Fiscal Year 2015 Vermont Hospital Budgets

Green Mountain Care BoardSeptember 11, 2014

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Agenda

What were GMCB instructions?

What did GMCB receive?

GMCB staff recommendations - hospital net patient revenue increases

Hospital budgets we are voting on today.

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GMCB FY15 Budget Instructions

Net patient revenue increase is allowed up to 3.0%

Increase applied to FY 2014 base budget of $2.182 billion

Possible new money - $65.5 million

The GMCB will examine whether health care investments are allowable for an additional 0.8% increase

Possible new money - $17.5 million

Total estimated new money increase allowed – $83 million; 3.8% increase

$83 million/ $2.182 billion = 3.8%

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What did GMCB staff receive?

Budget instructions allowed: $83 million/$2.182 billion = 3.8%

Net patient revenue increase is allowed up to 3.0% or $65.5 million

New money actually requested - $55.3 million

The GMCB will examine whether health care investments are allowable for an additional 0.8% increase or $17.5 million

New money actually requested - $12.8 million

Total requested new money increase - $68.1 million; 3.1% increase

$68.1 million/ $2.182 billion = 3.1%

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Explanation of GMCB staff recommendations

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FY 15 based upon hospital budget requests received July 1

7.8%

5.0%5.3%

5.6%

7.1%

2.7%2.2%

0.0%

1.0%

2.0%

3.0%

4.0%

5.0%

6.0%

7.0%

8.0%

9.0%

A08-A09 A09-A10 A10-A11 A11-A12 A12-A13 B13-B14 B14-B15

All Vermont Community Hospitals Net Patient Revenue Annual % Increase

Notes:a Budget increase as approved by the GMCBb Budget increase as reported by hospitals in July of 2014Adjusted to reflect bad debt reporting change in 2012

a b

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FY 15 based upon hospital budget requests received July 1

$124.1

$86.1$95.4

$105.0

$142.3

$57.9$47.4

$0

$20

$40

$60

$80

$100

$120

$140

$160

A08-A09 A09-A10 A10-A11 A11-A12 A12-A13 B13-B14 B14-B15

Mill

ions

All Vermont Community Hospitals Net Patient Revenue Annual $ Increase

Notes:a Budget increase as approved by the GMCBb Budget increase as reported by hospitals in July of 2014Adjusted to reflect bad debt reporting change in 2012

a b

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Net Patient Revenue change GMCB staff recommendations

GMCB Staff Adjustments to

Budget 2015 Net Patient Rev

Growth

Adjusted Budget 2015 Net Patient

Rev Growth

Adjusted Net Patient Rev %

change Status1,491,506$ 2.1% Approved

(762,673)$ 5,086,794$ 3.2%1,804,859$ 3.1%

10,310,301$ 38,708,338$ 3.7%6,648,791$ 295,564$ 0.5%

1,419,747$ 8.6% Approved1,608,040$ 3.4% Approved

(1,789,153)$ -2.4% Approved636,947$ 1.0% Approved

3,036,580$ 3.5% Approved(440,902)$ 2,446,528$ 3.5% Approved

6,318,228$ 2.9% Approved4,869,811$ 4,335,185$ 3.1%

2,673,801$ 5.1% $ 20,625,328 $ 68,072,964 3.1%

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Hospital budgets we are voting on today

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Net Patient Revenue change Analysis of unapproved hospital budgets

Schedule B

Hospital

Adjusted Net Patient Rev $

change

Adjusted Net Patient Rev %

change Amount over 3%

Southwestern 4,335,185$ 3.1% 147,900$ Central Vermont 5,086,794$ 3.2% 275,623$ Copley Hospital 1,804,859$ 3.1% 70,990$ Gifford Medical Center 295,564$ 0.5% -$

Fletcher Allen 38,708,338$ 3.7% 6,927,246$ Springfield 2,673,801$ 5.1% 1,114,454$

Hospital responses why hospital exceeds 3%

Health care Reform - ACO

Health care Reform - other

Surplus Increase

Physician transfer Other * Total Explained

350,000$ 495,000$ -$ -$ 845,000$ -$ 2,100,000$ -$ -$ 2,100,000$

70,990$ -$ -$ -$ 70,990$ -$ -$ -$ -$ -$

-$ 8,000,000$ -$ -$ 8,000,000$ 75,000$ 158,600$ 588,077$ 292,777$ 1,114,454$

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History of Approved Rates

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Resources

Hospital Budget Hearings schedule on the web: http://www.gmcboard.vermont.gov/hospital_budgets/2014scheduleGMCB reports and hospital budget information on the web: http://gmcboard.vermont.gov/hospitalbudgetsNew process for enforcement of budgets once they have been approved: http://gmcboard.vermont.gov/sites/gmcboard/files/B14_enforcement_concepts041113.pdfTo provide public comment on the web: http://gmcboard.vermont.gov/publiccommentsEmail/Mail comments to: Anna.Bassford@state.vt.us

Green Mountain Care Board 89 Main StreetMontpelier, Vt. 05620

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Contact Info.If you have questions about this report or if you would like more detail, please contact GMCB (802) 828-2177 and ask for: Michael Davis Janeen Morrison Lori Perry

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Endalso known as the 19th hole