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

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

New MACPAC Reports

The Medicaid and CHIP Payment and Access Commission has released several new reports, including:

a look at how states exercise flexibility in their individual Medicaid programs;
methodologies for setting Medicaid per capita caps;
a review of how states are addressing high-cost hepatitis C drugs in their Medicaid programs;
an analysis of Medicaid disproportionate share hospital payment (Medicaid DSH) allotments and payments; and
an analysis of when states will exhaust their CHIP allotments.

MACPAC is a non-partisan legislative branch agency that advises Congress, the states, and the administration on Medicaid and CHIP payment and access issues.
Find links to these and other MACPAC reports here, on the MACPAC web site.

PA Safety Net Admin2017-04-18T06:00:00+00:00April 18th, 2017|Federal Medicaid issues|Comments Off

Medicaid Per Capita Caps Explained

In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to resurface in the near future.
Among other things, the article

explains what per capita caps are and how they would work
describes how per capita caps differ from current Medicaid policy
considers how the implementation of per capita caps might affect low-income people, providers, and insurers

Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid Per Capita Caps,” which can be found here.

PA Safety Net Admin2017-04-17T09:56:53+00:00April 17th, 2017|Federal Medicaid issues, Uncategorized|Comments Off

New MACPAC Study Evaluates Medicaid, Medicare Payments

Medicaid payments to hospitals are comparable to or even higher than Medicare payments.
Or at least they are once supplemental Medicaid payments are included.
So concludes a new study by the Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises the states, Congress, and the administration on Medicaid and CHIP payment and access issues.
In what MACPAC bills as the “first-ever study to construct a state-level payment index to compare fee-for-service inpatient hospital payments across states and to benchmark Medicaid payments to other payers such as Medicare,” the study found that

Across states, base Medicaid payment for inpatient services varies considerably, ranging from 49 percent to 169 percent of the national average. This variation is similar to the variation across states previously reported for physician fees.
States are not consistently high or low payers across all inpatient services due to differences in their payment policies.
Payment amounts for the same service can also vary within a state.

The MACPAC analysis also concluded that

Overall, Medicaid payment is comparable or higher than Medicare.
Specifically, the average Medicaid payment for 18 selected conditions was 6 percent higher than Medicare, and the average Medicaid payment for all but two of the conditions was higher than Medicare.
The average Medicaid payment for these 18 services was higher than Medicare in 25 states and lower than Medicare in 22 states.

Learn more about what MACPAC found – and how Pennsylvania Medicaid payments stack up – in the new MACPAC report “Medicaid Hospital Payment: A Comparison across States and to Medicare,” which can be found here, on MACPAC’s web site.

PA Safety Net Admin2017-04-14T06:00:19+00:00April 14th, 2017|Medicaid supplemental payments, Pennsylvania Medicaid policy, Uncategorized|Comments Off

Medical Homes and High-Need Patients

With five percent of patients accounting for 50 percent of health care costs, such high-need patients are the subject of increasing attention as health care providers search for better ways to serve them at less cost. Such patients are especially challenging when they lack the financial resources and personal support systems needed to address their considerable medical needs.
One of those ways is through the concept of the medical home: an approach to primary care, also often referred to as a patient-centered medical home, that is a team-based approach to delivering patient-specific, coordinated, accessible care that focuses on quality and safety and that features as one of its defining characteristics closer contact between patients and their caregivers.
Pennsylvania safety-net hospitals typically care for large numbers of such high-need patients.
In a new report, the Commonwealth Fund tells how one such program, Chicago’s Medical Home Network, is attempting to make a difference in the lives of its low-income, high-need patients. See that report here.

PA Safety Net Admin2017-04-12T16:16:27+00:00April 12th, 2017|Uncategorized|Comments Off

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