Best practices within the ihs system itself and shared those and incense vized the ability to move that kind of activity that is providing highquality care for individuals in that system, in certain areas, and making certain that were able to extend that across the country in the ihs. Okay. We look forward to working with you on that. I think Best Practices is a good place to start. Obviously, those have not been employed in a lot of facilities in our state. In 2009, cms issued a final rule that required all Outpatient Therapeutic Services to be provided under direct supervision every year since then. The rule has been delayed. Either administratively or legislatively in small and rural hospitals. I shared this with you as well. In my statement we have a lot of critical access hospitals, rural areas, big geography to cover, and sometimes difficult to get providers out to these areas. So, the question is, if confirmed, will you work to
charge of some of these issues in a way that remove
complain. no one likes change, even from worst to better. but on the other hand, there are some reforms that will line the incentives between the patients, the state, and the federal government. like what? i think the per beneficiary payment is a really very positive. what s that? in layman s terms? so if you have one person, the federal government gives a certain amount of money of state for the care of that one person. the state then does the same thing with the medicaid managed care company. it takes that chunk of money and it gives it to the insurance company. and you kind of align incentives so the federal government pays the state what the state then pays the managed care company to take care of the patient. if you do that, you take care of the patient, studies show that that patient gets better care. a big piece of this, senator, is medicaid expansion and its rollback. we asked rand paul about it in our last hour. how concerned are you? i understand the obligation it p
employee self-benefit program pays for these federal employ s employees, they pay per beneficiary payment to an insurer, fair statement? correct. wouldn t it be great if medicare worked as as well as federal employee health insurance in terms of outcome? when you talk about the medicaid population, it s not a monolithic population. there are four different demographic groups within it seniors and disabled and then healthy moms and kids, by and large. we treat each one of those folks exactly the same from the medicaid rules. so, when you re pressed on whether, by golly, you believe in block grants, i don t hear any nuance in that queshgs are you speak being a per beneficiary payment? are you speak being each of those four, one of those four? how do you dice that? new york is an older state demographically. utah is a young statement. fair statement? absolutely. those are the things i think we tend not to look at, because they re more difficult to measure. they re more diffic
it, some states won t keep it. is the plan financially feesible? yes t is financially feasible because we take the dollars that are currently allocated for obamacare and we just redistribute those to this system. i would argue it is more financially feetible under obamacare the open-ended obligation where folks can pass their costs to the federal taxpayer and she or he is out no matter what is passed to them. under ours a per beneficiary payment so if you will align the incentives. the state has an incentive to watch cost, the federal taxpayer is protected but we provide essential benefits for those lower income. i want to make sure i m clear. you re not changing the money federal government is sfending on this, but the way it s distributed. yes. does that answer concerns of republicans saying this is too expensive? no, we begin to bend the cost curve so as opposed to state medicaid programs which because the federal taxpayer is paying