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New Medicare Program Readmitted for Additional Work

Medicare’s new hospital readmissions reduction program has itself been readmitted for extra work after the federal government concluded that faulty calculations have resulted in inaccurate penalties and payments.
The Centers for Medicare & Medicaid Services (CMS) has announced that as part of a recent reexamination of hospitals’ performance under the program, more than 1200 hospitals were overpenalized and more than 200 will have to pay larger penalties than they were originally assessed.
The readmissions reduction program is being credited with a decrease in Medicare hospital readmissions across the country.  At the same time, however, a report in the New England Journal of Medicine suggested that the program will penalize hospitals that care for especially poor and sick patients.  MedPAC, the independent federal agency that advises Congress on Medicare reimbursement issues, recently expressed similar concerns.
Read more about the technical problems the program has encountered, the successes for which it is being credited, and the concerns that some people still have about it in thisHospital Kaiser Health News report.

2013-03-21T06:00:44+00:00March 21st, 2013|Uncategorized|Comments Off on New Medicare Program Readmitted for Additional Work

DSH Losses Will Hurt Safety-Net Hospitals

Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014.
So concludes Moody’s, the bond-rating agency.
The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes.
Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act.
Hospitals face other specific challenges as well as a result of these cuts.
Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this reportFinancial graphs in Becker’s Hospital Review.

2013-03-20T06:00:57+00:00March 20th, 2013|Health care reform|Comments Off on DSH Losses Will Hurt Safety-Net Hospitals

Hospitals Weigh Potential Impact of Medicaid Expansion in PA

Medicaid expansion in Pennsylvania could help compensate hospitals for the care they are currently providing to uninsured patients.
And enhanced Medicaid payments made possible under the Affordable Care Act also could help hospitals with their Medicaid shortfalls:  the difference between what Pennsylvania pays hospitals for the Medicaid services they provide and the actual cost of those services.
So hospital executives around the state recently told the Johnstown Tribune-Democrat.
To learn more about how selected hospital executives view Medicaid expansion and why the Corbett administration has been reluctant so far to go ahead with that expansion, read the article “Small hospitals could gain from expansion” in this Johnstown Tribune-Democrat article.
 

2013-03-19T06:00:38+00:00March 19th, 2013|Health care reform, Pennsylvania Medicaid policy|Comments Off on Hospitals Weigh Potential Impact of Medicaid Expansion in PA

Bill Would Create New Residency Positions

Doctor listening to patientA new bill before Congress would create 15,000 new Medicare-sponsored medical residency spots – the first such new positions in 15 years.
Half of those slots would be for physicians training for careers in primary care.
The bill, which has bipartisan sponsorship, would cost between $9 billion and $10 billion over the next 10 years.
Medical residents play a major role in caring for low-income and uninsured patients in many Pennsylvania safety-net hospitals.
Read more about the possibility of new medical residency slots in this article from The Hill.

2013-03-18T06:00:44+00:00March 18th, 2013|Uncategorized|Comments Off on Bill Would Create New Residency Positions

New DPW Secretary Testifies Before Senate

Acting Department of Public Welfare Secretary Beverly Mackereth appeared before the Senate Appropriations Committee this week for the first time to present and defend her department’s proposed FY 2014 – including its Medicaid budget.
Mackereth, herself a former member of the state House, also responded to committee members who questioned Governor Corbett’s decision not to expand Medicaid eligibility in the state, as provided for in the federal Affordable Care Act.
She also promised more dialogue with the General Assembly in the future.
Read more about Ms. Mackereth’s budget testimony before the Senate Appropriations Committee in this Allentown Morning Call article

State Budget


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2013-03-08T06:00:05+00:00March 8th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget|Comments Off on New DPW Secretary Testifies Before Senate

Court Rules Against State in adultBasic Case

A Pennsylvania judge has concluded that the state violated its own constitution when it ended the adultBasic program without making other provisions to use tobacco settlement funds to help lower-income adults.
The Corbett administration ended adultBasic in 2011 and used money previously designated for that program to support Pennsylvania’s Medicaid program.  Commonwealth Court judge Dan Pelligrini declared the laws that ended the program unconstitutional and said the state must use the money for adultBasic or a similar program.
Learn more about the court decision, the circumstances surrounding the challenge to the end of adultBasic, and what might happen next in this York Daily Record article.

2013-03-07T06:00:28+00:00March 7th, 2013|Uncategorized|Comments Off on Court Rules Against State in adultBasic Case

State Mulls Shuttering Health Centers

Saying there are better ways to reach more people, Pennsylvania Department of Health officials are considering closing half of the state’s health centers, many of which serve rural parts of the state.
The state would then focus on better ways of reaching people with public health services.
Learn more about this potential policy initiative in this Harrisburg Patriot-News report

State Budget


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2013-03-06T06:00:55+00:00March 6th, 2013|Proposed FY 2014 Pennsylvania state budget|Comments Off on State Mulls Shuttering Health Centers

PA Officials Estimate Sequestration’s Impact

Now that federal budget sequestration has taken effect, Pennsylvania state officials are busy calculating its potential effects on various health-related state activities.
As part of planning for sequestration, officials have developed estimates in a wide variety of areas, including cuts in substance abuse programs, meals for low-income seniors, food programs, immunizations, AIDS/HIV screenings, medical tests for women and children, and more.  They also are looking at how much Pennsylvania health care organizations will lose in research funding and how many jobs might be lost across the state as a result of significant reductions in federal spending under sequestration.
For Pennsylvania’s safety-net hospitals, the biggest problem will be a two percent cut in all Medicare payments.
For a closer look at the anticipated impact of sequestration on these and other aspects of health care spending in Pennsylvania, see this articlePennsylvania State Map in the Pittsburgh Business Times.

2013-03-04T06:00:17+00:00March 4th, 2013|Uncategorized|Comments Off on PA Officials Estimate Sequestration’s Impact

States Can Cut Medicaid Payments, Administration Says

States are free to reduce payments to providers to keep down their Medicaid costs, the Obama administration has told a court considering a challenge to a 10 percent cut in provider payments by California’s Medicaid program.
The administration weighed in on this subject in a legal brief submitted in a court case that will decide whether California can reduce its Medicaid payments to providers.
If California’s defense of its Medicaid payment cuts proves successful, it could provide a blueprint for other states to reduce payments at a time when most states are preparing for a significant expansion of their Medicaid rolls.  Many states are already concerned about the potential for rising Medicaid costs while others have opted out of Medicaid expansion or are still undecided, typically citing the potential for growing costs as the primary reason for their reluctance to expand their Medicaid programs as envisioned under the Affordable Care Act.
Any movement toward reducing Medicaid payments to providers would be extremely harmful to Pennsylvania’s safety-net hospitals, which already suffer from inadequate payments that fail to cover the cost of the care they provide to the state’s 2.1 million Medicaid recipients.
To learn more about the California case and its potential implications elsewhere, see this New York Times articleDoctor listening to patient.
 

2013-02-28T06:00:15+00:00February 28th, 2013|Pennsylvania Medicaid policy|Comments Off on States Can Cut Medicaid Payments, Administration Says
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