Expanding KanCare Makes Good $ense

Kansas Hospital’s “At a Glance”

127 Kansas Community Hospitals - Including 83 CAHs 2

Hospitals Contribute to the Kansas Economy

Hospitals’ contribution to the local economy is critical to the economic viability of communities: • As a major source of employment • As a purchaser of goods and services • As a provider of health care services • • Kansas hospital and health care services:

4 5 th th

largest aggregate employer in Kansas largest producer of total income and total sales in Kansas Source: The Importance of the Health Care Sector to the Kansas Economy, Office of Local Government, K-State Research and Extension 3

Impact on Jobs

Kansas hospitals: • Employ approximately 81,931 people – 4.4 percent of all job holders • Support an additional 61,855 jobs in other business and industry – For every hospital job another 0.75 job supported • Total employment impact of more than

143,000 jobs

(Your Hospital Name) • Employ (XXX) people • Support an additional (XXX)+ jobs in other business and industry (number employed times 0.75) • Total employment impact of more than ( xxx – number employed times 1.75) jobs Source: The Importance of the Health Care Sector to the Kansas Economy, Office of Local Government, K-State Research and Extension 4

Impact on Income and Sales

Kansas hospitals: • Generate approximately $4.9 billion in direct labor income • Impact on income throughout all business and industry of nearly $7.2 billion – For every $1 another $0.48 is generated • Generate more than

$2.2 billion

on area retail sales (Your Hospital Name) • Generate approximately (XXX) in direct labor income • Impact on income throughout all business and industry of nearly (XXX) – For every $1 another $0.48 is generated • Generate more than (XXX) on area retail sales Source: The Importance of the Health Care Sector to the Kansas Economy, Office of Local Government, K-State Research and Extension 5

On the Horizon …

Major changes occurring in all phases of health care Kansas business and community leaders should be aware of opportunities for Kansans 6

Kansas’ Innovative Medicaid Program KanCare

• KanCare is a managed care solution to slow the growth of Medicaid costs in Kansas by controlling costs and improving health outcomes.

• KanCare went into effect Jan. 1, 2013, and is estimated to save $1.0 billion over five years.

Vision of KanCare

• To serve Kansans in need with a transformed, fiscally sustainable Medicaid program that provides high-quality, holistic care and promotes personal responsibility.

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Addressing the Uninsured Problem

• • • • The Affordable Care Act passed by Congress in 2010 mandated that states expand their Medicaid programs beginning in 2014.

The law also reduced hospital payments from Medicare and Medicaid, with the loss to be offset by covering more of the uninsured.

The U.S. Supreme Court limited Congress’ power to enforce the Medicaid mandate and expansion became a state option.

Kansas must decide if it will expand KanCare. 8

Kansas Hospitals Support Kansans

Kansas community hospitals continue to see a RISE in uncompensated care….

$1 000 000 000 $900 000 000 $800 000 000 $700 000 000 $600 000 000 $500 000 000 $400 000 000 $300 000 000 $200 000 000 $100 000 000 $ 2008

Uncompensated Care In Kansas Hospitals

2009 2010 2011 2012 Uncompensated Care = charity care + bad debt 9

Further, the Affordable Care Act will

drastically reduce

hospital payments under the Medicare and Medicaid programs….

Projected Cuts to Kansas Hospitals

$300 000 000 $250 000 000 $200 000 000 $150 000 000 $100 000 000 $50 000 000 $ 2013 2014 2015 2016 2017 Medicaid DSH Cuts 2018 ACA Cuts 2019 2020 2021 2022 10

Who Benefits from Additional Insurance Coverage?

• • • •

Private insurance payers

– Reduces the impact of the “hidden health care tax”

Kansas employers

– Insured workers are healthier workers

Health care providers and patients

– Maintains existing jobs and health care access – Provides payments for the previously uninsured

The uninsured

– Will have access to preventive care and reduce expensive emergent care provided in hospital EDs 11

Expanding KanCare

• • • • 169,000 low-income Kansans would gain insurance coverage.

The federal government pays 100% of the cost for the first three years, transitioning to 90% by 2020.

Expansion would impact individuals with an income under 133 percent of the Federal Poverty Level Example: a family of four with an annual income of $31,322 would be eligible.

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Eligible Kansans

Source: Kansas Hospital Association 13

Numbers of Kansans Under Age 65 Earning Incomes at or Below 138% FPL

KanCare Expansion Would Benefit a Diverse Population of Kansans By Occupation

Restaurants and Food Services Construction Medical and Health Services Cashiers Maids and Housekeeping Retail Sales Grounds Maintenance Workers Agricultural Workers Elementary and Secondary School Teachers Child Care Workers 26,802 22,058 11,546 7,288 3,472 8,981 2,991 2,961 836 2,768

Expanding KanCare Will Create Jobs

• • • Medicaid reform will generate 3,400 new jobs in 2014.

More than 4,000 new jobs will be sustained through 2020.

These jobs will be in hospitals, clinics, nursing and other facilities, PLUS the industries that support Kansas health care providers.

Expanding KanCare Provides Financial Benefits

• • • $800 million in federal dollars to Kansas from 2014-2016 Almost $2 billion over seven years Helps keep Kansas hospitals financially strong 17

Federal Cuts in Medicare and Medicaid Occurring

• • • Kansas hospitals will sustain $1.3 billion in federal cuts over 10 years.

Cuts occur even if KanCare isn’t expanded to reduce the uninsured population.

Without KanCare expansion, uninsured population likely to grow.

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Annual Impact of KanCare Expansion on (Insert Your Hospital Name)

Medicare ACA Cuts * Medicaid DSH Cuts * Total Losses Under the ACA KanCare Expansion * $ (XX,XXX) $ (XX,XXX) $ (XX,XXX)

Net Gain/Loss

$ XXX,XXX

$ (XXX,XXX)

Charity Care/Bad Debt $ (XX,XXX) Annual Impact Beginning in 2014 * 10-year average Source: HANYS 10-year estimated impact of the ACA; Kansas Department of Health and Environment data; Kansas Hospital Association data and calculations 19

An Opportunity for the Kansas Medicaid Program

• Kansas hospitals support expanding KanCare because we know that lack of insurance keeps people from receiving regular care. • Kansas should opt for a truly Kansas solution to the uninsured; one that builds upon the KanCare program which focuses on providing the right care, in the right amount, in the right setting and at the right time. 20

Two-Thirds of Kansans Support Medicaid Expansion

In a statewide public opinion poll, the majority of Kansans surveyed were supportive of Medicaid expansion for one of three reasons: 1) covering individuals with an income up to 138% of the federal poverty level 2) bringing additional federal funds to Kansas, or 3) preventing Kansas tax dollars from going to other states. Source: Public Opinion Poll was administered by ETC Institute of Olathe, Kansas.in December 2012. The complete survey results can be found on the KHA Web site at www.kha-net.org

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Kansas Has a Choice

• • Expand KanCare, inject $800 million into the Kansas economy over three years, cover 169,000 low-income uninsured Kansans,

OR

Let Kansans’ tax dollars help finance Medicaid expansion in other states, jeopardize Kansas hospitals’ financial stability, compromise access to care for all 22

What Can You Do?

• Pass a resolution supporting KanCare expansion and publicize your actions.

• Contact your lawmakers and the governor and express your support for KanCare expansion and bringing Kansas tax dollars back home.

• Act now, before it is too late!

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For More Information

Insert your Name Hospital Contact Information

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