This presentation will discuss the Independent Study of Rate Methodologies for Services Delivered by the Divisions within the Delaware Department of Health and Social Services that Burns & Associates prepared for the Delaware Department of Health & Social Services (DHSS) per the Fiscal Year 2020 Budget Bill. The Budget Bill required that DHSS complete a comprehensive review of all services, populations services, funding sources, current rates, method of rate setting, and last rate increase. 

In this presentation, Mark Podrazik will review the following: 

• Background on rate setting including the common types of rate methodologies used by state and federal entities for medical and community-based services

• Approach to conducting this study, gathering information, and analyzing the data; •The layout of the data & findings to help users navigate the report

• The nine (9) recommendations made by Burns & Associates that DHSS should consider to adapt common industry standard and strengthen rate methodologies. 

About the Presenter:
Burns & Associates, Inc. (B&A) was founded in 2006 by its Principals, Peter Burns and Mark Podrazik. Prior to this, the Principals of the firm worked together for eight years at another consulting firm. The main office is in Phoenix with staff located in Maryland, North Carolina and Ohio. B&A focuses almost exclusively on assisting public sector clients, more specifically Medicaid agencies and their sister agencies. There are currently 13 professional staff members on the team. 

Since its founding, B&A has worked with 31 state agencies in 24 states: Arizona, California, Georgia, Hawaii, Illinois, Indiana, Louisiana, Maine, Minnesota, Mississippi, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, Texas, Vermont, Virginia, and the Canadian province of Alberta. B&A is also a preferred vendor to the Medicaid and CHIP Payment and Access Commission (MACPAC). 

Mark Podrazik (President, B&A) has over 23 years of experience managing projects with Medicaid agencies in 14 states. Among the variety of projects he has managed include the evaluation of public programs either in the capacity as an External Quality Review Organization (EQRO) or independent evaluator (for IN, NY, OK, VT), the design and implementation of acute care payment reform models, and the design and implementation of models for agencies serving clients with intellectual or developmental disabilities (I/DD). 

For Vermont, he was involved in the design, development, procurement and ongoing monitoring of accountable care organizations (ACOs) first under a Medicaid Shared Savings arrangement and, later, under a Next Generation ACO framework (full risk).