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

PA Reverses “MAWD” Elimination

The Corbett administration has reversed an earlier decision and decided to retain Pennsylvania’s Medical Assistance for Workers With Disabilities program, frequently referred to as “MAWD.”
MAWD provides low-cost health insurance to Pennsylvanians with disabilities who do not otherwise qualify for Medical Assistance because they work and have earnings.
The program, which serves about 34,000 people, costs the state $7 million a year. A Department of Public Welfare spokesman said preserving the program is consistent with the Corbett administration’s Healthy Pennsylvania initiative.
Learn more about MAWD here and about the decision to retain it in this Insurance Net News article.

PA Safety Net Admin2014-07-29T06:00:28+00:00July 29th, 2014|Healthy PA, Pennsylvania Medicaid laws and regulations|Comments Off

Group to Assess Impact of Socioeconomic Factors on Care

The National Quality Forum (NQF) will perform a “robust trial” to assess the role and impact of sociodemographic factors on health care outcomes.
In a news release, the NQF announced that

Sociodemographic factors can be socioeconomic, e.g., income, education, and occupation, and demographic, e.g., race, ethnicity, and primary language. Growing evidence shows that sociodemographic factors may influence patient outcomes, which has implications for comparative performance measurement used in pay-for-performance programs.

Among the socioeconomic and sociodemographic factors the NQF will consider are income, education, and occupation, and demographic considerations such as race, ethnicity, and primary language.
With the Affordable Care Act requiring Medicare to adjust payments based on outcomes such as hospital readmissions, value-based purchasing requirements, hospital-acquired conditions, and more, reviews of the preliminary results of such programs have led some to question whether hospitals that serve especially large numbers of low-income patients – like Pennsylvania’s safety-net hospitals – may be especially and unfairly harmed by such programs.
Learn more about the NQF plan for a new study from this news release and find a link to further information about the planned study as well.

PA Safety Net Admin2014-07-25T06:00:35+00:00July 25th, 2014|Affordable Care Act|Comments Off

CMS Seeks to Jump-Start Medicaid Innovation

A new federal program seeks to encourage states to work faster to find ways to improve care and improve the health of their Medicaid patients and to reduce health care costs through payment and service delivery reforms.
The Center for Medicare & Medicaid Services’ (CMS) new Medicaid Innovation Accelerator Program is a collaboration between the Center for Medicaid and CHIP Services, the Center for Medicare and Medicaid Innovation, the Medicare-Medicaid Coordination Office, and other federal agencies and centers. According to a CMS fact sheet, the program

…aims to jumpstart innovation in key areas while supporting states in their efforts to improve health, improve health care, and lower costs. In consultation with states and stakeholders, the IAP will develop strategically targeted functions aimed at advancing delivery system and associated payment reforms, aligned with transformation efforts underway in Medicare and the commercial market.

The program will develop resources to support innovation through four key functions: identifying and advancing new models of care delivery and payment; data analytics; improving quality measurement; and state-to-state learning, rapid-cycle improvement, and federal evaluation.
Learn more about the launch of the Medicaid Innovation Accelerator Program from this CMS fact sheet and go here for a more detailed description of the program and a summary of the resources surrounding it.

PA Safety Net Admin2014-07-17T14:49:18+00:00July 17th, 2014|Uncategorized|Comments Off

Foundation to Track Effect of ACA on Hospitals

The Robert Wood Johnson Foundation has launched a project to measure the impact of the Affordable Care Act on hospitals.
Working with 24 state hospital associations, the foundation’s Hospital ACA Monitoring Project will collect quarterly hospital data on admissions, emergency room visits, and selected diagnoses and procedures. The project will collect data from different types of hospitals with different payer mixes.
According to the foundation, the project “is designed to shed light on some of the effects of health reform on hospitals and provide extremely timely data to researchers, policymakers and hospital leaders.”
Learn more about the Robert Wood Johnson Foundation’s Hospital ACA Monitoring Project from this notice on the foundation’s web site.

PA Safety Net Admin2014-07-14T06:00:42+00:00July 14th, 2014|Affordable Care Act, Health care reform|Comments Off

Keep Medicaid Pay Boost, Docs Ask Congress

Physician groups and other health care organizations are asking Congress to continue the increase in Medicaid payments that primary care providers have been receiving for nearly two years.
The pay raise, mandated by the Affordable Care Act, was instituted to help induce more primary care providers to serve Medicaid patients in anticipation of the reform law’s significant expansion of Medicaid eligibility. That pay raise, which brings Medicaid rates up to the level of Medicare rates and is paid for entirely by the federal government, expires at the end of 2014.
Now, primary care physicians have written to the leaders of the Senate Finance Committee and the House Energy and Commerce Committee asking them to extend the raises and add ob/gyns to providers eligible for the enhanced payments.
See their letter here.

PA Safety Net Admin2014-06-30T13:00:37+00:00June 30th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

SNAP Warns of Challenges Ahead

As Pennsylvania lawmakers contemplate the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania has issued a new position paper reminding those officials of the challenges the state’s private safety-net hospitals face in the current environment and the need for adequate, stable funding as they tackle those challenges.
Among those challenges are low-income patients with distinct needs, major cuts in federal Medicare payments that especially target safety-net hospitals, and powerful economic forces marshaled by government, insurers, and others that seek to compel hospitals to deliver care in different ways, be paid differently for their efforts, align their incentives differently with other providers, and invest heavily in information technology.
Pennsylvania’s safety-net hospitals are prepared to do all these things, but to achieve such progress, they need financial stability and predictability: they need to know that their Medical Assistance funding will not be at risk as the state experiences various budget challenges.
Read SNAP’s perspective on these issues in its new position paper, “Pennsylvania’s Safety-Net Hospitals: The Need for Stable and Predictable Funding Amid Increasing Challenges,” which can be found here, on SNAP’s web site.

PA Safety Net Admin2014-06-30T06:00:31+00:00June 30th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Protect Uncompensated Care Payments, SNAP Tells State Officials

Although only 25 percent of the state’s acute-care hospitals, Pennsylvania’s private safety-net hospitals account for 45 percent of the $1 billion in uncompensated care those hospitals provide to uninsured Pennsylvanians every year.
And now, as the governor and legislature consider the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania is urging those officials to preserve state payments that help qualified hospitals with those uncompensated care costs and enable them to continue constituting the core of Pennsylvania’s health care safety net.
Tobacco Uncompensated Care Fund payments are supplemental state payments to hospitals that provide significant amounts of uncompensated care; they are underwritten by proceeds from the national master tobacco settlement of 1998 and matched by the federal government. As lawmakers work on the state’s FY 2015 budget, SNAP is urging them to expend available FY 2014 funding already authorized for this purpose and not to use FY 2015 tobacco settlement funding for any purpose other than what was prescribed in Act 71 of 2013.
These views and background information on the role private safety-net hospitals play in caring for low-income, Medicaid-covered, and uninsured Pennsylvanians are addressed in a new SNAP position paper, “The Importance of Preserving Uncompensated Care Payments.” Find that position paper here.

PA Safety Net Admin2014-06-27T06:00:37+00:00June 27th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Safety-Net Hospitals Mean Jobs

While providing most of the care to Pennsylvania’s Medicaid and uninsured populations, the state’s 41 private safety-net hospitals also employ more people than other hospitals and pay better wages than most employers.
They also are among the biggest employers in their communities, drive local economic development, and generate millions in local and state tax revenue.
As state lawmakers consider Pennsylvania’s FY 2015 budget, the Safety-Net Association of Pennsylvania urges them to preserve adequate funding for the state’s Medicaid program so these hospitals can continue their work serving Pennsylvanians in need and functioning as one of the state’s major economic engines.
Read more about the outsized role private safety-net hospitals play in Pennsylvania’s health care safety net and its economy in the new SNAP paper “Pennsylvania Safety-Net Hospitals: Economic Engines Driving Pennsylvania Communities,” which can be found here.

PA Safety Net Admin2014-06-26T06:00:56+00:00June 26th, 2014|Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

340B Program Under the Microscope

Federal officials continue to cast a wary eye on a program that gives discounts on prescription drugs to hospitals that care for large numbers of low-income patients.
The federal 340B Prescription Drug Program requires drug manufacturers to give discounts to eligible providers for the prescriptions they provide patients on an outpatient basis; the hospitals then provide their low-income patients with their prescriptions at a discount or free of charge. The program has grown a great deal in recent years and now, critics argue that some hospitals that currently receive the discounts should not qualify for them and others are not reinvesting the savings the program generates in care for low-income patients.
Hospitals, meanwhile, note that program savings enable them to fund clinics and otherwise unaffordable programs and services and help them absorb the cost of uncompensated care.
The controversy has drawn congressional interest, and the federal agency that administers the program, the Health Resources and Services Administration, was expected to produce new guidelines governing eligibility and the use of prescription drug discounts. Those guidelines have been delayed in the wake of a federal court ruling involving orphan drug sales that has called into question the agency’s regulation-issuing authority.
Most Pennsylvania safety-net hospitals participate in the program.
Learn more about the 340B Prescription Drug Program, its growth in recent years, the concerns raised about it amid that growth, and what to expect next in this Kaiser Health News article.

PA Safety Net Admin2014-06-25T06:00:32+00:00June 25th, 2014|Uncategorized|Comments Off

Corbett Administration Announces Healthy PA MCOs

While the federal government has not yet announced whether it will approve the Corbett administration’s “Healthy Pennsylvania” Medicaid expansion plan, the administration continues to plan in anticipation of the proposal’s approval.
In May, the administration published a Request for Applications (RFA) from managed care organization interested in serving the state’s Medicaid expansion population through a private, market-driven approach to Medicaid expansion.
Now, the administration has announced that it has approved nine insurers as potential participants and will begin negotiating with those insurers.
Learn more about this latest action, including the criteria for qualifying to participate and a list of the selected insurers in the nine regions the state has established for Healthy Pennsylvania Medicaid expansion, in this news release from the governor’s office.

PA Safety Net Admin2014-06-24T06:00:44+00:00June 24th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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