mmpc - National Indian Health Board

More documents

Recommendations

Info

Findings Figure 11. Unadjusted Mean Payment per Recipient for outpatient visits, laboratory & imaging, dental, and other IHS outpatient services through IHS or Tribal clinics or hospitals. Compare with IHS AIAN Groups 1 and 2 in Figure 9. Aberdeen Alaska Albuquerque Bemidji Billings California Nashville Navajo Oklahoma Phoenix Portland Tucson Outpatient Payments to IHS & Tribal Programs $- $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 27 1.IHS Program claims & Active User 2.IHS Program claims but Not Active User
Findings Table 10. Unadjusted Mean Fee-for-Service payments per IHS AIAN Recipient for Outpatient Visit, Laboratory, Imaging and Dental services. Outpatient Visit, Laboratory, Imaging, and Dental* Payments per IHS AIAN Recipient Group 1.IHS Program claims & Active User IHS Program All Providers Providers* All Providers 28 Group 2.IHS Program claims but Not Active User IHS Program Providers* IHS Area Unadjusted Mean Payments Difference Unadjusted Mean Payments Difference Aberdeen $ 2,045 $ 1,330 $ 715 $ 1,471 $ 1,045 $ 426 Alaska $ 2,554 $ 554 $ 2,000 $ 2,140 $ 387 $ 1,753 Albuquerque $ 2,124 $ 1,191 $ 933 $ 1,453 $ 974 $ 479 Bemidji $ 2,437 $ 592 $ 1,845 $ 2,417 $ 1,105 $ 1,313 Billings* $ 1,202 $ 2,039 $ (837) $ 1,202 $ 1,724 $ (521) California $ 2,026 $ 1,397 $ 629 $ 1,882 $ 1,052 $ 830 Nashville $ 1,688 $ 842 $ 846 $ 2,351 $ 530 $ 1,821 Navajo $ 4,827 $ 3,340 $ 1,486 $ 2,200 $ 2,200 $ - Oklahoma $ 1,854 $ 943 $ 910 $ 1,935 $ 918 $ 1,017 Phoenix $ 6,892 $ 4,102 $ 2,790 $ 4,841 $ 3,318 $ 1,523 Portland $ 1,963 $ 1,791 $ 173 $ 1,809 $ 1,356 $ 453 Tucson $ 7,588 $ 3,470 $ 4,118 $ 6,143 $ 3,769 $ 2,374 Area Mean $ 3,100 $ 1,800 $ 1,300 $ 2,487 $ 1,530 $ 956 Recipients in Medical Comprehensive Managed Care Plans (CMCP) Age, Sex, Disability & Morbidity Do Not Explain Differences in Payments for Recipients with Managed Medical Care If left unadjusted for any determinants, the mean total payment for IHS AIAN recipients with capitated medical care in a Comprehensive Managed Care Plan (CMCP) who are less than 65 years of age is slightly higher for Whites ($4,268 compared to $3,865, or about $400 difference), but substantially higher for Other AIAN ($3,426, or $842 difference) (Figure 11). The minimal actuarial adjustment for age and sex differences increases the difference in payments between IHS AIAN and Whites ($6,273 compared to $5,265, or about $1,000) but not with Other AIAN ($6,273 compared to $5,398, or about $875). As with the FFS recipients not in CMCP plans, this effect is expected because the IHS AIAN have a younger age distribution than that of Whites and therefore lower expected payments, but a similar age distribution to that of Other AIAN and therefore similar expected payments. Again, the mean adjusted payment increases for all three groups with the age adjustment because payments for older more costly recipients are given equal weight with less costly younger recipients which constitute the vast majority of the recipients in all three groups. This is how the statistical adjustment controls for the differences in age distributions across the three groups. Adjusting payments further for disability status, either because of Medicaid eligibility as a disabled enrollee, or as a Medicare-Medicaid ‘Dual’ enrollee under age 65, increases the adjusted means but not the differences in means for the groups (Figure 11). The mean total payment for IHS AIAN is about $1,000 higher for Whites ($7,439 compared to $6,490) and for Other AIAN ($6,479). Again the adjusted mean rises for all groups because the higher payments for the smaller groups of Disabled are given equal weight with less costly but higher proportions of non-disabled recipients during the statistical adjustment.
Page 1 and 2:
MEDICARE, MEDICAID, & HEALTH REFORM
Page 3 and 4:
GENERAL INFORMATION TABLE OF CONTEN
Page 5 and 6:
Last Updated: November 12, 2012 2.
Page 7 and 8:
Ref. # 2. Task/Issue Person(s) CMS
Page 9 and 10:
Ref. # II. POLICY Task/Issue Person
Page 11 and 12:
Ref. # Task/Issue Person(s) 9. Stra
Page 13 and 14:
Ref. # Task/Issue Person(s) 15. Eva
Page 15 and 16:
IV. OUTREACH AND EDUCATION MMPC: SU
Page 17 and 18:
Ref. # Task/Issue Person(s) 25. Med
Page 19 and 20:
MMPC October 9, 2012 Teleconference
Page 21 and 22:
To do List: -Myra will have draft b
Page 23 and 24:
Internal Revenue Service Meeting No
Page 25 and 26:
with a “interim/acting”. Can al
Page 27 and 28:
8/7/12 DRAFT COMPANION TO ADDENDUM
Page 29 and 30:
Indian Self-Determination and Educa
Page 31 and 32:
Under federal law, There are privac
Page 33 and 34:
1. Purpose of Addendum; Supersessio
Page 35 and 36:
(1) ISDEAA, 25 USC §450 et seq.; (
Page 37 and 38:
13. Medical Quality Assurance Requi
Page 39 and 40:
edits on documents are due back fro
Page 41 and 42:
d. CCIIO Philosophy - CCIIO is taki
Page 43 and 44:
- I/T/U provider receives their all
Page 45 and 46:
i. CMS rep. commented that an analy
Page 47 and 48:
IHS TRIBAL SELF-GOVERNANCE ADVISORY
Page 49 and 50:
Letter: Dr. Robert Petzel, Under Se
Page 51 and 52:
October 17, 2012 Dr. Robert Petzel,
Page 53 and 54:
A BILL To correct inconsistencies i
Page 55 and 56: California Rural Indian Health Boar
Page 57 and 58: As people have changes in employmen
Page 59 and 60: Indian eligibility determinations,
Page 61 and 62: v.7, 2012‐09‐23a ACA, (2) the s
Page 63 and 64: Indian tribe means any Indian tribe
Page 65 and 66: v.7, 2012‐09‐23a In issuing thi
Page 67 and 68: (1) to ensure the highest possible
Page 69 and 70: v.7, 2012‐09‐23a Delays in acc
Page 71 and 72: v.7, 2012‐09‐23a 1997. The prov
Page 73 and 74: v.7, 2012‐09‐23a 48 Enacted thr
Page 75 and 76: Prepared by James Crouch MPH Chair,
Page 77 and 78: Summary T he Indian Health Service
Page 79 and 80: Summary providers that were either
Page 81 and 82: Introduction Reliable determination
Page 83 and 84: Analysis Groups IHS AIAN Methods Th
Page 85 and 86: Methods group for the statistical m
Page 87 and 88: Enrollees with no Payments Methods
Page 89 and 90: Methods Table 5. Mean Medicaid and
Page 91 and 92: Restricted Benefits Methods Enrolle
Page 93 and 94: Age and Sex Methods Medical care pa
Page 95 and 96: Methods Table 9. Findings for all s
Page 97 and 98: Methods Map 1. 12 IHS Areas: Contra
Page 99 and 100: Findings Figure 1. Adjustment of Me
Page 101 and 102: Findings Payments are Higher for IH
Page 103 and 104: Findings for Group 3 was $600 and W
Page 105: Findings Unadjusted mean payments f
Page 109 and 110: Findings Figure 13. Adjusted Mean T
Page 111 and 112: Analysis Group Compiled Findings fo
Page 113 and 114: Findings Adjusted Mean Payments for
Page 115 and 116: Findings Figure 18. Percent differe
Page 117 and 118: Findings providers for services nee
Page 119 and 120: Findings Figure 21. Medicaid Altern
Page 121 and 122: Conclusions and Recommendations pro
Page 123 and 124: Indian Health Service, 2012. Federa
Page 125 and 126: Tribal Consultation Policy HHS 1. P
Page 127 and 128: defined in Sections 8 and 9 of this
Page 129 and 130: 2. Office of Intergovernmental Affa
Page 131 and 132: will give equal consideration to th
Page 133 and 134: provide Indian Tribes with a region
Page 135 and 136: 4. Each Operating Division Head/Dep
Page 137 and 138: Department’s ability to address i
Page 139 and 140: 17. Sovereignty - The ultimate sour
Page 141 and 142: 1. Selection of workgroup co-chairs
Page 143 and 144: It is unclear if this was just an o
Page 149 and 150: November 14 -15, 2012 TTAG FACE TO
Page 151 and 152: AGENDA: Day 2 Thursday - Nov. 15, 2
Page 153 and 154: Subpart G--Social Services Block Gr
Page 155 and 156: organization applying for or receiv
Page 157 and 158:
members of a tribe receiving direct
Page 159 and 160:
is at or below the poverty line. (d
Page 161 and 162:
under this part. Grantees that rece
Page 163 and 164:
income home energy assistance progr
Page 169 and 170:
Need for Uniform Operational Guidan
Page 171 and 172:
Dear Tribal Representatives, Octobe
Page 173 and 174:
There is a strong correlation betwe
Page 175 and 176:
Wed. Nov 14 th : SDPI National Call
Page 177 and 178:
Future MMPC Meetings & Conference C
Page 179 and 180:
Regulation Review and Impact Analys
Page 181 and 182:
64. Policy on Conferring with Urban
Page 183 and 184:
RRIAR Ref. # 1.c. 8. 9. 13. Short T
Page 185 and 186:
RRIAR Ref. # 20. 23. 26. 28.a. Shor
Page 187 and 188:
RRIAR Ref. # 43. 44. 46. 61. Short
Page 189 and 190:
RRIAR Ref. # 83. 84. 85. 86. Short
Page 191 and 192:
RRIAR Ref. # 2.c. 2.d. 3.a. Short T
Page 193 and 194:
RRIAR Ref. # 4.b. 5. 10.a. 10.b. Sh
Page 195 and 196:
RRIAR Ref. # 11.e. 11.f. 11.g. Shor
Page 197 and 198:
RRIAR Ref. # 22. 24. 25.a. Short Ti
Page 199 and 200:
RRIAR Ref. # 52.a. 52.b. 52.c. 57.
Page 201 and 202:
RRIAR Ref. # 60.b. 60.c. 60.d. Shor
Page 203 and 204:
RRIAR Ref. # 71.b. 72. 73. Short Ti
Page 205 and 206:
RRIAR Ref. # 6.b. 6.c. 7.a. Short T
Page 207 and 208:
RRIAR Ref. # 7.e. 7.f. 7.g. 12.a. S
Page 209 and 210:
RRIAR Ref. # 29. 31.a. 31.b. 31.c.
Page 211 and 212:
RRIAR Ref. # 39. 42. 45. 47. Short
Page 213 and 214:
RRIAR Ref. # 54. 56. 63. 64. Short
Page 215 and 216:
RRIAR Ref. # 69. 77. 88. Short Titl
Page 217 and 218:
RRIAR Ref. # 92. 35. 36. 74. Short
Page 219 and 220:
RRIAR Ref. # 94. 95. 96. 97. Short
Page 221 and 222:
premium tax credit assistance and c
Page 223 and 224:
Access to this benefit is criticall
Page 225 and 226:
community providers for purposes of
Page 227 and 228:
November 12, 2012 Centers for Medic
Page 229 and 230:
_________ American Indian or Alaska
Page 231 and 232:
November 9, 2012 Page 2 We are comm
Page 233 and 234:
Tribal Consultation for Health Insu
Page 235 and 236:
Background Analysis of Tribal Consu
Page 237 and 238:
Analysis of Tribal Consultation Pol
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 249 and 250:
Page 251 and 252:
D. FFE Data Analysis of Tribal Cons
Page 253 and 254:
John O'Brien Director, Healthcare &
Page 255 and 256:
Draft Report: Currently being circu
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
show all

mmpc - National Indian Health Board

Create successful ePaper yourself

Delete template?

Save as template?