Vermont Bundled Payment Program
Service Category: Program Design and OperationsProgram Design and OperationsB&A is providing technical support to Vermont Medicaid on the design and implementation of a bundled payment program for a set of priority episodes of care.
Home Health Payment System
Service Category: Strategic PlanningStrategic PlanningBB&A is providing strategic planning services on the design and implementation of a new value-based home health prospective payment system.
Medical Benefit Payment System Management in Vermont Medicaid
Service Category: Rate SettingRate SettingB&A supports Vermont Medicaid maintain payment systems for facilities, professionals, laboratories, durable medical equipment providers, ambulance, and non-emergency transportation services. Highlights include transitioning the state to MSDRGs and APCs and continues to support the state in annual updates to policies, budget and systems.
Federally Qualified Health Center (FQHC) Payment System
Service Category:- Strategic Planning: B&A is providing strategic planning services on the design and implementation of a new value-based federally qualified health center (FQHC) payment system.
- Rate Setting: B&A is working with the state of Vermont to design a value-based, prospective payment system for home health services.
Medicaid Shared Saving Program (VMSSP) / Strategic Planning
Service Category: Strategic PlanningStrategic PlanningB&A provided strategic planning services to state staff in support of the design and launch of the Vermont Medicaid Shared Savings ACO Program.
Medicaid Shared Saving Program (VMSSP) / Budget Development and Program Financing
Service Category: Budget Development and Program FinancingBudget Development and Program FinancingB&A designed the financial reporting materials in support the Vermont Medicaid Shared Savings ACO Program including forecasts of the actual and projected per capita spend.
Medicaid Shared Saving Program (VMSSP) / Program Design and Operations
Service Category: Program Design and OperationsProgram Design and OperationsB&A provided Vermont Medicaid technical support in the design and implementation of the Vermont Medicaid Shared Savings ACO Program.
Medicaid Shared Saving Program (VMSSP) / Data and Analytics
Service Category: Data and AnalyticsData and AnalyticsB&A supports monitoring and evaluation efforts in Vermont Medicaid by using claims data to conduct policy analysis and calculate performance metrics.
All Payer Models
Service Category: Public/Private Insurance InitiativesPublic/Private Insurance InitiativesStrategic PlanningStrategic PlanningB&A is one of a team of contractors who provide strategic planning services to state staff in support of the exploration and design of all payer waivers and rate setting models including: universal primary care, global hospital budgets and next generation accountable care organizations (ACOs) with a focus on implications for Medicaid.
UPL Calculations for Rebase Project
Service Category: Disproportionate Share and Upper Payment Limit Program FinancingAs part of the requirements for submitting a state plan amendment to change OVHA’s inpatient and outpatient reimbursement methodologies, B&A calculated the Upper Payment Limit tests for both systems to ensure federal approval. A methodology was written up to accompany the UPL calculations submitted to CMS.
Waiver Budget Development
Service Category: Budget Development and Program FinancingBudget Development and Program FinancingOVHA hired B&A to reformat its budgeting tool to support the Global Commitment for Health waiver. This new design was accompanied by a budget forecast we completed for the coming fiscal year.
Inpatient and Outpatient Hospital Reimbursement Redesign
Service Category: Rate SettingRate SettingB&A developed new payment methodologies for inpatient and outpatient hospital services. The previous methodologies had not been substantially updated for 15 years. Activities included developing multiple impacts for hospital CFOs as methodologies developed, facilitating hospital CFO and billing staff meetings on implementation, technical assistance to EDS on pricing algorithms, changes to the state plan and communications with CMS. The inpatient system (DRG) was implemented 1/1/08. The outpatient system (based on Medicare OPPS) was implemented 5/1/08. OVHA recently extended B&A’s contract for an additional year to assist in ongoing maintenance and monitoring.
Update DSH Methodology – OVHA
Service Category: Disproportionate Share and Upper Payment Limit Program FinancingMark Podrazik assisted Vermont in the redesign and implementation of their disproportionate share program to ensure federal compliance. Alternatives were modeled for the state’s consideration and the change in methodology was implemented in October 2008. A DSH methodology document was delivered to hospitals and procedure manual was produced for OVHA staff to make the DSH calculations going forward.