency rooms or through state/county medical indigency programs. • Prevalent chronic medical conditions, including mental illnesses. 6

  7. Good for Idaho’s State and County Budgets Net Savings= $84.6 M over 10 years Elimination of county/state indigent program Accepting enhanced federal funding to support expanded Medicaid enrollment

  8. Good for Idahoans’ Health • Multiple studies show two major factors in improving health outcomes • Usual source of care • Health care coverage • Optional Medicaid expansion provides an opportunity to address both factors • Opportunity to redesign the Medicaid program and invest in needed mental health services to promote health and protect public safety • incorporate personal accountability • align incentives to promote value rather than volume • invest in community mental health supports

  9. Good for Idaho’s Economy • $9.2 billion in new dollars flowing through Idaho’s economy • 16,000 new jobs (all sectors) • $717 million in payroll • $614 million in tax revenue (sales, income, etc) • Economic Impact Analysis, Idaho Hospital Association 2012

  10. Good for Taxpayers • Relieves property tax burden associated with paying for indigent healthcare • County indigent fund • State catastrophic healthcare fund • Prevents Idaho taxpayers from bearing the burden for Medicaid expansion in other states without value to Idaho citizens and businesses

  11. Good for Business • Eliminates cost shifting from indigent healthcare • Prevents employers from facing coverage penalties up to $1.3 B nationwide (Jackson Hewitt) • Offsets Medicare reimbursement cuts Idaho hospitals will face (preventing additional cost shift to business) • Makes Idaho more competitive for business and prevents job losses to other states

  12. Idaho Has a Choice • Status Quo: • Cover 45,500 Idahoans at a cost of $394 million in state funds (not including county) – no offsets OR • Expansion: • Cover 150,000 Idahoans with net savings of $84.6 million in state funds

  13. Delay Costs Idahoans • Year 1 Loss: $54 M (partial year) • Year 2 Loss: $106 M • Year 3 Loss: $110 M

  14. The Cost of Inaction • If Idaho does not expand Medicaid, there will be a $90.1 M negative impact over 10 years through: • Increased tax burden • High cost coverage for indigent population • Plus, decreased attractiveness to new business

  15. Join the Coalition Supporting Expansion • Join the Coalition for regular updates and action alerts • For more info, go to http://medicaid.nickkorte.com

  16. Corey Surber Director, Community Health Initiatives coresurb@sarmc.org (208)367-7078

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