State Medicaid Waivers

Many states are pursuing Medicaid waivers that bring significant new federal resources with which to plan and invest in innovative new ways of serving their low-income residents. Such waivers offer major new financial, programmatic, and service opportunities for hospitals, but maximizing these opportunities demands unusual health policy expertise and a sophisticated ability to navigate highly competitive, complex, technical, and very political processes.

Some states are not aware of the potential offered by such waivers, and DeBrunner & Associates has helped hospitals introduce the waiver concept to their state Medicaid officials and describe the potential such waivers hold for improving access to quality care for their state’s residents.

For most hospitals, the biggest opportunity Medicaid waivers offer is access to delivery system reform incentive payments, or DSRIPs: federal money distributed by state governments, often in six- and seven-figure increments. Competition for DSRIP funds is typically fierce and closely tied to the ability of hospitals to propose specific projects that meet narrowly defined objectives.

With extensive experience working with providers in states with Medicaid waivers, DeBrunner & Associates helps hospitals with the many challenges inherent in pursuing DSRIP funding, including developing and describing proposed projects and ensuring that they meet eligibility criteria; fitting proposed projects into state-defined project categories; developing project valuations; and preparing project proposals.

DeBrunner & Associates also helps hospitals through other critical Medicaid waiver processes: the review of proposed Medicaid state plan amendments; cultivating participation in new regional health partnerships; project financing; evaluating the potential impact of proposed changes in Medicaid reimbursement systems; and more.

State Medicaid waivers offer hospitals the prospect of vital resources and new policies and programs through which to improve their facilities and operations and enhance their ability to serve their communities. With extensive experience working with state Medicaid waivers, DeBrunner & Associates helps hospitals make the most of this opportunity.