Identifying Funding Strategies: Using Purchasing Power

1
Identifying Funding StrategiesUsing Purchasing
Power

• Charles Milligan, J.D., M.P.H.
• Executive Director
• Center for Health Program Development and
  Management
• UMBC

2
Using Purchasing PowerDriving Vendor Performance

• Require vendors to collect and measure data, and
  to improve performance
• Managed Care Organizations
• Provider-based
• Member-based
• External Quality Review Organizations
• Satisfaction measures
• Access measures
• Outcome measures
• This will drive funding what is measured gets
  done

3
Using Purchasing PowerSpecific Medicaid Issues

• Medicaid is permitted to subsidize medical
  education (IME, GME)
• Could tie funding to goals related to disparities
• Medicaid also is permitted to subsidize forms of
  indigent care to safety-net hospitals (DSH)
• Could tie funding to goals related to disparities

4
Using Purchasing PowerGeneral Contracting

• Contracts specifically designed to remediate
  barriers based on race and ethnicity
• Community organizations
• Translators
• Government sometimes uses set-asides to remediate
  disparities
• Minority-owned firms

5
Using Purchasing PowerState Regulatory Efforts

• Baseline data Examples
• Eligibility data based on race or ethnicity
• Language access collect data at state customer
  service centers and other entry points
• Establish regulations to affect change in funding
  by private entities

6
Discussion