Newsletter December 2024
Finance
Leslie Thomas, MBA, CPA
Chief Financial Officer
As reported in October 2024, MSHN’s Finance Team is continuing Fiscal Year 24 close-out activities.
Two items reported in October 2024 are highlighted directly below this month for ongoing efforts. Both items assist
with financial planning and have demonstrated the importance of managing and reviewing the region’s fiscal status
at multiple times throughout the fiscal year to monitor fluctuations. The Interim Financial Status Report (FSR) (item
2) is utilized in calculating Interim cost settlement figures (item 1). As we continue evaluating MSHN’s FY 24 fiscal
picture, the additional revenue from the Michigan Department of Health and Human Services (MDHHS) FY 24
amended rates will offset the board approved deficit but to a lesser degree than originally believed. Estimates from
the Interim MDHHS FSR is showing a likely deficit of close to $23 M instead of the $19 M calculated in
September. MSHN will not have any FY 24 Medicaid Savings carryforward. Medicaid Savings is generated when
the region’s expenses [Community Mental Health Service Programs (CMHSPs) and Pre-paid Inpatient Health
Plans (PIHPs)] are less than the current fiscal year’s revenue.
- MSHN and CMHSP Interim Cost Settlement - MSHN is obligated to cover allowable CMHSP Medicaid and
Healthy Michigan Plan (HMP) expenses. Any dollars in excess of CMHSP expenses must be returned to
MSHN. The region typically completes 85% of its preliminary cost settlement transactions in mid-
November. If CMHSP expense exceeded revenue provided by MSHN, the PIHP is responsible for sending
additional funds to cover the costs. - MSHN and MDHHS Interim Reporting – November is the month MSHN also submits an interim Financial
Status Report (FSR) to MDHHS. This report includes a breakdown of Medicaid and HMP expenses by
CMHSP and MSHN. It outlines revenue, expenses, potential savings amounts, and Internal Service Fund
(ISF) calculations.
FY25
MSHN monitors its fiscal its fiscal position periodically throughout the fiscal year. The purpose of this monitoring is
to not rely solely on the Financial Statements presented to the board as CMHSP expense lines generally represent
per-eligible per month (PEPM) payments. Through ongoing monitoring, the PIHP collects anticipated CMHSP
expenses as compared to MDHHS revenue and both components show an anticipated Savings or Deficit. Savings
amounts are evaluated for contributions to the Region’s ISF if it is not fully funded at the MDHHS allowable 7.5%
maximum. As a reminder, Savings is not expected for FY 25 and there will likely be at least $10 M used from the
ISF based on MDHHS rates received in late September.
For further information or questions, please contact Leslie @ Leslie.Thomas@midstatehealthnetwork.org.