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LHA Update HFMA Winter Institute January 20, 2020

1 1 Hospital Association Overview

Established in 1926, the LHA is a not-for-profit association representing more than 150 hospitals and healthcare systems of all types throughout the state. Our mission is to support members through advocacy, education and services.

Primary Roles: • Representation and Advocacy • Relationships and Convener • Public Policy Leadership • Influence and Reputation • Education and Training • Coordination with Regional and • Quality and Patient Safety National Associations • Services and Information Topics of Discussion

• Legislative Update

• Medicaid Update

• Federal Update

• Looking Ahead 2020-2024 Legislature Breakdown

Senate • Republicans hold supermajority of 27 (out of 39) in the Senate.

• Republicans hold a strong majority of 69 (out of 105) in the House.

House

Republican Democrat Independent 2020-2024 Legislature Breakdown

65 members, or 45% of the legislature, will be Freshmen in their respective chambers.

Senate House

20 Freshmen • 9 First-Time Legislators

19 Incumbents 45 Freshmen • 43 First-Time Legislators 60 Incumbents 2020-2024 Legislative Leadership

Louisiana Senate House of Representatives

Sen. Rep. R-Lafayette R-Gonzales President of the Senate Speaker of the House

Sen. Beth Mizell Rep. R-Franklinton R-Houma Senate President Pro Tem Speaker Pro Tem 2020-2024 Legislative Term Dates

Important Dates in 2020:

• Jan. 13: Organizational SessionꟷCompleted

• Feb. 28: Pre-file Deadline

• March 9: Regular Legislative Session Begins

• June 1: Regular Legislative Session Ends

7 2020-2024 Legislative Term Forecast

Leadership and political posturing will dominate session. • Top issues currently being discussed: ◦ Tort Reform ◦ Workforce ◦ Redistricting ◦ Tax Reform

8 Current Medicaid Environment

Medicaid Enrollment: • Louisiana Medicaid Enrollment ≈ 1.59M ◦ For Context: LA Population ≈ 4.65M • Medicaid Managed Care Enrollment ≈ 1.5M • Medicaid Expansion ≈ 456K of Medicaid Population Covered through Expansion

Sources: LDH Enrollment Trends Report; July 2019 U.S. Census Population Estimate for LA; Managed Care Enrollment by Plan & Parish Report; and LDH Healthy Louisiana Dashboard Current Medicaid Environment

Medicaid Budget

• SFY 2020 Total State Budget: $34.9B • SFY 2020 Medicaid Budget: $13.3B ◦ Medicaid comprises approximately 38% of total state budget. ◦ $3.5B State

◦ $9.8B Federal

Sources: SFY 2020 State Budget Document, Div. of Administration & December 2019 Medicaid Monthly Forecast Report Current Medicaid Environment

Medicaid Managed Care Reprocurement • Awards announced in August 2019 currently under protest. • LDH operating under emergency contracts with the five MCOs that were previously under contract while protest is in process. Federal Update

• Hospital Price Transparency – Final Rule • Transparency in Coverage – Proposed Rule • Medicaid Fiscal Accountability – Proposed Rule • Surprise Billing Legislation • DSH • OPPS Litigation • AND…It’s an Election Year! Federal Update

CY 2020 OPPS Estimates Marketbasket 2.42% ACA-Mandated MB Reductions -0.32% Other BN Adjustments -0.57% Wage Index – Wage Data & Reclass -1.01% Wage Index – Other Changes 1.23% APC Factor/Updates 0.07% Total Estimated Change from CY 19 to CY 20 1.80% • Approximate $20M increase over previous year for Louisiana hospitals Upcoming LHA Finance-Specific Education

• Payor Day Series • Begins March 11; Baton Rouge; Register Online for Sessions or Series • This powerful five-part series provides hospital leaders with the opportunity to interact with health plan representatives, who will provide specific information on their processes and programs and will answer questions to assist hospitals with maneuvering through common challenges. • Healthy Louisiana (Medicaid): March 11; Register • Commercial: May 5; Register • Medicare, Medicare Advantage and Medicare Dual-Eligible: Sept. 16; Register • Behavioral Health: Oct. 14; Register • Veterans Health Administration: Nov. 18; Register Questions

Contact: Kevin Bridwell VP of Healthcare Reimbursement Louisiana Hospital Association [email protected]