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average expense per discharge by the average case weight | | for the hospital, using case weights issued by the | | federal Centers for Medicare and Medicaid Services. |
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| | | Sec. 14. Outpatient cost-efficiency. By January 1, 2006, the Maine | | Hospital Association and the Governor's Office of Health Policy | | and Finance shall agree on a timetable, format and methodology | | for the hospital association to measure and report on outpatient | | cost-efficiency. The methodology must use the ambulatory payment | | classification system as the unit of cost. |
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| | | Sec. 15. Standardization of administrative cost tracking. The Legislature | | requests that the Maine Hospital Association develop, by January | | 1, 2006, standardized definitions of various administrative cost | | categories that hospitals may use when establishing budgets and | | reporting on spending on administrative costs. |
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| | | Sec. 16. Health care administrative streamlining work group. |
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| | | 1. Work group established. The Governor's Office of Health | | Policy and Finance shall convene a health care administrative | | streamlining work group to facilitate the creation and | | implementation of a single portal through which hospitals can | | access and transmit member eligibility, benefit and claims | | information from multiple insurers. The work group shall | | investigate: |
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| | | A. Funding mechanisms, including seeking outside funding | | for start-up and ongoing operational costs, with the | | intention that the portal become independent and sustainable | | over time; and |
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| | | B. Ways to ensure that savings resulting from | | implementation of such a portal are passed on to purchasers | | in the form of rate reductions by hospitals and other | | providers and by reductions in administrative costs by | | insurers and 3rd-party administrators. |
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| | | The work group may also consider the incorporation of medical and | | quality data to the extent possible in the future. |
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| | | 2. Membership. The work group consists of 17 members | | appointed by the Governor. The membership of the work group must | | reflect the geographic diversity of the State. Members serve as | | volunteers and without compensation or reimbursement for | | expenses. The membership consists of the following persons: |
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| | | A. Four members representing community hospitals chosen |
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