1. ACA Symposium December 16, 2013 Esther L. Muña, MHA, Interim CEO
The ACA and CHCC
ACA Symposium
December 16, 2013
Esther L. Muña, MHA, Interim CEO

2. Additional ACA funds huge help in funding CHCC operations
Prior to ACA:
Approximately $6M Medicaid cap
50% Federal Matching funds
ACA:
Allowed more funding to CHCC, above Medicaid Cap
Additional 5% Federal Matching (beneficial for CPE)

3. Certified Public Expenditure (CPE)
Matching Requirement – CHCC cannot be reimbursed for services without a CNMI local match.
In FY 2012, only $2.5M in local appropriation was available for the entire CNMI health care providers.
As of January 2012, CPE methodology was approved by Medicaid and it allowed CHCC to be reimbursed WITHOUT local match and allowed Medicaid to use funds beyond the CAP and the ACA funds
Based on actual costs of treating Medicaid- eligible

4. COST of HEALTH CARE FY 2012: CHC Hospital alone cost
$32M & RHC & THC cost about
$3M combined
FY 2013: CHC Hospital costs were $36M
$3M combined for RHC/THC

5. ACA and Medicaid In 2012, $10M of Medicaid/ACA funds paid to CHCC
Represents $18M of actual costs; $8M not reimbursed
In 2013, approximate $800K paid to CHCC monthly
Represents $1.4M of actual monthly costs; $600K not reimbursed

6. What Next
In 2013, approx. 400 patients applied for CHCC Indigent program; more patients applying for program.
There’s a need to fund the unmatched funds. A loss of $600K per month is not sustainable.
Strategic Plan needs to consider the end of ACA funding support - when match returns to 50% match instead of current 45% and when CAP is again enforced.

7. Thank You Si Yu’us ma’åsi’ yan Ghilisoow!