SNAPShots

SNAPShots

About PA Safety Net Admin

This author has not yet filled in any details.
So far PA Safety Net Admin has created 1195 blog entries.

PA Improves Access to Contraceptives

Citing the challenges and risks associated with unplanned pregnancies that occur within two years of a delivery, Pennsylvania’s Medicaid program is making long-acting contraceptives more readily available to program participants.
Pennsylvania State MapBeginning on December 1, Medicaid will pay for long-acting contraceptives administered after delivery and also will increase payments to doctors who provide those contraceptives. Currently, those costs are generally borne by hospitals in the lump-sum payment Medicaid makes for deliveries.
Learn more about the state’s new policy for encouraging the use of contraceptives among Medicaid beneficiaries who have delivered babies in this Lancaster Online article.

2016-12-09T06:00:58+00:00December 9th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Improves Access to Contraceptives

A Look at Medicaid’s Immediate Future

With a new president taking office in January who vows to repeal and replace the Affordable Care Act, it is not clear what will happen to Medicaid, which currently covers 73 million Americans.
reform-flagA new paper from the Kaiser Family Foundation looks at some of the major questions that will arise in the coming months, including:

  • How would ACA repeal affect Medicaid?
  • What would changes in the financing structure mean for Medicaid?
  • How could Medicaid be changed through administrative actions?

For this and more, go here to see the Kaiser paper “Key Medicaid Questions Post-Election.”

2016-12-08T09:21:04+00:00December 8th, 2016|Affordable Care Act|Comments Off on A Look at Medicaid’s Immediate Future

Integrating Medicaid Supplemental Payments into Value-Based Purchasing

New health care delivery and reimbursement systems and new federal regulations will result in changes in how states deploy their Medicaid resources through supplemental payments in the coming years.
A new Commonwealth Fund report describes the kinds of supplemental Medicaid payments states currently make to hospitals – such as disproportionate share and upper payment limit payments – and notes the differing degree to which individual states use such supplemental payments.
financeIt also describes how those supplemental payments may be restructured in the coming years to foster greater use of value-based purchasing and to reward achieving state-created quality goals through new delivery and reimbursement systems such as accountable care organizations, bundled payments, shared savings program, capitated arrangements, and shared risk.
Such changes have potentially serious implications for Pennsylvania safety-net hospitals – as SNAP members learned first-hand from state Medicaid director Leesa Allen when she met with them in November in Philadelphia to discuss the commonwealth’s plans for value-based purchasing and changes in Medicaid reimbursement.
Learn more about what the future may have in store for Medicaid supplemental payments in the Commonwealth Fund report Integrating Medicaid Supplemental Payments into Value-Based Purchasing.

2016-12-07T06:00:49+00:00December 7th, 2016|Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off on Integrating Medicaid Supplemental Payments into Value-Based Purchasing

Profile of Nominee to Head CMS

President-elect Donald Trump has nominated Seema Verma, a health care consultant, to serve as administrator of the Centers for Medicare & Medicaid Services. That agency runs the Medicare and Medicaid programs.
vermaIn this capacity she would have enormous influence on the development of new Medicare and Medicaid initiatives, including many proposals for change from the incoming administration and Congress – all matters of vital concern to Pennsylvania safety-net hospitals.
Go here to see a Kaiser Health News profile of Ms. Verma and learn more about her past work, especially on Medicaid issues.

2016-12-06T06:00:58+00:00December 6th, 2016|Medicare, Pennsylvania Medicaid|Comments Off on Profile of Nominee to Head CMS

Social Determinants and Health Care

Amid growing recognition that social factors play at least much a role in the health of communities as medical care, growing attention is being paid to how best to address those social determinants in a health care system.
With increasing use of alternative delivery models such as accountable care organizations, some approaches place health care at the heart of a hub-and-spoke model to address population health, supported by functions such as affordable housing, home health care, job training, and more. Another approach places community organizations at the hub of care models, with the health care system as a spoke feeding into that hub.
Stock PhotoSocio-economic issues that affect the health of communities are among the biggest challenges Pennsylvania safety-net hospitals face ­– challenges that take them well beyond their ability to provide quality care to their patients.
A recent article on the Health Affairs Blog explores the hub-and-spoke approach to addressing the social determinants that play such a major role in population health. Go here to read the blog article “Defining The Health Care System’s Role In Addressing Social Determinants And Population Health.”

2016-12-01T06:00:04+00:00December 1st, 2016|Pennsylvania safety-net hospitals|Comments Off on Social Determinants and Health Care

Financial Performance Strong at PA Non-General Acute Hospitals

For non-general acute-care hospitals in Pennsylvania, FY 2015 was generally a good year.
Long-term acute-care hospitals saw their average operating margins rise from 5.24 percent to 8.04 percent.
Operating margins for rehabilitation hospitals rose from 12.7 percent to 12.87 percent.
phc4And while operating margins for psychiatric and specialty hospitals declined, they still remain generally strong at 8.81 percent and 7.78 percent, respectfully.
Learn more about the financial performance of non-acute-care hospitals in Pennsylvania in Financial Analysis 2015: An Annual Report on the Financial Health of Pennsylvania Non-GAC Hospitals, a new report from the Pennsylvania Health Care Cost Containment Council.

2016-11-28T06:00:44+00:00November 28th, 2016|Uncategorized|Comments Off on Financial Performance Strong at PA Non-General Acute Hospitals

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its October 2016 newsletter.
phlpIncluded in this edition are stories about problems older adults are encountering when they seek to enroll in the state’s Aging Waiver program; an update on the implementation of Community HealthChoices, the new state program of managed long-term services and supports for qualified seniors; upcoming Medicare changes and enrollment and application deadlines; coverage of diabetes testing supplies for dual eligibles; new state guidelines addressing access to treatment for mental health conditions and substance abuse disorders; and more.
Go here for the latest edition of PA Health Law News.
 

2016-11-03T06:00:54+00:00November 3rd, 2016|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

PA Hospitals Reducing Readmissions, Mortality

Pennsylvania hospitals have seen a state-wide decrease in their mortality and readmission rates, according to new data released by the Pennsylvania Health Care Cost Containment Commission.
phc4According to the new numbers, which cover hospital performance from January 1 through September 30 of 2015, hospital mortality rates fell for ten of the 16 conditions PHC4 tracks while readmissions fell for nine of the 13 conditions for which the agency collects data.
PHC4 estimates that this improved performance saved 3900 lives and avoided 2700 hospital readmissions.
For a closer look at the data PHC4 collected, the conditions it tracked, and a hospital-by-hospital, region-by-region, and state-wide look at hospital performance go here, to the PHC4 web site, to find a summary of the report, the news release that accompanied its publication, and three separate reports with all of the numbers and findings.

2016-10-21T06:00:42+00:00October 21st, 2016|Uncategorized|Comments Off on PA Hospitals Reducing Readmissions, Mortality

PA Uninsured Rate Declines

Pennsylvania’s uninsured rate has fallen to 6.4 percent, according to the U.S. Census Bureau.
That’s less than half the state-wide rate of 13 percent in 2011 and 2012.
wolfSince that time the state’s Medicaid expansion has added 670,000 Pennsylvanians to the ranks of the insured, with others purchasing insurance through the federal health insurance marketplace.
Learn more about the decline in the number of uninsured Pennsylvanians in this news release from the office of Governor Tom Wolf.

2016-10-19T09:30:43+00:00October 19th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Uninsured Rate Declines

A New Approach to Serving High-Cost, High-Need, High-Risk Medicaid Patients

A partnership consisting of a county government, a public hospital, a county-run Medicaid managed care plan, and a federally qualified health center, Hennepin Health is an accountable care organization that seeks to serve high-cost, high-need, high-risk Medicaid patients in the greater Minneapolis area.
Hennepin Health targets such individuals – all childless adults who became eligible for Medicaid when the state expanded its Medicaid program in 2011 – with the help of algorithms, identifies those most likely to incur high medical costs. It then offers a blend of social services, preventive care, and other services to address members’ medical conditions while bringing stability and order to their lives. Seventy-five percent of the program’s members are male, 70 percent are non-white, half lack stable housing, two-thirds suffer from mental illness, 80 percent have substance abuse problems, and 19 percent suffer from chronic pain.
These are the very kinds of patients typically served in especially high numbers by Pennsylvania safety-net hospitals.
The results of the program have been encouraging: the program has improved participants’ access to primary care, reduced emergency room visits, and stabilized the health of participants with chronic medical conditions.   While hospitalizations have not declined, medical costs have fallen an average of 11 percent a year since 2012.
Happy medical team of doctors togetherLed by the county government, Hennepin Health currently serves 12,000 members whose care is financed by Medicaid, with the county assisting with the cost of social services. All four ACO partners invested an initial $1.6 million for staff and data infrastructure and have assumed full financial risk for the venture.
Learn more about how one program is seeking to make a difference in the lives of high-risk, high-need patients while reducing high health care costs in the article “Hennepin Health: A Care Delivery Paradigm for New Medicaid Beneficiaries,” which can be found here, on the web site of The Commonwealth Fund.

2016-10-17T06:00:48+00:00October 17th, 2016|Pennsylvania safety-net hospitals|Comments Off on A New Approach to Serving High-Cost, High-Need, High-Risk Medicaid Patients
Go to Top