Budget Amendment ID: FY2016-S3-185
Regional Health System Grant Program
Mr. Welch moved that the proposed new text be amended by inserting after section 105 the following 2 sections:-
“SECTION 105A. (a) Notwithstanding section 2GGGG of chapter 29 of the General Laws or any other general or special law to the contrary, the health policy commission shall establish a 1-year pilot program to increase efficiencies and align system-wide goals within 1 regional hospital system to improve the overall sustainability of the system. The program shall provide a system-wide grant to create a comprehensive approach to system-wide needs. The program shall include measurable milestones that shall demonstrate progress in at least 1 of the following areas: (i) care coordination, integration and delivery transformations; (ii) electronic health record and information exchange advancements; (iii) increasing alternative payment methods and accountable care organizations; (iv) enhancing patient safety; (v) increasing access to behavioral health services; or (vi) increasing coordination between system hospitals and community-based providers and organizations.
(b) The commission shall select 1 regional hospital system. The regional hospital system selected shall have not more than 1 academic hospital as part of the regional hospital system and include an acute care hospital not receiving delivery system transformation initiative payments with both a Medicaid payer mix more than 1 standard deviation above the statewide average and a commercial payer mix more than 1/2 standard deviation below the statewide average based on the cost report data from fiscal year 2012.
(c) The program shall authorize a $5,000,000 grant from the Distressed Hospital Trust Fund established in said section 2GGGG of said chapter 29 to the regional hospital system selected in subsection (b). The commission shall assess the needs of the regional hospital system to determine the amount of the grant and shall consider all resources available to the regional hospital system. As a condition of an award, the commission may require the regional hospital system to agree to an independent financial and operational audit to recommend steps to increase sustainability and efficiency of the regional hospital system.
(d) The commission shall file a report on the program not later than December 31, 2016 after the date of the initial grant award. The report shall include: (i) a description of the projects completed through the grant program; (ii) an analysis of cost savings realized by the regional hospital system through the grant program; and (iii) any other outcomes the commission considers relevant. The report shall be filed with the clerks of the house of representatives and senate, the joint committee on health care financing and the house and senate committees on ways and means.
SECTION 105B. Not more than 6 months after the award of the grant under section 105A, the executive director of the health policy commission shall submit a progress report to the director of Medicaid certifying whether the selected regional hospital system is on track to complete all identified measurable milestones required under subsection (a) of said section 105A within the time set by the commission. If the report indicates that the selected regional hospital system is on track to meet said milestones, the director shall make an additional payment to the hospital system of $5,000,000 within 30 days of receipt of the report.
Not more than 12 months after the award of the grant under said section 105A, the executive director of the health policy commission shall submit a progress report to the director of Medicaid certifying whether the selected regional hospital system has completed all identified measurable milestones required under said subsection (a) of said section 105A within the time set by the commission. If the report confirms that the selected regional hospital system has completed said milestones, the director shall make an additional payment to the hospital system of $5,000,000 within 30 days of receipt of the report.
Notwithstanding any general or special law to the contrary, the department shall seek to obtain federal financial participation for the payments to the regional hospital system.”