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

The Prospect of a Medicaid Work Requirement

Over the past three years a dozen states have proposed establishing a work requirement for eligibility for their Medicaid programs and in its proposed FY 2018, the Trump administration has called for extending the ability to impose such a requirement to all states.
But how would a Medicaid work requirement work? To whom would it apply and what kinds of work might satisfy such a requirement for the approximately 22 million Medicaid recipients (out of 76 million total recipients) to whom it might apply?
Work requirements would have significant implications for the patients and communities that Pennsylvania safety-net hospitals serve, and possibly for the hospitals as well.
A new Commonwealth Fund report looks at these and other issues. Go here to find the article “What Might a Medicaid Work Requirement Mean?”

PA Safety Net Admin2017-06-01T06:00:06+00:00June 1st, 2017|Federal Medicaid issues|Comments Off

New Book Addresses Social Risk Factors in Medicare

In the new book, the National Academies of Sciences, Engineering, and Medicine addresses the question of what social risk factors might be worth considering in Medicare value-based payment programs and how those risk factors might be reflected in value-based payments.
The book, the culmination of a five-part NASEM process, focuses on five social risk factors:

socio-economic position
race, ethnicity, and cultural context
gender
social relationships
residential and community context

Addressing such factors in Medicare value-based payments, the book finds, can help achieve four important goals:

reduce disparities in access, quality, and outcomes
improve the qualify and efficiency of care for all patients
foster fair and accurate reporting
compensate provides fairly

Doing so also can help prevent five types of unintended consequences from a failure to address social risk factors in Medicare payment policy:

providers avoiding patients with social risk factors
reducing incentives to improve the quality of care for patients with social risk factors
underpaying providers that serve disproportionately large numbers of patients with social risk factors
a perception of different medical standards for different populations
obscuring disparities in care and outcomes

The kinds of patients these social risk factors seek to identify are precisely those served by Pennsylvania safety-net hospitals in far greater numbers than other community hospitals throughout the state.
Learn more about social risk factors and their potential role in Medicare value-based payment policy in the new book Accounting for Social Risk Factors in Medicare Payment, which can be downloaded free of charge here, from the web site of the National Academies of Sciences, Engineering, and Medicine.

PA Safety Net Admin2017-05-24T13:10:08+00:00May 24th, 2017|Pennsylvania safety-net hospitals|Comments Off

PA Medicaid to Expand Access to Hep C Drugs

Pennsylvania’s Medicaid program will make treatment for hepatitis C more readily available to Medicaid beneficiaries beginning on July 1, state officials have announced.
In recent years, new drugs have become available that effectively cure hepatitis C but their exceptionally high costs led many insurers, including most state Medicaid programs, to limit access to those drugs until patients show more advanced signs of the disease. A year ago the Pennsylvania Department of Human Services’ pharmacy and therapeutics committee recommended expanding access to these drugs for Pennsylvania Medicaid beneficiaries and now, that recommendation has been adopted and that expansion will begin with the new state fiscal year on July 1.
Under the new criteria, patients with lower scores of severity of hepatitis C will become eligible for treatment. Previously, Medicaid patients were required to show more advanced signs of illness before the medicine was provided to them.
Learn more about the Pennsylvania Medicaid program’s revised approach to serving Medicaid patients with hepatitis C in this Philadelphia Inquirer article.

PA Safety Net Admin2017-05-18T06:00:32+00:00May 18th, 2017|Pennsylvania Medicaid policy|Comments Off

Hospital Uncompensated Care Down

As was surely expected, reforms introduced through implementation of the Affordable Care Act have driven down uncompensated care costs for many hospitals.
How much?
A new study published by the Commonwealth Fund offers the following findings:

uncompensated care declines in expansion states are substantial relative to profit margins;
for every dollar of uncompensated care costs hospitals in expansion states had in 2013, the Affordable Care Act erased 41 cents by 2015; and
Medicaid expansion reduced uncompensated care burdens for safety-net hospitals that are not made whole by Medicaid disproportionate share payments (Medicaid DSH).

Learn more, including how the decline in uncompensated care costs affected different kinds of hospitals in different kinds of states, in the report “The Impact of the ACA’s Medicaid Expansion on Hospitals’ Uncompensated Care Burden and the Potential Effects of Repeal,” which can be found here, on the Commonwealth Fund’s web site.

PA Safety Net Admin2017-05-16T06:00:57+00:00May 16th, 2017|Affordable Care Act, Pennsylvania safety-net hospitals|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2017 newsletter.
Included in this edition are articles about:

the budget bill passed by the state House and its potential impact on Medicaid in Pennsylvania;
the potential impact on Medicaid of the American Health Care Act under consideration by Congress;
an update on Community HealthChoices, the state’s new program of managed long-term services and supports for seniors struggling to continue living in the community;
information on the income verification process for those seeking to apply for or renew Medicaid eligibility; and
the process of shifting prescriptions from Medicaid to Medicare.

Find the latest edition of PA Health Law News here.

PA Safety Net Admin2017-05-12T06:00:03+00:00May 12th, 2017|Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget|Comments Off

Department Consolidation in PA?

Is it a good idea to consolidate Pennsylvania’s Human Services, Aging, Health, and Drug and Alcohol Programs departments into a single new Department of Health and Human Services?
Governor Tom Wolf offered such a proposal in his FY 2018 budget message and the Pennsylvania General Assembly is now weighing the merits of this proposal.
To explain more about its intentions and plans, the Wolf administration has established a web page that explains the proposed consolidation, which it refers to as “unification.” Included on the web page are a general description of the proposal, explanations of the benefits the administration believes it offers, a proposed organizational table for the new Department of Health and Human Services, and a link to proposed enabling legislation.
Find it all here.

PA Safety Net Admin2017-05-11T06:00:57+00:00May 11th, 2017|Pennsylvania proposed FY 2018 budget|Comments Off

New Report on PA Hospital Financial Performance

The Pennsylvania Health Care Cost Containment Council has published its annual report detailing the financial health of acute-care hospitals in the state.
According to the report, hospital net patient revenue increased in FY 2016, accounts receivable are being paid faster, operating and total margins rose, and uncompensated care declined.
The report describes hospital financial performance and utilization state-wide and by region and also presents FY 2016 margin, uncompensated care, and Medicare and Medicaid share data for every acute-care hospital in the state.
Go here to find the PHC4 report Financial Analysis 2016: General Acute Care Hospitals.

PA Safety Net Admin2017-05-10T11:23:09+00:00May 10th, 2017|Uncategorized|Comments Off

MACPAC Meets

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. The agency performs policy and data analysis and offers recommendations to Congress, the Department of Health and Human Services, and the states.
During two days of meetings, MACPAC commissioners received the following presentations:

Federal CHIP Funding Update: When Will States Exhaust Their Allotments?
Review of June Report Chapter: Program Integrity in Medicaid Managed Care
Review of June Report Chapter: Medicaid and the Opioid Epidemic
Medicare Savings Program: Eligible But Not Enrolled
Medicaid Reform: Implications of Proposed Legislation
Preliminary Findings From Evaluations of Medicaid Expansions Under Section 1115 Waivers
Potential Effects of Medicaid Financing Reforms on Other Health and Social Programs
Review of June Report Chapter: Analysis of Mandatory and Optional Populations and Benefits
Managed Long-Term Services and Supports: Network Adequacy for Home and Community-Based Services
Update on MACPAC Work on Value-Based Payment and Delivery System Reform

For links to all of these publications and a transcript of the two-day meeting go here, to the MACPAC web site.

PA Safety Net Admin2017-05-05T06:00:59+00:00May 5th, 2017|Federal Medicaid issues|Comments Off

SNAP, Other Groups Caution PA Delegation About Health Reform Bill

The Safety-Net Association of Pennsylvania has joined 13 other groups in writing to members of the state’s congressional delegation to warn about shortcomings in the American Health Care Act, health care reform legislation currently being considered by the U.S. House of Representatives.

Safety-Net Association of Pennsylvania logo The letter warns that the American Health Care Act would “…dramatically reduce Medicaid coverage and strain resources for this critical program.”

Read that letter here, on SNAP’s web site.

PA Safety Net Admin2017-05-03T06:00:03+00:00May 3rd, 2017|American Health Care Act, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Work Requirements

Both Congress and a number of states have discussed introducing work requirements into their Medicaid programs. Such a proposal was part of the American Health Care Act, a number of governors and state legislators have discussed work requirements as a condition of Medicaid eligibility, and some states are reportedly considering including such requirements in section 1115 Medicaid waiver applications.
In a new report, the Congressional Research Service examines the U.S. Department of Health and Human Services’ authority to grant such waivers and how courts might look at such requirements if they were be contested.
Go here to see the Congressional Research Service report “Judicial Review of Medicaid Work Requirements Under Section 1115 Demonstrations.”

PA Safety Net Admin2017-04-21T06:00:50+00:00April 21st, 2017|Federal Medicaid issues|Comments Off

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