Agenda

•	Chapter 257 of the Acts of 2008
•	Overview of Child & Family Nutrition
•	Definition and Overview of Programs
•	Procurement Approach
•	Review of Pricing Analysis and Methodologies
•	What does c.257 mean for WIC providers?
•	Data Sources & Rate Considerations
•	Timeline and Key Milestones

Chapter 257 of the Acts of 2008 Regulates Pricing for the POS System
In implementing Chapter 257, EOHHS will leverage three POS Reform Strategies to improve services and client outcomes
The Cost Analysis and Rate Setting Effort has Several Objectives and Challenges
Objectives and Benefits

•	Development of uniform analysis for standard pricing of common services
•	Rate setting under Chapter 257 will enable:
•	Predictable, reimbursement models that reduce unexplainable variation in rates among comparable, economically operated providers 
•	Incorporation of inflation adjusted prospective pricing methodologies 
•	Standard and regulated approach to assessing the impact of new service requirements into reimbursement rates 
•	Transition from “cost reimbursement” to “unit rate” 

Challenges

•	Ambitious implementation timeline 
•	Data availability and integrity (complete/correct) 
•	Unexplained historical variation in reimbursement rates resulting from long-term contracts and individual negotiations between purchasers and providers
•	Constrained financial resources for implementation, especially where pricing analysis warrants overall increases in reimbursement rates
•	Cross system collaboration and communication
•	Coordination of procurement with rate development activities

In Many Cases, Contract Reform is Necessary to Implement Chapter 257
Agenda

	Chapter 257 of the Acts of 2008
	Overview of Child & Family Nutrition Services
•	Definition and Overview of Programs
•	Procurement Approach
	Review of Pricing Analysis and Methodologies
•	What does c.257 mean for WIC providers?
•	Data Sources & Rate Considerations	
	Timeline and Key Milestones

Child & Family Nutrition Service Class

EOHHS, HCFP and DPH WIC continue to work collaboratively to adequately define and price WIC services
Child & Family Nutrition Procurement Plan

•	DPH will procure their Child & Family Nutrition (WIC) services upon adoption of the rate regulation so that services can be reimbursed under the regulated rates in SFY14.

•	The RFR will comply with all USDA requirements regarding reporting, payments and spending categories.
  
•	The RFR for those services brought under Chapter 257 rate regulation will result in rate contracts.  Fully federally funded components will remain cost reimbursement.
  
•	Contracts will continue to designate services areas.

•	Separate correspondence from DPH will outline the expected billing level for the fiscal year.

Agenda

	Chapter 257 of the Acts 2008
	Overview of Child & Family Nutrition Services
•	Definition and Overview of Programs
•	Procurement Approach
	Review of Pricing Analysis and Methodologies
•	What does c.257 mean for WIC providers?
•	Data Sources & Rate Considerations
	
	Timeline and Key Milestones

How will the transition to a unit rate from a cost reimbursement rate impact WIC providers?
Child & Family Nutrition Rate Analysis: Data Sources
WIC: Rate Considerations

•	The WIC program currently pays 3 distinct bands with accommodations made for smaller programs (<1,000) on an annual case load basis.
–	A WIC provider’s given band does not change throughout the duration of the procurement period; it is reevaluated during each procurement to ensure the determining factors still apply.

•	Considerations in rate development will include:
•	Current rate bands
•	Personnel, occupancy and other cost drivers

•	Provider stability will be an important concern in the rate development process.

•	What are some operational realities that may not be captured in the budgets but should be considered within rate development?

Agenda
	Chapter 257 of the Acts of 2008
	Overview of Child & Family Nutrition
•	Definition and Overview of Programs
•	Procurement Approach
	Review of Pricing Analysis and Methodologies
•	What does c.257 mean for WIC providers?
•	Data Sources & Rate Considerations
	
	Timeline and Key Milestones

Updated Implementation Timeline and Key Milestones for Child and Family Nutrition Services
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