wyoming developmental disabilities (dd) “full” cost and ......©2020 guidehouse inc. all rights...

Wyoming Developmental Disabilities (DD) “Full” Cost and Wage Survey Training

July 20, 2020

1©2020 Guidehouse Inc. All Rights Reserved

Agenda

1. Introduction to DD Rate Study

2. Overview of “Full” Cost and Wage Survey

3. Survey Walk Through

4. Questions and Next Steps


Agenda






WDH is rebasing rates for developmental disabilities (DD) services provided under

the State’s Comprehensive and Supports waivers. WDH’s rate methodology is a

“rate build up approach” based on the Centers for Medicare & Medicaid Services

(CMS) recommended approach.

3

Rate Study Overview

Collect cost and service data from provider surveys and industry standards / comparable

states

Use feedback and decisions from stakeholders to determine rate assumptions and factors

The project has two main components:


Spring 2020

• Initial research, stakeholder meetings, survey development

Summer 2020

• Release and collect provider surveys

Fall 2020

• Review survey results, continue stakeholder meetings as needed

Winter 2020 & Spring

2021

• Conduct additional research, develop draft rate models

Summer 2021

• Finalize rate models

Fall & Winter 2021

• Present final rates to State Legislature, Update CMS waiver application

Project Timeline

We are

here!


Agenda






WDH has developed three survey versions to accommodate different provider

types.

6

Three Survey Types

Survey Type Provider Type

Full Cost and Wage Survey

(Full Survey)

“Large” provider agencies who received

more than $1 million in Medicaid

payments for waiver services in SFY 2019

Short Cost and Wage

Survey (Short Survey)

“Small” provider agencies who received

less than $1 million in Medicaid payments

for waiver services in SFY 2019 (including

independent providers)

Case Manager Cost and

Wage Survey (CM Survey)

Case management agencies and

individual case managers who delivered

case management services only


Cost and Wage Survey Goals The Cost and Wage Survey is intended to capture the finances and costs currently

associated with providing DD waiver services.

• Use financial statements as the source for costsIdentify Total

Costs

• Identify and allocate portion of costs which support waiver services

Allocate Waiver Program Costs

• Cost surveys will include total costs and waiver costs

Submit Cost Survey

Costs to

Develop DD

Service

Rates

Guidehouse will

analyze the cost

reports and

identify all

allowable costs

for potential

future rates


Survey Submission

• The deadline for submission of

the completed survey is

Wednesday, August 26, 2020.

• The survey should be completed in

Excel and submitted electronically

via email.*Exception for those who do not have access to Excel –

a PDF version is also available

• Email all completed surveys to: [email protected]

Helpful Hints

• Start early to allow time for

questions!

• When working in Excel:

– Save frequently

– Complete all tabs in the workbook

(each worksheet is on a tab)

• Utilize resources and support

options

Survey Submission Info & Helpful Hints

mailto:[email protected]


Project website

Website address: https://public.navigant.com/sites/wyddccwsurvey

On this site, you will find provider survey materials, instructions, and other information to help complete the survey

The Uniform Charts of Accounts and Program Cost Guidelines can be found here

Frequently asked questions (FAQs) will be updated throughout the survey process and posted to the project website every Tuesday

Where to go for assistance

Email Guidehouse: [email protected]

Refer to the provider survey instructions and FAQs

Project Resources

https://public.navigant.com/sites/wyddccwsurvey



• The reporting period for this survey should be your organization’s most recent

audited financials.

• Some worksheets capture information that align with the reporting year and

others are a point in time reference:

Reporting Period

Worksheet Time Period

A. Provider Information Aligns with Reporting Year

B. Services Aligns with Reporting Year

C. Provider Costs Aligns with Reporting Year

D. Wages Point in time – July 1, 2020

E. Health Insurance Benefits Current Provider Fiscal Year

F. Case Management Questions Current Provider Fiscal Year

G. Telehealth As of date of survey

H. Error Check N/A


Agenda






• Each worksheet in the file collects different information

• Helpful tips for navigating the cost survey:

– Review and complete all worksheets

– Be specific when adding information to “other” fields

– Enter data in the yellow fields (see screenshot)

• Select each yellow field to see brief instructions. Refer to the corresponding

instructions document for more details.

Survey Navigation and Helpful Tips


Worksheet Description

A. Provider InformationGeneral identifying information about the provider, including

locations, service area, revenues and total staffing

B. ServicesServices your organization delivers to Comprehensive and

Supports waiver participants

C. Provider Costs

Total Fiscal Year (FY) costs incurred, including employee salaries

and wages, program support costs, general & administrative costs

and employee-related costs

D. WagesTotal direct care employee wages, hours and benefits incurred by

the provider for services, broken down by employee type

E. Health Insurance Benefits Health insurance benefit costs and details

F. Case Management Questions Information about case management clients, if applicable

G. Telehealth Information about delivery of services via telehealth

H. Error Check Check for potential errors in survey

Worksheets Included in Survey


The purpose of this worksheet is to identify the survey respondent and collect

information on the locations/sites, including number of participants served.

Worksheet A. Provider Info


Worksheet A. Provider Info (continued)Example site information: Complete this information for Sites 1, 2, 3, 4 (if applicable).


Worksheet A. Provider Info (continued)

Example

Responses


Worksheet B. ServicesThe purpose of this worksheet is to identify the Comprehensive and Supports

waiver services your agency delivers.


Worksheet C. CostsThe purpose of this worksheet is to report the costs incurred by the provider to

deliver services during the 2019 fiscal year.

Overview of cost worksheet columns:


Worksheet C. CostsThe purpose of this worksheet is to report the costs incurred by the provider to

deliver services during the 2019 fiscal year.

Overview of cost worksheet columns:Providers complete the highlighted

columns only – Columns 3,4,6,7.


Worksheet C. Costs (continued)Cost centers


Worksheet C. Costs (continued)Example cost center – Salaries and Wages


Worksheet D. WagesThe purpose of this worksheet is to report employees’ wages, paid time off, and

unfilled positions as of July 1, 2020.


Worksheet E. Health Insurance BenefitsThe purpose of this worksheet is to provide information on the health insurance

benefits offered to employees, based on the current fiscal year.


Worksheet E. Health Insurance Benefits (continued)


Worksheet F. Case Management QuestionsThe purpose of this worksheet is to understand providers’ time spent delivering

case management services. Only complete this worksheet if your organization

provides case management services.

Example:

The number of participants you

enter in lines 2-5 should equal your

total from Line 1.


Worksheet F. Case Management Questions (continued)Example:


Worksheet F. Case Management Questions (continued)Example:

The number of participants you

enter in lines 7-8 should equal your

total from Line 1.


Worksheet G. TelehealthThe purpose of this worksheet is to describe your use of telehealth before, during,

and potentially after the COVID-19 health emergency.

Example:

In Table 1, you only need to complete the rows

for services you deliver. These are highlighted in

green based on your response in Worksheet B –

Services.


Worksheet G. Telehealth (continued)


Worksheet H. Error CheckThe purpose of this worksheet is to assist providers in confirming that all applicable

information has been completed.

Example:


Agenda






1. What is the purpose of the survey? Am I required to participate?

– DHCF is required by WY Stat §42-4-120(g) to rebase provider rates every

two to four years for the DD waiver programs. Chapter 45, Section 11(c) of

the Department of Health's Medicaid Rules establishes that, upon request,

providers shall submit cost data, claims data, and participant needs

assessment data to the Division.

2. I am new to Medicaid and had no Medicaid clients in 2019, should

I still fill out the survey?

– No, organizations who have not served Medicaid recipients in 2019 do not

need to complete the survey.

Frequently Asked Questions


3. What will the Division do with the information I provide? Is my

information anonymous?

– Completion of this survey is your opportunity to provide important

information to DHCF and the State Legislature regarding provider costs and

wages. A strong provider response is critical to the development of rate

assumptions and values for these important services.

It is important to note the following:

– The data you provide will be used to inform reimbursement rates. This

activity is not an audit of your records and there are no punitive activities

related to this project.

– The data you share with the Division will not be released publicly.

Individual providers/agencies will not be identified in the final public rate

study report.



4. Will you accept a partial set of survey data?

– DHCF will consider any data received if a provider is not able to fill out the

entire survey. However, if only partial data is submitted, it will be

difficult for DHCF to perform a complete rate analysis. If a provider

chooses to submit partial data, the provider should indicate the following in

the email accompanying the survey: (1) which worksheets they are

submitting and (2) the reason(s) for not submitting data for the remaining

worksheets. Please note that if you are unable to complete a worksheet in

its entirety, it is likely that Guidehouse will not be able to use the data.



Final Thoughts

Accurate responses are critical for DHCF to complete the rate

studyDeadline is August 26, 2020

Guidehouse is here to help –

Email us: [email protected]

Visit the project website: https://public.navigant.com/sites/w

yddccwsurvey/

Thank you for your time and commitment to this project!


https://public.navigant.com/sites/wyddccwsurvey/SitePages/Home.aspx


Contact

©2020 Guidehouse Inc. All rights reserved. This content is for

general information purposes only, and should not be used as

a substitute for consultation with professional advisors.

Andrea Pederson

Partner

Dennis Finnegan

Associate Director

Veronica Ross-Cuevas

Senior Consultant

[email protected]


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