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

Controversy Continues Over HealthChoices Awards

Pennsylvania appears to be no closer to awarding new contracts to serve its HealthChoices Medicaid physical health program than it was when it first launched the process of soliciting bids for such contracts in September of 2015.
When losing bidders protested the contracts awarded based on the state’s original request for proposals and took the state to court, the state threw out all the bids and cast aside its decision and started the process all over again, issuing a new request for proposals last year. When the state announced new awards in January the losing bidders again protested, this time alleging “irregularities” in the decision-making process. With the renewed threat of litigation, the planned implementation of the new contracts on June 1 now appears to be in jeopardy.
For a closer look at the issues, the alleged irregularities, and what is being done to resolve this matter once and for all, see this Philadelphia Inquirer article.

PA Safety Net Admin2017-02-28T17:16:45+00:00February 28th, 2017|HealthChoices|Comments Off

Comparing “Repeal and Replace” Proposals

How can you keep score while Congress considers multiple proposals to repeal and replace the Affordable Care Act?
The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals: you pick the proposals you want to compare and you select the aspects of those proposals that interest you.
Find this new interactive tool here, on the web site of the Kaiser Family Foundation.

PA Safety Net Admin2017-02-22T06:00:39+00:00February 22nd, 2017|Affordable Care Act|Comments Off

Impact of ACA Repeal on Pennsylvania

How might Pennsylvania be affected by a repeal of the Affordable Care Act?
In a new report, the Pennsylvania Health Funders Collaborative attempts to answer that question, offering projections on the impact of the 2010 health reform’s repeal on jobs, prescription drug coverage for seniors, insurance status for low-income Pennsylvanians, hospitals, and the state’s economy as a whole.
The study looks at this impact on a state-wide level as well as on a congressional district-by-district basis while also examining anticipated impact on some individual counties and even some individual hospitals.
Learn more about how repeal of the Affordable Care Act might affect Pennsylvania and Pennsylvanians by going here to see the Pennsylvania Health Funders Collaborative report The Pennsylvania Health Funders Collaborative Impact to Pennsylvania of Repealing the Affordable Care Act.

PA Safety Net Admin2017-02-21T06:00:18+00:00February 21st, 2017|Affordable Care Act|Comments Off

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing.
In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts.
Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently chosen to serve the state’s Medicaid population through the HealthChoices physical health program.
For a closer look at Medicaid value-based purchasing, go here to read the National Association of Medicaid Directors’ issue brief “Medicaid Value-based Purchasing: What Is It & Why Does It Matter?”

PA Safety Net Admin2017-02-17T06:00:19+00:00February 17th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Changing Medicaid

House Chamber of the State House With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider.
Among them are:

giving states greater flexibility in the design and implementation of their own Medicaid programs
requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments
limiting benefits
employing incentives to encourage healthy behaviors

The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years.
Because Pennsylvania’s safety-net hospitals care for so many low-income and Medicaid patients, they could be affected by any major federal Medicaid policy changes far more than the typical Pennsylvania hospital.
Learn more about some of the options Congress will have as it looks at possible Medicaid reform in the Health Affairs Blog article “The Future Of Medicaid: When Improving Upon The Wheel, Start With Something Round,” which can be found here.

PA Safety Net Admin2017-02-16T06:00:00+00:00February 16th, 2017|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Wolf Asks Ryan to Preserve Medicaid Expansion

In a letter to House Speaker Paul Ryan, Pennsylvania Governor Tom Wolf urged Congress, no matter how it addresses the Affordable Care Act, to preserve that law’s expansion of access to Medicaid-covered health care services.
The governor specifically pointed to the many people who receive substance abuse treatment through those services.

If the Affordable Care Act, or Obamacare, is repealed and not replaced, over a million Pennsylvanians could lose access to health care and tens of thousands of people – people who are our friends, our neighbors, and our family members that are currently receiving treatment for a substance use disorder – would lose insurance coverage and no longer be able to afford their treatment.

See Governor Wolf’s complete letter to House Speaker Ryan here.

PA Safety Net Admin2017-02-15T06:00:28+00:00February 15th, 2017|Affordable Care Act, Uncategorized|Comments Off

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals.
Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare.
With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such high health care costs and hospital readmissions rates.
Many of these high-need, high-cost patients live in low-income communities served by private urban safety-net hospitals, making this a subject of particular interest to NAUH and its members
Many of these high-need, high-cost patients live in low-income communities served by Pennsylvania’s safety-net hospitals, making this a subject of particular interest to SNAP and its members.
Among the care models this review considers are Medicare Advantage plans, Medicare Advantage Dual-Eligible Special Needs Plans, Medicare Shared Savings Program Accountable Care Organizations, Next Generation ACOs, Comprehensive Primary Care Plus Model Participants, and Programs for All-Inclusive Care for the Elderly (PACE).
Find this all in the Bipartisan Policy Center report Challenges and Opportunities in Caring for High-Need, High-Cost Medicare Patients, which is available here.

PA Safety Net Admin2017-02-13T06:00:02+00:00February 13th, 2017|Medicare, Pennsylvania safety-net hospitals|Comments Off

Governor Proposes FY 2018 Budget

On Tuesday Pennsylvania Governor Tom Wolf unveiled his proposed FY 2018 budget to the state’s General Assembly.
This budget proposal includes a number of provisions with potential implications for Pennsylvania’s safety-net hospitals.
The Safety-Net Association of Pennsylvania has prepared a detailed review of those provisions. Officials of safety-net hospitals who would like to receive a copy of this memo may request one by using the “contact us” link on the upper right-hand corner of this screen.
Find a news release from the governor’s office that outlines the proposed budget here and go here (scroll to the bottom of the screen) for links to budget overviews, the entire budget itself, the Wolf administration’s presentation on its plan to consolidate Pennsylvania’s Department of Human Services, Department of Health, Department of Aging, and Department of Drug and Alcohol Services into a single new Department of Health and Human Services, and other related materials.

PA Safety Net Admin2017-02-10T06:00:00+00:00February 10th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2018 budget|Comments Off

Pennsylvania Health Law Project Newsletter

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

impending changes in the lineup of managed care providers that serve Medicaid participants in the state’s HealthChoices program for physical health services;
the status of the state’s implementation of its Community HealthChoices program of managed long-term services and supports for low-income, elderly Pennsylvanians who seek to continue living independently in the community;
the potential impact of a repeal of the Affordable Care Act on Pennsylvanians; and
Pennsylvania’s receipt of a Certified Community Behavioral Health Clinic demonstration grant from the federal government to improve services and care coordination for individuals on Medicaid or CHIP.

Go here for the latest edition of PA Health Law News.

PA Safety Net Admin2017-02-08T17:39:17+00:00February 8th, 2017|Affordable Care Act, HealthChoices PA, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

ACA Replacement?

While both the Trump administration and Congress insist that they will repeal and replace the Affordable Care Act, neither has yet provided information about what that replacement might look like.
But one place worth looking for a possible glimpse into the future is the Affordable Care Act replacement plan proposed by Rep. Tom Price (R-GA), President Trump’s nominee to serve as Secretary of the Department of Health and Human Services.
In 2015, Rep. Price proposed the Empowering Patients First Act as a vehicle for replacing the Affordable Care Act. While the bill was not adopted by Congress at the time, Dr. Price should soon be in a position to exert meaningful influence over the manner in which the Trump administration and Congress go about replacing the Affordable Care Act.
The Kaiser Family Foundation has prepared a summary of Dr. Price’s 2015 proposal. Go here to see that summary and to find a link to the legislation itself.

PA Safety Net Admin2017-01-24T06:00:29+00:00January 24th, 2017|Affordable Care Act|Comments Off

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