Bill Text: HI SCR93 | 2012 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Pilot Program; Medicaid; DHS; DOH

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2012-03-30 - (S) Report adopted, as amended (SD 1) and referred to WAM. [SCR93 Detail]

Download: Hawaii-2012-SCR93-Introduced.html

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THE SENATE	S.C.R. NO.	93
TWENTY-SIXTH LEGISLATURE, 2012
STATE OF HAWAII

SENATE CONCURRENT

RESOLUTION

 

 

requesting the department of human services and the department of health to develop a pilot demonstration program focused on the top five percent of Medicaid beneficiaries whose care needs account for a significant portion of Medicaid expenditures in the State.

 

 

     WHEREAS, a small proportion of the total population in the United States accounts for half of all medical spending in the country -- according to a report by the federal Agency for Healthcare Research and Quality, five percent of the United States population that spent the most on health care accounted for forty-nine percent of total health care spending; and

 

     WHEREAS, according to the same report, the fifteen most expensive health conditions in the United States account for forty-four percent of total health care spending, and expenses for individuals with five or more chronic conditions are approximately fourteen times greater than spending for individuals without any chronic conditions; and

 

     WHEREAS, potentially avoidable costs are considered to be the result of care defects, or health problems resulting in technical care under the professionals' control which could have been avoided by following best professional standards, and these potentially avoidable costs account for twenty-two percent of all private-sector health care expenditures in the United States; and

 

     WHEREAS, information from health care claims, hospital records, and emergency service providers can help identify high cost beneficiaries for coordinated outpatient and social services; and

 

     WHEREAS, a high level of outpatient care includes strengthening relationships with patients; a comprehensive team of providers, nurse practitioners, social workers, community workers, and emergency department personnel; and connections to social services such as housing, home visits, and meals; and

 

     WHEREAS, a Medicare demonstration project designed to improve coordination of care for the most chronically expensive patients at a Boston, Massachusetts, hospital resulted in hospital stays and emergency room visits dropping by more than fifteen percent; and

 

     WHEREAS, care management programs that focus on coordination of care for the most chronically expensive beneficiaries can incentivize and reward unrelated providers in a fee-for-service environment, reduce potentially avoidable costs due to care defects, reduce emergency room admissions, and create better health outcomes and cost savings; now, therefore,

 

     BE IT RESOLVED by the Senate of the Twenty-sixth Legislature of the State of Hawaii, Regular Session of 2012, the House of Representatives concurring, that the Department of Human Services and the Department of Health are requested to develop a two-year pilot demonstration program that is focused on the top five percent of Medicaid beneficiaries whose care needs account for a significant portion of Medicaid expenditures in the State; and

 

     BE IT FURTHER RESOLVED that the pilot demonstration program coordinate services to the highest need, highest cost Medicaid beneficiaries; include an outpatient care component with comprehensive health care and social services; and identify methods of reducing potentially avoidable costs due to care defects and emergency room admissions; and

 

     BE IT FURTHER RESOLVED that the Department of Human Services and the Department of Health are requested to report on the status of the pilot demonstration program no later than twenty days prior to the convening of the Regular Session of 2014; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Human Services and the Director of Health.

 

 

 

	OFFERED BY:	_____________________________

Report Title:  

Pilot Program; Medicaid; DHS; DOH