Tuesday, March 28, 2017

Rising health care costs could put pressure on EMS revenue

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The issue of health care costs is front and center for the Legislature in the 2017-2018 legislative session.
Gov. Charlie Baker’s fiscal 2018 budget proposal would direct nearly 40 percent of its $40 billion total to MassHealth. The budget also contains outside sections that propose both health care cost containment measures and new revenue proposals to support health care costs that are likely to continue to climb.
On March 15, the Special Commission on Provider Price Variation released its extensive report with recommendations to reduce unwarranted price variations. The commission was tasked with identifying factors that contribute to price variation and determining whether those factors are acceptable. The report provides evidence to support its recommendations.
It now falls to the governor, Legislature and various state agencies to consider the report’s recommendations and take action as they see fit.
While many cost containment measures may help municipalities directly and indirectly, any type of rate capping structure could have unforeseen consequences on municipal budgets, specifically on municipal fire departments that provide emergency medical services. EMS tends to be more costly than other medical services due to a number of factors, including the requirement for immediate response and the fact that consumers aren’t able to choose an “in network” provider. The high cost of EMS could lead to these services being reimbursed at lower rates under some of the cost containment measures being considered.
Lower reimbursement rates could cause significant financial problems for municipal fire departments that provide EMS, as they could lose hundreds of thousands of dollars in revenue annually.
Local officials and fire chiefs appreciate the importance of implementing health care cost containment measures, but worry about doing so with too broad a brush. EMS is a unique type of service and treating it the same as other services could have unintended consequences. EMS providers have limited options for reducing costs, and may need to be addressed separately rather than being included with other services.
Legislation has not been filed specifically addressing EMS costs, but as the session continues and health care stays at the forefront, this and other health care cost issues are likely to be considered.
The MMA is working with fire chiefs and other interested parties to meet with legislators on this issue and will continue to monitor the situation.
For more information and to download the special commission report, see the report here.

posted by Jeff Bennett

Narragansett Regional School

Budget/Finance committee meeting
Tuesday, March 28, 2017 (Today)
5:00 PM - Central Office
          1. Review FY budget
          2. Other

The above should be a link to the town web site and the fiscal year budget book.
As I am technology challenged, if it does not work, let me know and I will try to fix but so far, it has worked several time for me. It is important, so please take a look.

posted by Jeff Bennett

As I posted before, the number given for the school assessment at a previous meeting of selectmen and Advisory Committee when the FY 2018 spending plan was handed out and discussed was NOT the actual school budget. It was an estimate and as the selectmen were told last night, that estimate was off and low and there will now have to be some adjustments to meet the school budget numbers presented to them (BOS) by the Town Administrator.

Weekly Town bills warrant; After checking on that, I learned that not much has changed since i served on the board, the warrant still comes with reference material in the form of bills, receipts, purchase orders etc., except for the legal bills. Apparently one change made by Bob Markel and also apparently okay with the selectmen, was that the details of the bill were removed from the warrant and now only a cover sheet is included in the warrant with date and some totals. Apparently the detailed "backup" or the when, who, what and how much is kept in the office of the selectmen. So Diane Brooks was telling the truth when she said the details of the legal bills were/are not in the warrant. My question now is, who or why would anyone sign off on a bill without seeing or knowing the details? i know I would not pay a credit card bill with out seeing dates, places, items and dollar figures first. However, from what Diane Brooks commented and from what I found out by checking on the warrant, it looks that is exactly what selectmen Brooks did and has done, signed off on paying a bill without any explanation of those bills, without any real invoice and perhaps this present practice should stop and the process should go back to the way it was, when the details of the legal billing was included in the warrant. Of course, the warrant being a public record that anyone can go to town hall and ask to see it. That is the way it is suppose to work anyway. Perhaps that is the reason for the change, so not just anyone can go to town hall and see the details of the legal billing. Of course, there is John Columbus who served as chairman of the selectmen and as he stated, he and Markel shared the same thoughts and ideas on alot of things.

The recommendations of the insurance committee were put off until the April 3 meeting, when the selectmen and advisory committee will be meeting jointly.

posted by Jeff Bennett