mmpc - National Indian Health Board

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Findings Adjusted Mean Payments for IHS AIAN without IHS Program Medicaid Claims are Lower than Others IHS AIAN who were Active Users but had not IHS Program Medicaid claims had substantially lower payments than all other groups (Table 12). Payments for the three different subgroups of IHS AIAN created by the linkage of data with the IHS registry system were analyzed in the same way as in Table 11 to arrive at an overall measure that allowed comparison of IHS Active Users with no IHS Program Medicaid claims with the two groups of IHS AIAN with IHS Program claims as well as Other AIAN and Whites (Attachment Table L.5). There were sufficient numbers of IHS AIAN without Medicaid IHS Program claims under age 65 to allow analyses but not over age 65, and therefore a total of 4 analyses were possible. The per capita payments for IHS AIAN Active Users without IHS Program Medicaid claims were substantially lower for all types of Medicaid recipients when compared to either IHS AIAN subgroup with IHS Program Medicaid claims (IHS Active Users with IHS Program claims: 64% to 93% lower; and IHS Program claims only: 26% to 100%). Payments were substantially lower than those of other AIAN who did not use the IHS system (11% to 30% depending on the type of Recipient), and of whites living in the same counties (14% to 46% depending on the type of Recipient). Table 12. Difference in Adjusted Mean Total Payment per Recipient for IHS AIAN Active Users (group 3) with no IHS Program Medicaid claims of each type of Recipient analyzed compared to IHS AIAN groups IHS Program Medicaid claims (groups 1 and 2), Other AIAN and Whites in each Area. IHS Area Analysis Group Recipie nts 1 FFS Medical (220,368) Mean Paymt Differe nce Recipie nts Mean Paymt 35 Analyses 2 3 4 Recipients Less than 65 years of Age 12 months Enrollment Any Months of Enrollment Capitated Medical (34,490) Differe nce Recipie nts FFS Medical (336,888) Payments per Year Payments per Month Mean Paymt Differe nce Recipie nts Capitated Medical (116,277) All Areas 1.IHS Claims & User -64% -76% -93% -71% Mean Paymt Differe nce 2.IHS Claims -52% -81% -100% -26% 3.IHS Active User 55670 $ 3,820 13951 $ 4,134 103859 $ 585 46931 $ 465 Other AIAN -16% -11% -30% -16% Whites -27% -14% -32% -46% When the overall measure was calculated by IHS Area across the 4 types of Medicaid recipients, only Nashville Area was found to have overall higher payments (26% higher) for the IHS AIAN Active Users without IHS Program Medicaid claims than for Other AIAN who did not use the IHS system (Figure 18, Attachment Table L.6). Only Tucson was found to have substantially higher payments for the IHS AIAN Active User group than Whites (13%, Figure 19). Nashville had only 1% higher payments than Whites, which is negligible. Oklahoma Area had lower payments for the IHS AIAN Active User group than all four of the other groups but only 1% to 4% lower (Attachment Table L.6). Aberdeen Area also had lower payments that were only 1% to 9% lower than the four other groups.
Findings Figure 18. Percent differences in the adjusted Mean Total Payments for IHS AIAN recipients without Medicaid IHS Program claims compared to Other AIAN for the 4 analyses under age 65. See Attachment Table L.6. Aberdeen Alaska Albuquerque Bemidji Billings California Nashville Navajo Oklahoma Phoenix Portland Tucson -60% -40% -20% 0% 20% 40% 60% Figure 19. Percent differences in the adjusted Mean Total Payments for IHS AIAN recipients without Medicaid IHS Program claims compared to Other AIAN for the 4 analyses under age 65. See Attachment Table L.6. Aberdeen Alaska Albuquerque Bemidji Billings California Nashville Navajo Oklahoma Phoenix Portland Tucson -60% -40% -20% 0% 20% 40% 60% 36
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MEDICARE, MEDICAID, & HEALTH REFORM
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GENERAL INFORMATION TABLE OF CONTEN
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Last Updated: November 12, 2012 2.
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Ref. # 2. Task/Issue Person(s) CMS
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Ref. # II. POLICY Task/Issue Person
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Ref. # Task/Issue Person(s) 9. Stra
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Ref. # Task/Issue Person(s) 15. Eva
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IV. OUTREACH AND EDUCATION MMPC: SU
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Ref. # Task/Issue Person(s) 25. Med
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MMPC October 9, 2012 Teleconference
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To do List: -Myra will have draft b
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Internal Revenue Service Meeting No
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with a “interim/acting”. Can al
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8/7/12 DRAFT COMPANION TO ADDENDUM
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Indian Self-Determination and Educa
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Under federal law, There are privac
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1. Purpose of Addendum; Supersessio
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(1) ISDEAA, 25 USC §450 et seq.; (
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13. Medical Quality Assurance Requi
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edits on documents are due back fro
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d. CCIIO Philosophy - CCIIO is taki
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- I/T/U provider receives their all
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i. CMS rep. commented that an analy
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IHS TRIBAL SELF-GOVERNANCE ADVISORY
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Letter: Dr. Robert Petzel, Under Se
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October 17, 2012 Dr. Robert Petzel,
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A BILL To correct inconsistencies i
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California Rural Indian Health Boar
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As people have changes in employmen
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Indian eligibility determinations,
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v.7, 2012‐09‐23a ACA, (2) the s
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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
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Page 97 and 98: Methods Map 1. 12 IHS Areas: Contra
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Page 101 and 102: Findings Payments are Higher for IH
Page 103 and 104: Findings for Group 3 was $600 and W
Page 105 and 106: Findings Unadjusted mean payments f
Page 107 and 108: Findings Table 10. Unadjusted Mean
Page 109 and 110: Findings Figure 13. Adjusted Mean T
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Page 113: Findings Adjusted Mean Payments for
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
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Page 139 and 140: 17. Sovereignty - The ultimate sour
Page 141 and 142: 1. Selection of workgroup co-chairs
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Page 157 and 158: members of a tribe receiving direct
Page 159 and 160: is at or below the poverty line. (d
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Need for Uniform Operational Guidan
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Dear Tribal Representatives, Octobe
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There is a strong correlation betwe
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Wed. Nov 14 th : SDPI National Call
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Future MMPC Meetings & Conference C
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Regulation Review and Impact Analys
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64. Policy on Conferring with Urban
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RRIAR Ref. # 1.c. 8. 9. 13. Short T
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premium tax credit assistance and c
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Access to this benefit is criticall
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community providers for purposes of
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November 12, 2012 Centers for Medic
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_________ American Indian or Alaska
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November 9, 2012 Page 2 We are comm
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Tribal Consultation for Health Insu
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Background Analysis of Tribal Consu
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Analysis of Tribal Consultation Pol
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D. FFE Data Analysis of Tribal Cons
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John O'Brien Director, Healthcare &
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