Background

Dozens of safety net providers across several counties in a state had low Medicaid reimbursement rates and struggled financially to care for low-income residents. The state had to come up with a sustainable funding stream to bring in additional dollars to help safety net hospitals continue to provide critical services to their Medicaid and uninsured populations. To secure additional funding, Sellers Dorsey partnered with stakeholders to create and enact a local hospital fee program for seven counties.

The Collaboration

In November 2018, state lawmakers enacted legislation allowing seven counties the option to enact a local hospital fee program. Sellers Dorsey worked with state officials and county stakeholders to design the program, provided technical assistance during discussions between all stakeholders, and assisted the counties in drafting all seven preprints for CMS approval. Our team also provided technical assistance to the state and counties as they worked through various components of the program, including the development of all materials and methodologies necessary for the counties and hospitals to submit a plan to participate in the initiative, and project managed a detailed calendar of activities to keep the entire initiative on track. The Sellers Dorsey team represented the state’s interest when designing program logistics to ensure the least amount of risk and ease of the logistics for the longevity of the program.

The Results

Through our efforts, each of the seven separately designed programs received CMS approval in July 2021. The program provides hospitals increased Medicaid payments to expand health care access and provide quality care to vulnerable populations in the state. Sellers Dorsey continues its work to implement the program that will provide approximately $400 million in annual supplemental payments to 40 eligible hospitals across the seven participating counties for essential health care services, thus increasing access to life-saving services and promoting equitable health care for vulnerable communities and individuals.