District of Columbia Department of Health Care Finance

This document outlines the Fiscal Year 2026 Performance Plan for the Department of Small and Local Business Development. Its core purpose is to support the development, economic growth, and retention of District-based businesses, and to promote economic development across the District's commercial areas. The plan is structured around three key objectives: creating pathways to the middle class, revitalizing commercial corridors, and ensuring an efficient, transparent, and responsive government. Key activities include maximizing federal grant opportunities, reforming CBE laws, streamlining certification processes, providing technical assistance and training, fostering strategic partnerships, and increasing access to capital for small businesses.

The meeting agenda included DHCF Updates and Discussion, covering Q&A on the DHCF Report, updates on Eligibility and Enrollment (noting Medicaid stability, Alliance/ICP decreases, and BHP updates), and Medicaid Eligibility Changes. Specific focus was given to eligibility thresholds decreasing to 138% FPL effective October 1, 2025, for the Alliance program and January 1, 2026, for certain Medicaid adults, leading to disenrollments and transitions to the Healthy DC Plan. Subcommittee reports were presented, focusing heavily on the Health System Redesign Subcommittee's recommendations regarding screening, referral, technology, care coordination, workforce integration (including Community Health Workers), and the pending renewal of the 1115 Waiver. Additionally, planning for FY26 included updates on the MAC Transition and the selection of 15 individuals for the Beneficiary Advisory Committee (BAC).

The meeting discussed the Health Home II (HH2) provider standards for enrollment being considered by DHCF, including minimum capacity standards, NCQA standards for case management models, certified EHR systems, after-hour access to care, and care coordination plan requirements. The proposed opt-out with utilization trigger process for the HH2 program was also discussed, covering attribution, inactivity, status change, and the ability for beneficiaries to change providers or opt-out of the program.

The Quality Metrics Workgroup discussed the Health Home Measures Core Set and additional DHCF measures, including All-cause 30-day Readmission, Potentially Preventable Hospital Admissions, and Low Acuity Non-Emergent Emergency Department Visits. They also considered clinical measures like Follow-up after Discharge from the Emergency Department for Mental Health or Alcohol or Other Drug Dependence and Hospital-based Inpatient Psychiatric Setting Admission Screening. The work group shifted its focus to developing a District-wide quality strategy with a focus on the Medicaid program, aligning with CMS Core Quality Measures Collaborative Announcement to establish core quality measures for less complexity in reporting, decreased cost burden, and high-quality care. The core sets focus on areas such as Accountable Care Organizations, Patient Centered Medical Homes, Cardiology, Gastroenterology, HIV/Hepatitis C, Medical Oncology, Orthopedics, Obstetrics and Gynecology, End Stage Renal Disease, and Autoimmune Diseases -- Sickle Cell Anemia.

The document outlines a strategic roadmap for care coordination, focusing on improving health outcomes, patient experience, and healthcare spending value for high-cost, high-need patients in D.C. Key strategic areas include defining care coordination and its components, implementing a Chronic Condition Health Home, and transforming the payment and delivery system to hold providers accountable for outcomes. It also details chronic condition management initiatives such as Medicaid Health Home and Medicare Chronic Care Management programs.