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

PHC4 Reports on Hospital Financial Performance

The Pennsylvania Health Care Cost Containment Council (PHC4) has released its annual report on the financial performance of the state’s acute-care hospitals.
Among the highlights (changes in performance are from 2013 to 2014):

The total margin of hospitals state-wide declined 0.36 percentage points, from 6.06 percent to 5.7 percent.
The operating income of acute-care hospitals fell from $1.8 billion to $1.7 billion.
Thirty-four percent of hospitals lose money on operations and 28 percent lost money overall.
Uncompensated care rose 2.2 percent, or $22 million, to $1.07 billion.
The number of hospital discharges and patient days declined.
The number of outpatient visits fell 3.2 percent.
Outpatient services accounted for 44.8 percent of net patient revenue.

To learn more about what PHC4 learned, see its new report Financial Analysis 2014: Volume One: General Acute Care Hospitals.

PA Safety Net Admin2015-05-22T06:00:44+00:00May 22nd, 2015|Uncategorized|Comments Off

Medical Malpractice Suits Fall in PA

Since new laws designed to reduce the number of medical malpractice suits in Pennsylvania were passed in 2003 and 2004, the number of such suits has been cut in half.
Last year, 1463 medical malpractice suits were filed in Pennsylvania. In 2002, 2904 such suits were initiated.
And possibly related, the number of physicians practicing medicine in Pennsylvania has risen – a development that follows a nation-wide trend but is doing so at a rate that exceeds the growth in the number of doctors in other states.
To learn more about what Pennsylvania did to reduce medical malpractice lawsuits, how those laws are working, and how this may or may not be affecting the state’s supply of practicing physicians, see this Pittsburgh Post-Gazette article.

PA Safety Net Admin2015-05-21T06:00:46+00:00May 21st, 2015|Uncategorized|Comments Off

GAO Examines Medicaid Section 1115 Waivers

The U.S. Department of Health and Human Services (HHS) frequently exercises the authority granted to it under section 1115 of the Social Security Act to authorize Medicaid expenditures for uses not strictly permitted under that law if those uses extend Medicaid coverage to populations not already served by Medicaid or promote Medicaid objectives.
Pennsylvania’s Medicaid program has long taken advantage of section 1115 waivers.
At the request of the chairmen of the Senate Finance Committee and the House Energy and Commerce Committee, the U.S. Government Accountability Office (GAO) examined recently approved section 1115 waivers to evaluate whether those waivers met the criteria for the exemptions and whether the documents HHS issues when approving those waiver requests adequately convey what the approved expenditures are for and how they will promote Medicaid’s objectives.
As part of its investigation, GAO reviewed waiver requests from 25 states covering 150 programs and found that HHS lacked formal, written criteria for waivers and suggested that the agency more clearly express, in its approval documents, the objectives it expects programs to achieve in return for their exemption from some federal Medicaid requirements.
For a closer look at the study and its findings, see the report Medicaid Demonstrations: Approval Criteria and Documentation Need to Show How Spending Furthers Medicaid Objectives here, on the GAO web site.

PA Safety Net Admin2015-05-19T06:00:33+00:00May 19th, 2015|Pennsylvania Medicaid policy|Comments Off

Post-Mortem on the Medicaid Primary Care Fee Bump

The Affordable Care Act required state Medicaid programs to raise their fees for primary care services to the same level as Medicare rates, with the federal government shouldering the full cost of the difference. The rationale for the increase was that with millions of additional Americans expected to enroll in Medicaid in the coming years, a rate increase would encourage more primary care physicians to serve Medicaid patients because historically, many choose not to do so because of what they believe to be inadequate payments.
That two-year Medicaid primary care fee bump ended on December 31, 2014. Sixteen states and the District of Columbia felt the increase was beneficial enough to extend it using their own resources. Pennsylvania is not among the states that continued paying the enhanced rates.
The question of whether the fee increase accomplished its objective and is worth re-establishing remains unanswered. The brief nature of the experiment – only two years – and the delays many states experienced before they started paying the enhanced rates left little time for meaningful research. One quantitative analysis suggests the rate increase helped, there have been several more qualitative approaches to research, and some studies remain under way.
Because they care for so many more Medicaid patients than the typical hospital, the adequacy of Medicaid payments has long been of special concern to Pennsylvania safety-net hospitals.
For a closer look at the Affordable Care Act’s Medicaid primary care fee bump, how it worked, its impact, and its future, see the new health policy brief “Medicaid Primary Care Parity” here, on the web site of the journal Health Affairs.

PA Safety Net Admin2015-05-15T06:00:54+00:00May 15th, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

5% of Medicaid Recipients Account for 50% of Costs

Just five percent of all Medicaid recipients are responsible for nearly half of the program’s expenditures.
Or so says a new report by the U.S. Government Accountability Office (GAO).
Conversely, the 50 percent of Medicaid’s least costly recipients account for only eight percent of the program’s costs.
Disabled Medicaid recipients, while fewer than 10 percent of the overall total, represent nearly two-thirds of the highest-cost group.
These figures reflect spending from 2009 through 2011.
The greatest Medicaid expenditures were invested in seven types of care: for patients with asthma, diabetes, HIV/AIDS, mental health conditions, substance abuse, and delivery or childbirth along with those residing in long-term-care facilities.
To learn more about the GAO’s findings, see a summary of the report Medicaid: A Small Share of Enrollees Consistently Accounted for a Large Share of Expenditures and find a link to the complete report here on the GAO web site.

PA Safety Net Admin2015-05-14T06:00:46+00:00May 14th, 2015|Uncategorized|Comments Off

New 340B Rules Expected Soon

The federal Health Resources and Services Administration (HRSA) is expected to release new rules governing its section 340B prescription drug discount pricing program in the near future.
The new rules have long been in development and were in the verge of being published late last year when the agency decided to try another approach to addressing some of the program’s problems, but now, new draft guidelines are being reviewed by the White House Office of Management and Budget (OMB) in anticipation of being published soon in the Federal Register.
The 340B program, which provides discounts on prescription drugs to hospitals and others that serve large numbers of low-income patients, has encountered controversy in recent years with providers complaining about the lack of transparency in drug manufacturers’ prices and the manufacturers claiming that the program’s benefits are being extended to some patients who do not qualify for the assistance.
The 340B program is a vital resource for most Pennsylvania safety-net hospitals.
To learn more about the program and what might be expected when the new rules are proposed, see this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2015-05-13T06:00:39+00:00May 13th, 2015|Pennsylvania safety-net hospitals|Comments Off

PA Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the April edition of Health Law PA News, its monthly newsletter.
Included in this edition are articles about the status of Pennsylvania’s latest Medicaid expansion effort; an explanation of state policy for calculating applicants’ income for the purpose of determining whether they are eligible for Medicaid; health insurance options for immigrants; and more.
Find the latest edition of Health Law PA News here.

PA Safety Net Admin2015-05-12T06:00:12+00:00May 12th, 2015|HealthChoices PA, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

Minutes of MAAC Fee-For-Service Subcommittee Meeting

The Fee for Service Subcommittee of Pennsylvania’s Medical Assistance Advisory Committee (MAAC) has approved the minutes of the subcommittee’s February 11 meeting.
That meeting addressed the introduction of in-house radiology review in the state’s Medicaid fee-for-service program, Medicaid expansion in the state, provider enrollment and revalidation efforts as required by the Affordable Care Act, and more.
See those minutes here.

PA Safety Net Admin2015-05-07T06:00:28+00:00May 7th, 2015|Pennsylvania Medicaid policy|Comments Off

Chairmen Seek Ideas for Improving Medicaid

The chairmen of four key congressional committees have written to the Medicaid and CHIP Payment and Access Commission (MACPAC) seeking “assistance in developing policy options to ensure the sustainability of the Medicaid program so it can continue to provide essential coverage and services to vulnerable populations.”
The letter, signed by the chairmen of the Senate Finance Committee, Senate Committee on Health, Education, Labor, and Pensions, the House Energy and Commerce Committee, and the Energy and Commerce Committee’s Health Subcommittee, asks MACPAC to “analyze and evaluate” financing reforms to reduce government spending; past reform proposals; ways to give states greater flexibility; options for Medicaid block grants; and other potential changes.
See the letter here.

PA Safety Net Admin2015-05-06T06:00:17+00:00May 6th, 2015|Uncategorized|Comments Off

Report on Pennsylvania Medicaid Expansion Transition

The Pennsylvania Department of Human Services (DHS) has issued a report on its progress toward stated goals in the transition from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s Medicaid expansion via the state’s existing HealthChoices managed care program.
See that report here.

PA Safety Net Admin2015-05-05T06:00:59+00:00May 5th, 2015|Pennsylvania Medicaid policy|Comments Off

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