2020 Provider Preparation Project: Financing Models Purpose: To provide high level information on the project, process, and outcomes
Funding Models Objective: Accessibility to quality services, sustainability of the network, and data that ensures stewardship of public funds. O Past: Cost Plus . Total agency costs are paid plus an additional percentage. The cost per unit can vary monthly and amongst providers. O Current: Fee for Service (most outpatient programs). Providers are reimbursed for each clinical service provided to eligible enrollees. Cost per unit is clearly identifiable. O Future: Possible Hybrid Payment model and incentives for completing ‘Special Projects’/achieving ‘Milestones’ related to system preparation for Integrated Managed Care
Hybrid Funding Model O Primary Drivers: Quality, sustainability and stewardship of services with public funds by: O Increasing key performance indicator outputs for clients served; O Measuring outcomes of increased access and penetration rate and quality service delivery; O BHAs will have a ceiling for Cost Plus if BHA are unsuccessful Fee for Service. Details will be provided in the future. O Monitor to ensure reasonable and acceptable service unit costs
Promoting and Incentivizing BHA Change O BHAs ‘Special Projects’/2020 Milestones examples * EHR implementation and modification for IMC * IT review and upgrade * Claims and Credentialing O BHAs need to be whole in the short and mid- term to year 2020 to enhance service delivery infrastructure with the hybrid funding model and special projects.
Crossing the Finish Line O Progress BHAs have made in the last 2 1/2 years toward IMC * Examples from BHA’s O Common Provider/GRBHO goal is improved clinical service delivery and infrastructure to sustain healthcare reform to WA State BHAs, and adjust to the new single payer system. The focus will be maintaining our well- established and growing systems of care for all of communities served in our region
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