PA Rural Hospitals to Get Boost From State
A new law seeks to stabilize the financial condition of Pennsylvania’s rural hospitals.
Senate Bill 314, passed by the legislature and signed by Governor Wolf, establishes a new Rural Health Redesign Center Authority and Pennsylvania Rural Health Redesign Center fund that will seek to support the delivery of health care by rural hospitals in the state by, as a legislative co-sponsorship memo explained,
- creating an annual, prospective budget with regular, predictable payments;
- improving the ability to develop and carry out expanded and innovative community health services; and
- providing the capacity to pursue programs addressing key needs such as behavioral health and substance abuse and cooperative EMS.
The new approach will shift participating hospitals from fee-for-service to global payments. Eligible hospitals will receive monthly global budget payments from payers based on historic revenue data that is adjusted for care delivery changes and inflation.
Learn more from the Becker’s Hospital Review article “Pennsylvania governor signs law providing regular, predictable payments to rural hospitals” and from the co-sponsorship memo that accompanied the bill’s introduction in Pennsylvania’s General Assembly.
The shift away from using the federal exchange and developing a state-based exchange was approved by the state legislature earlier this year. That shift took a major step forward recently when the state hired a contractor to create the site’s platform.
According to the bond rating agency, non-profit hospitals are seeing growing amounts of bad debt as they struggle, often unsuccessfully, to collect from patients whose high deductibles leave them on the hook for meaningful amounts of care.
A cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states is mandated by the Affordable Care Act and has been delayed several times by Congress. If implemented, Medicaid DSH allotments to the states would be slashed $4 billion in FY 2020 and then $8 billion a year through FY 2025.
The statement, an annual OMB document, organizes the priorities as follows:
According to the Centers for Medicare & Medicaid Services, the Medicaid improper payment rate in FY 2019 was 14.9 percent, amounting to $57.36 billion in improper payments. The improper payment rate that year for CHIP services was 15.83 percent, representing $2.74 billion in improper payments. Both are significant increases over FY 2018, when the Medicaid improper payment rate was 9.7 percent, representing $36.25 billion, and the CHIP rate was 8.57 percent, for $1.39 billion.
While DHS’s area of endeavor is broad and goes beyond health care, Medicaid is an important aspect of its work and that importance is reflected in the plan, which includes descriptions of DHS’s ambitions in the following areas:
Included in this month’s edition are articles about:
The report presents information on hospital volume and outcomes for 17 different medical conditions and surgical procedures from October 2017 through September 2018. It also compares hospital performance over the five-year period from 2013 through 2018 on an aggregate state-wide basis and for individual hospitals.
The report includes: