PA Safety Net Admin, Author at Safety-Net Association of Pennsylvania

Are Readmission Penalties Bad Medicine for Medicare Patients?

As the federal government prepares to penalize hospitals with high readmission rates, new research suggests that appropriate readmissions may actually result in better care for the nation’s seniors.

According to new research, some hospitals that have high readmissions rates for the medical conditions that Medicare tracks – heart attacks, heart failure, and pneumonia – also have higher survival rates among patients with those conditions.

Such findings, while preliminary, call into question the manner in which Medicare intends to adjust future payments to hospitals based on their readmission rates in the value-based purchasing program it will introduce in October of this year.

This issue is of particular concern to Pennsylvania’s safety-net hospitals, which care for many low-income and dually eligible seniors who have had sporadic contact with the health care system throughout their lives and often present multiple medical challenges that require more than one hospitalization to address.

Read more about these new findings and their implications in this Kaiser Health News report .

PA Safety Net Admin2012-07-27T06:00:16+00:00July 27th, 2012|Uncategorized|Comments Off

Failure to Expand Medicaid Could Hurt PA Hospitals

A decision by Pennsylvania state officials not to expand the state’s Medicaid program as envisioned in the Affordable Care Act would be harmful to the state’s private hospitals – and especially to its safety-net hospitals, according to a Pittsburgh Post-Gazette report.
The law previously required all states to expand their Medicaid programs, but that mandate was struck down last month by the Supreme Court.
The court’s decision has serious implications, Safety-Net Association of Pennsylvania (SNAP) president Michael Chirieleison explained in the article.
“When you remove a critical part of the act like this, it leads to a lot of questions and concerns about the viability and credibility of the remaining initiatives.”
State officials have not yet indicated whether Pennsylvania will expand its Medicaid program.
Read the Post-Gazette article here .

PA Safety Net Admin2012-07-25T09:38:41+00:00July 25th, 2012|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

New Medicare Program Could Hurt PA’s Safety-Net Hospitals

A new federal initiative will use patient satisfaction to help determine Medicare payments to hospitals.

Under the new value-based purchasing program it will launch in October, Medicare will use the results of patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) as a factor in determining its payments to hospitals.

As reported in the Pittsburgh Post-Gazette, not everyone believes there is a tangible link between patient satisfaction and the quality of care a hospital provides – and not everyone believes the HCAHPS survey accurately measures either.

In addition, a recent article in the Archives of Internal Medicine reported that safety-net hospitals generally receive lower scores on the HCAHPS survey than other providers – a potentially major concern for Pennsylvania’s safety-net hospitals.

Read more about this controversial program in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2012-07-24T06:00:56+00:00July 24th, 2012|Uncategorized|Comments Off

DSH and the Affordable Care Act

The National Health Law Program has prepared a useful Q&A about how the Affordable Care Act and its Medicaid expansion will affect Medicare disproportionate share (Medicare DSH) and Medicaid disproportionate share (Medicaid DSH) payments, both of which are so important to Pennsylvania’s safety-net hospitals.

Download that summary here .

PA Safety Net Admin2012-07-19T06:00:21+00:00July 19th, 2012|Health care reform, Medicaid supplemental payments|Comments Off

Safety-Net Hospitals Could Lose Ground Under New Medicare Payment Plan

The value-based purchasing program that Medicare plans to unroll in October could result in reduced payments to the nation’s safety-net hospitals.
A report published in the Archives of Internal Medicine found that safety-net hospitals receive lower scores in measures that Medicare will use as part of its new value-based purchasing program. Those scores are based on data from the Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey.
As a result of those lower scores, the article “Patient Experience in Safety-Net Hospitals: Implications for Improving Care and Value-Based Purchasing” concluded that safety-net hospitals could receive lower Medicare payments that could affect their financial health.
Read a Kaiser Health News on the new study here and the Archives of Internal Medicine report itself here Hospital building .

PA Safety Net Admin2012-07-18T10:32:35+00:00July 18th, 2012|Uncategorized|Comments Off

PA Cuts Medicaid Dental Benefits

Pennsylvania has reduced its Medicaid dental benefits to basic services – mostly, cleanings, fillings, and extractions.
It has eliminated root canal and periodontal procedures and limits dentures. The changes are expected to save $42 million this year.
Most states do not pay for any dental care.
Read more about the changes in Pennsylvania’s Medicaid dental benefits and their impact on beneficiaries here.

PA Safety Net Admin2012-07-17T06:00:55+00:00July 17th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

New PA Health Law Project Newsletter

The Pennsylvania Health Law Project has just published its June/July “Health Law PA News” newsletter. The latest edition includes articles about the recently passed state Medical Assistance budget, the implications of the Supreme Court’s Affordable Care Act decision for Pennsylvania, changes in state human resources funding, a delay in HealthChoices expansion in western Pennsylvania, and the lawsuit to compel the state to reinstitute the AdultBasic program.
Read the newsletter here .

PA Safety Net Admin2012-07-16T06:00:50+00:00July 16th, 2012|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Feds Probe Steep Drop in PA Medicaid Enrollment

Federal officials have asked the Pennsylvania Department of Public Welfare why the state dropped 130,000 people from its Medicaid rolls between August of 2011 and January 2012 and what the state is doing about the administrative challenges state officials say is one of the reasons for the precipitous drop.
In response to previous federal inquiries about the large numbers of recipients whose Pennsylvania Medical Assistance eligibility was revoked, state officials pointed to a backlog of cases to review. State and federal officials met to review the situation in April, and the latest federal correspondence with the state seeks answers to questions federal officials posed at the April meeting.
Read more about the problem, the interaction between state and federal officials, and the current status of this situation in this Philadelphia Inquirer article .

PA Safety Net Admin2012-07-12T09:10:59+00:00July 12th, 2012|Pennsylvania Medicaid policy|Comments Off

Disabled Face New Process for Medical Assistance Eligibility

Low-income and disabled Pennsylvanians who lost General Assistance payments when the state ended the cash assistance aspect of that program may still receive Medical Assistance but face a new process for applying for eligibility.
The current, one-page application form that was completed by providers has been expanded to a longer, more detailed form that seeks more information about the medical condition of the applicant.
Read more about the changes in the state program and the changes providers now face in this Philadelphia Inquirer article .

PA Safety Net Admin2012-07-10T09:51:07+00:00July 10th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Suit Seeking Resuscitation of AdultBasic Advances

Pennsylvania’s Commonwealth Court has ruled that a lawsuit that seeks restoration of the state’s AdultBasic program may proceed.
The program, which served 41,000 low-income working adults who qualified neither for Medicare nor Medicaid, expired in 2011 and the resources previously expended on it, from the state’s proceeds from the national tobacco settlement, were directed elsewhere.
Read more about the court case and the court’s rationale for allowing the suit to continue in this Legal Intelligencer article published in the Pittsburgh Post-Gazette.

PA Safety Net Admin2012-07-09T10:58:07+00:00July 9th, 2012|Uncategorized|Comments Off

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