MeetingSummary-CalDuals.org.docVIP

Fiscal and Rate-Setting Work Group: Duals Demonstration Stakeholder Work Group Meeting #1: Tuesday, June 5, 2012 This introductory meeting provided participants with a high-level overview of the fiscal and rate-setting process for the duals demonstration. This meeting started with an overview of the financial alignment process at the national level. Then discussions dove deeper into the key components and considerations of the initial rate structure document released by the Centers for Medicare and Medicaid Services (CMS). This is one of seven stakeholder work groups organized by California’s Department of Health Care Services (DHCS) to gain input on the dual eligibles demonstration. Background information on the work groups and all materials can be found at www.CalD. Key issues raised: The duals demonstration requires a unique rate-setting process; guidance from CMS is essential. Rate setting is a constantly evolving process. The goal is to create a “best start,” and then make necessary alterations to the rate-setting process over time. In California, a baseline capitated payment rate will be computed for each demonstration county. There is not going to be a statewide applicable rate. Health plans are requesting greater technical guidance from the state and CMS. Introduction to Duals Demonstration Work Group Process Led by Mari Cantwell, Deputy Director, Health Care Financing, DHCS Mari Cantwell introduced the panelists and welcomed everyone to the first Fiscal Rate Setting work group meeting. Relevant issues and concerns raised during this work group meeting will be shared with CMS to continue discussion around the rate-setting process for the duals demonstration. National Perspective: Financial Alignment Models and Rate-Setting Strategies for Dual Eligible Demonstrations Led by Suzanne Gore, Director of Integrated Care, Center for Health Care Strategies Suzanne Gore led a high-level discussion about the process used at the national level to set rates for M