Dec 19, 2019

In These Trying Time Try Something New!

In these trying economic times there is a dearth of good news; here is what little there is. Based upon the latest data released by the Department of Health, NYS spending for Medicaid is two and half percent (2.5%) below budget through August 2011. This was accomplished as a result of the efforts of the entire health care industry. Health Care Providers have done their part to meet the target established in this year’s Medicaid budget. This was a difficult task given the parameters of the Medicaid budget, which was capped at $15.3 billion, with no adjustment for the impact of increased Medicaid enrollment. The Department of Health also reported through August, a one and half percent (1.5%) increase in the number of Medicaid enrollees, or 73,000 new individuals covered by Medicaid. Such news, to be better than budget and caring for more individuals, is indeed positive news. Unfortunately, the good news is overshadowed by ongoing economic and political problems.

The news from Albany and Washington during November was extremely problematic, perhaps catastrophic. The NYS projected budget deficit for fiscal 2012-2013 was revised. An early projection of a $2.0 billion deficit was adjusted during the month; the new budget shortfall could be as high as $3.5 billion. The modification in the projected deficit was based upon shortfall in tax receipt; $404 million less than the estimates from earlier in the year. This news was soon overshadowed by reports from Washington and the so-called Super Committee.

The Super Committee was tasked with Budget Reduction alternative to those that were built into the Debt Ceiling legislation passed this summer. The legislated reductions were like a “poison pill’” designed to encourage more palatable reductions. Given the contentious relationships between the political parties, and the Congress and President, this seemed like an approach that could work. In November we learned that the Super Committee could not complete its task. If this Debt Ceiling related budget cuts are implemented, the impact on NY is enormous. According to the Governor, the loss of federal aid will lead to a loss of at least 155,000 jobs in the State and a loss of tax revenues.

The scenario planning related to the news from Albany and Washington is not pretty. For the health care industry it may mean an enormous increase in Medicaid enrollees, probably offset by drastic reductions in Medicaid reimbursement. This is likely for Fiscal 2013-14 when the Federal cuts will hit in earnest. It is equally likely that Medicaid will continue to be capped and growth in enrollment that exceeds the cap will be offset by reduced payments to providers. We could use all kinds of adjectives to describe to describe the dire situation that the industry is facing. Whatever word or word used, nursing homes need to come up with even more efficiencies than ever before. So Caretech steps up with yet another service to help nursing homes reduce expenses.

During 2011, as Caretech worked with its customers to find ways to continue to lower supply costs, we would often hear, “if only you could do something to help us with pharmacy expenses.” One administrator categorized the pharmacy expense as a black hole in space. The pharmacy expense is consuming more resources, just like a black hole that absorbs everything around it. In the past, The Pharmacy Consultant would have time to review the Pharmacy bill, assuring that the facility was being charged appropriately and generic drugs were maximized. Medicare Part D and Managed Care complicated the pharmacy bill. Changes in the Survey process, and new regulations forced facilities to focus the Pharmacy Consultant on clinical issues exclusively. With a thinner middle management core, facilities were not in a position to effectively monitor pharmacy expenses. Facility pharmacy bills grew significantly and so did the complexity of the bill. Too many administrators were uncomfortable with the validity and reliability of the bills. Yet they were unable to consistently and effectively review it and lower these costs. Caretech understands the challenges, concerns and has a response.

Caretech has entered into a strategic relationship with Accuscript, a service designed to review and lower pharmacy expenses. The benefit to a nursing home is as follows:
• Accuscript reviews your monthly invoice and assures that Medicare Part D, Managed Care and Medicaid are billed correctly and your facility is billed only when it should be
• Accuscript will work with your facility to minimize/eliminate Over The Counter Medications ordered from the pharmacy
• Accuscript will collaborate with the Medical Director and the Attending Physicians to assure generic and medication approved by the payer formularies are used as often as possible
• Accuscript fee is based upon shared savings – there is no financial risk to your facility!
Caretech and Accuscript are already helping facilities lower these expenses, generating significant savings.

In these trying times, try something new. As you strategic partner, Caretech can help your organization find innovative solutions. Let Caretech help you find new ways to weather these trying times