Sign New Hampshire Banking RFP Computer

Industry sign banking new hampshire rfp computer

hello everyone I'm Ron rohlfeam that's a preferred vendor coordinator here at a cap and I'd like to welcome you to our latest education series webinar presented by south beyond with me today is Eugene saying CEO and president of South Korea he will be presenting the webinar your guide to navigating CMS new 1115 waiver approval process a little bit about Eugene he leads south beyond in its mission to develop innovative solutions for healthcare payers providers and government agencies since 2000 has been responsible for the corporate strategic vision and direction prior to south beyond Eugene led big data and process measurement initiatives for Fortune 1000 companies and completed a tenure at IBM he received a bachelor's degree in local engineering and telecommunications from histone bull Technical University and a master's in computer science from New York Institute of Technology as most of you know by now the purpose of the achive bender education series is to share the preferred vendors vast knowledge on topics that are of interest to a cap health plan members but before I turn it over I have a few housekeeping items this webinar along with all hf calls and webinars will be held in accordance with the eight cap antitrust guidelines and these guidelines can be viewed on our web site we will be recording today's call and we'll post a slide deck and recording on our website and you'll receive an email when these items are ready to view we do have a few more webinars this week so if you can take some time out to view those and our list of preferred vendors is on our website look to the top of the page click on preferred vendors and this is a great place to look when your plan is issuing an RFP during the call you can ask a question at any time you can do this by typing in your questions in the question box in the control panel and hit Send and all questions will be answered at the end of the call now I'd like to pass it over to Yuji thank you Ron and good morning and good afternoon depending upon where you are today with us thank you again for taking the time to join to us join us this morning or this afternoon is we are proud and privileged a cap and prefer vendor been doing a quite a few series in fact we used to do do quite a few in the early days of ACA given our focus around ACA and in general public and private exchanges and this morning topics will be somewhat relevant to those early days of the ACA conversation here we are four plus years later from the time that initial the ACA when it did effect and we are now in an era that one may call ACA to dot o transition from Obamacare to Tromp care there is not a day goes by that we hear something on that topic on the media today and this is our I guess the our opening slide the health care is a national issue as we all know our health care spending is expected to exceed three point two trillion dollar eighteen or twenty percent of GDP despite all the efforts the cost of none of the medical expenses if you will continues to rise up there are some new payment models are being implemented aimed at controlling the rising cost and the new delivery systems are disrupting the existing relationships another important topic is the consolidation very recently we heard at the Aetna and CVS merger it is it is one may view that as a quite disruptive it may change the way the health care is being provided and serviced from the very much CVS clinics whatever it with a kind of a a 360-degree view of a health care coming from every angles we also see that the last couple of years we've seen a lot of innovations with new entrants the likes of Oscar Health and few others have the potential to disrupt the traditional market environments providing consumer centric tools in order to reduce the healthcare costs as we all seen it as have been happening and then traditional players are also looking for ways to remediate those challenges if you will renovate a programs in some cases they are spinning off their own startups if you will and take in a critical part of their business function and then handing it over and the healthcare reform has become the really kind of everything came together and primary focus was about improving quality access and lowering the cost there has been very challenging the sectors in the industry are seeing increased compliance requirements as a result of ACA where we are today obviously ACA kind of in a way level the field if you will based on a standard standard products or essential health benefits and also the you know no preconditions are allowed to in the process and then the the program is was being positioned as their one notch above Medicaid and for that reason one we have the opportunity to work with quite a few AFL plans be entrusted by them to build their and operate their ACA exchange environments all together - you're looking to the next slide is about health care is political it is a national topic it's also political will go back and refer to this particular slide throughout the day but I think that's what's noteworthy in this slide itself is the as we call the SEMA veer my influence Simar veer mothers be the architect of if Todaro pick todaro healthy Indiana plan is is the second version of the initial initial program started in 2008 as the nation's as Indiana will call as the nation's first consumer driven health plan for Medicaid beneficiaries back in 2014 under ACA if todaro was funded in the 1115 waiver which then truly transform the Medicaid operations in particularly in Indiana and we'll talk more about the the the metrics around that program altogether all the way from the the use of HSA like like savings accounts called power cards to the other forms of compliance requirements acceptance rates and so forth or grace periods in ACA light program indiana has implemented as a hip todaro as we call it so the next style solutions let's discuss the what's really being done a circulator up the Medicaid expansions as we have discussed the very earlier commonly referred as the 1115 waivers was basically filed by different states under the under the form of a modernizing or giving the states the opportunity to create their own interpretation of particularly Medicaid implementations so under the 1115 Medicaid demonstration waivers the states has an avenue to test new approaches in Medicaid that differ from the federal program rules the waivers can provide States considerable flexibility and they can operate their programs beyond what is available on the current law which can have significant impact on the program financing as I mentioned earlier was Indiana hip was one of those programs and there are 33 states so far as of September 2017 apply 41 approved waivers the waivers became very popular also under ACA as an ACA expansion waivers there are a few states who look for those waivers as part of the many ACA is Medicaid expansion in part because they could not otherwise secure the political support to expand the coverage as of September 2017 the seven states namely Arizona Arkansas Iowa Indiana Michigan Montana and New Hampshire have approved waivers to implement the ACA Medicaid expansion in ways that extend beyond the flexibility provided by the law as of March 14 2017 the CMS sent a new letter to the governor's that signaled a willingness to use 1115 Authority to support innovative approaches to increase the employment and community engagement to align with the private and public initiatives that is targeted for the Medicaid population several states with ACA expansion waivers already have approval to implement the provisions as in the case in New Hampshire and as well as in Nebraska in a very similar iteration altogether I was looking for as you may or may not know that 1115 and combined with a 1332 waivers to create their own exchanges this year they let go for go of that of that effort for the time being so we're all anxiously waiting for the final version of that tax reform how it may influence the the ACA in general and Medicaid as it relates to it and I think we're going to start seeing a lot more creativity around 1115 waivers the number of states have waivers pending a CMS that includes the provisions not previously approved under worked requirements drug screening and testing eligibility time limits and the premiums with disenrollment for non-payment to traditional Medicaid population and some of the requests are part of the expansion waivers others may apply to the traditional population as well stakeholders are waiting to see how CMS will respond to them pending waiver requests especially those that have been not been approved in the past could lead to a decrease program enrollment if we go back to for a moment to hip Todaro program as I mentioned that in early days in the back dating back to 2008 Indiana was experimenting with this program earlier and back in 2014 under steam of earmuff as they 1115 waiver I implemented so it had multiple components to it it is a as we said earlier it's a private Medicaid program we often refer to and it is becoming the model for quite a few other states and there are some few states are in the process of seeking for their waivers states like Kentucky SEMA Verma has worked very very in capacities if you will with states like Michigan as well in the process and the primary purpose of is about really enabling the legislation the negotiating the financing level with the states and hospital associations and developing a waiver program that basically addresses in couple areas one is reducing the number of uninsured it has a similar type of admission in mind like ACN we're not making any political statements bear in mind in here but it's nevertheless this is the intent of the program as it was as it was presented it's also designed to improve the low income residents access to healthcare services very similar to ACA and again Medicaid expansion programs promoting the value basis you're making a primary care and Prevention's chronic disease progressions evidence-based health care services and then the most importantly perhaps they ensure the state fiscal responsibility and program management as of 2017 little over 400,000 numbers I believe back numbers might be even close to 500 maybe of slightly above as of last year there were four carriers were participating in the Indiana program as the MCS and the there are various success factor is being reported by the state over the last couple of years so one of the cornerstone of the hip 2 data program is the premium billing member responsibility so individuals might be subject to you a premium billing as little as one dollar subsequently they are contribution and then the state contribution goes towards a power account power stands for personal wellness and responsibility account this is an HSA like account it's not an HSA doesn't have the triple tax advantages as we all know an HSA space it's not truly rollover you can only roll over 50% of the outstanding savings or whatever that's left in the account year-over-year so the individual that set up to its first twenty two thousand five hundred dollars in his or her name will be set up as a power account and then the medical expenses for cover cover services are paying with the power account and state will contribute most of the amount as we just said it earlier when you pay your monthly power account contribution it is deposited into your account consumers account and the consumer will receive a monthly statements then shows how much money he or she has remaining on the account cover services again paid by the MCO s and the states by pay by the state's service invited by sourcing NGOs and if you manage if the consumers manage your health counts and they and use their power account wisely they may have some luck money in the account as we said earlier and some of those money will be done rollover to just next year's contribution so there's an element of savings associated with it again as I said it's not a true HSA account it does not have the some of the long-term tax benefits on the investment side but we have her own HSA notion over the last year or so both on the initial ad from 88 to the BCRA especially under the Cruz amendment about the use of HSA accounts for the purpose of impact for premiums that the consumers responsibility and then the raising the HSA limits to equal to the the out-of-pocket expense if you will so that the basically the limit can be raised from 30 $700 individuals $7,500 family to as high as you know 15 $20,000 depending upon so again these are these were the statements were thrown around in early days of the debate Mon Tortuga and we don't know what the final version may come up let it be in the tax reform bill or a subsequent bills that the current administration is looking to introduce with the coming years proceeding with a 1115 waivers so let's go back