Wednesday, December 13, 2023

Feds Approve Governor's Medicaid Plan

 Governor Tate Reeves issued the following statement.  

Governor Reeves today announced federal approval of the first component in his sweeping Medicaid reimbursement reform plan that is estimated to generate nearly $700 million in additional funds for Mississippi hospitals. Governor Reeves first announced the plan in September.

“This plan is going to strengthen our state’s healthcare system and I’m glad that we could get it done for the people of Mississippi,” said Governor Tate Reeves. “This is the product of meetings with a range of medical professionals and healthcare leaders, and I’m truly thankful to all of them for helping to get us to today.”

Under the proposal, approved by the Centers for Medicare and Medicaid Services (CMS), hospitals will be reimbursed near the average commercial rate for services provided through the managed care delivery system, which has been considered the federal ceiling for Medicaid reimbursements in managed care.

In total, this component of the plan will generate approximately $600 million for Mississippi hospitals.

A second component of the plan supplementing Medicaid hospital payments in the fee-for-service delivery system is still awaiting approval from CMS.

The Mississippi Division of Medicaid is taking steps to deliver the first round of payments to hospitals in the coming weeks. The effective date of the approval is retroactive to July 1, 2023.

14 comments:

Anonymous said...

Well, hot damn. Looks like Elvis's second or third cousin might be able to get another gastric bypass now.

Anonymous said...

Substantive questions:
1. Who pays thes additional funds, the state or the federal government?
2. Does the state get anything for the additional funds paid other than higher reimbursement rates to struggling Mississippi hospitals?
3. How does this help reform the delivery of medical services, a main talking point of anti-expansionists?

Anonymous said...

That will help fund those "off-site" conferences at tropical locations.

Anonymous said...

12:43

1. Feds pay it. Based off commercial insurance reimbursement rates versus Medicare which is why the number increased so much.

2. No. Just another $600-700M EVERY YEAR to be divided between all hospitals.

3. These dollars are life changing for many hospitals. Millions of new dollars pouring into their hospital each year with no strings attached. They can spend on new doctors, nurses, equipment, expansions, etc. Big, big deal.

Anonymous said...

This is Tate showing the middle finger to Tim Moore.

Wow said...

12:43pm.

1. Usually Medicaid funding is 25/75 split with the 75 coming from the federal government.

Regarding your #2 and #3:

you are asking the right questions. Ultimately this does not solve the fundamental, deep structural issue plaguing our healthcare system. This just pays higher for utilization of services.

If we want everyone to be healthier, this means everyone will go to the hospital less. If we are reimbursing hospitals based on the use/utilization of their services, there is no fundamental structural incentive for our population to get healthier and go to the hospital less.

Until we implement a model where local physician groups and collaborating with rural hospitals to keep patients healthy and out of the hospital--and both the physician groups and hospital get paid for keeping patients healthy and not misusing care--nothing will change.

This is why, long term, until we fully transition to value based care like exampled above, where we reimburse and pay for improved outcomes, not just use of services, nothing will change.

This kicks the can down the road.

Anonymous said...

This is such a smoke screen. Interesting that the original Milliman analysis done on behalf of the Division of Medicaid showed only a $40 mm increase in hospital funding. Guess we'll see if these national healthcare finance experts are correct or Tater.

Also, to address a previous question, 75% of these dollars come from the federal government, 25% from State. Our learned politicians seem to forget to mention that federal dollars are also tax dollars!!

Anonymous said...

Milliman and Tim Moore are both clueless … glad they got sidelined so this could get finished and approved.

Congrats to hospitals and patients.

Anonymous said...

"Milliman and Tim Moore are both clueless"

Interesting comment. Based on your logic, thousands of hospitals, State agencies, insurers, and other healthcare entities across the United States hire a "clueless" consultant every year to analyze various projects. (Sarcasm applied).

While I'll agree with you regarding Mr. Moore, to say Milliman is clueless diminishes YOUR credibility.

Anonymous said...

This will not solve the problem - limited access to hospital care for the poor. Reeves could care less about those people. He cares only about his rich donors.

Anonymous said...

Ah yes, the GOP in Mississippi, love gobbling up federal handouts but bitch about federal handouts. I think State needs a new volleyball court.

Anonymous said...

10:07 I pay a lot more to the fed than to the state. Do you not pay taxes to the fed?

Imagine thinking people shouldn't feel entitled to use their own money.

Anonymous said...

@3:14pm - For every dollar Mississippians pay in federal income tax, the federal government sends $2.53 to Mississippi. We are a welfare state. A majority of taxpayer money being spent on the state is coming from states that pay more than they receive from the feds, like California and New York. But you keep your head in the sand mister little taxpayer.

Anonymous said...

So this is ObamaCare money without being called ObamaCare money?


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