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

Uncompensated Care Down in Medicaid Expansion States

Hospitals in states that chose to take advantage of the Affordable Care Act’s Medicaid expansion option are providing less charity care than hospitals in states that have not expanded their Medicaid programs.
So reports the Colorado Hospital Association after its survey of 465 hospitals in 30 states.
According to the survey, hospitals’ proportion of Medicaid patients increased in states that expanded their Medicaid programs and did not increase in states that did not expand their Medicaid program and uncompensated care fell in states that expanded their Medicaid programs but did not in other states.
Addressing the extent of these changes, the survey found that

The changes seen here are not only distinct, but also substantial. The Medicaid proportion of total charges increased over three percentage points to 18.8 percent in 2014 from 15.3 percent in 2013, representing a 29 percent growth in the volume of Medicaid charges. When compared to the first quarter of 2013, there was a 30 percent drop in average charity care per hospital across expansion states, to $1.9 million from $2.8 million. Similarly, total self-pay charges declined 25 percent in expansion states, bringing its proportion of total charges down to 3.1 percent from 4.7 percent. In contrast, the proportion of Medicare volume shows little variation through first quarter 2014.

Pennsylvania has not yet expanded its Medicaid program but is currently negotiating the terms of doing so with the federal government.
Find the complete Colorado Hospital Association report here.

PA Safety Net Admin2014-06-06T06:00:25+00:00June 6th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Members of Congress Urge Delay in Medicare DSH Cuts

Fifty-eight members of the House of Representatives have written to House leadership asking them to delay the continued implementation of Affordable Care Act-mandated Medicare disproportionate share (Medicare DSH) cuts.
The letter, to House Speaker John Boehner and minority leader Nancy Pelosi, notes that

…hospitals that qualify for Medicare DSH are, by definition, the very providers caring for the greatest numbers of low-income and low-income elderly patients. In recent years, hospitals have incurred $270 billion in Medicare cuts, including reductions in their annual cost-of-living adjustments, penalties through Medicare’s value-based purchasing and readmissions reduction programs, reduced Medicare bad debt reimbursement, and continued cuts from sequestration. Medicare DSH cuts at this time could jeopardize the health care safety net that our constituents and yours need and deserve.

Medicare DSH payments are vital to most of Pennsylvania’s private safety-net hospitals.
Read the entire congressional letter here.

PA Safety Net Admin2014-06-05T06:00:07+00:00June 5th, 2014|Affordable Care Act|Comments Off

Feds Question PA’s MCO Gross Receipts Tax

The federal government is questioning Pennsylvania’s use of proceeds from its tax on Medicaid managed care organizations to draw down federal Medicaid matching funds.
Federal law permits some use of revenue from health care-related taxes to help finance the state’s share of Medicaid spending, but such taxes must be “broad-based” and a 2009 change in the law narrowed the definition of what constitutes a broad-based tax.
According to an audit performed by the U.S. Department of Health and Human Services’ Office of the Inspector General, Pennsylvania’s current tax on HealthChoices managed care organizations (MCOs)

…is impermissible because it is not broad based (the Gross Receipts Tax does not apply to all MCOs) and because it holds the Medicaid MCOs harmless as taxpayers…

According to the inspector general’s report, the state collected $1.76 billion in gross receipts tax revenue from its Medicaid MCOs between FY 2009 and 2011 and drew down federal Medicaid funds to match that revenue.
State officials disagree with the inspector general’s findings and have submitted their opposing arguments to the federal government.
The loss of gross receipts tax revenue would leave an enormous hole in the state’s financing of its share of Medicaid spending and could pose a considerable challenge for the state’s private safety-net hospitals because they serve so many Medicaid patients.
Find the inspector general’s report, including its findings and recommendations and the state’s response to them, here on the web site of the Office of the Inspector General.

PA Safety Net Admin2014-06-03T06:00:47+00:00June 3rd, 2014|Pennsylvania Medicaid policy|Comments Off

CMS to Examine How States Set Medicaid Managed Care Rates

The Centers for Medicare & Medicaid Services (CMS) is launching an initiative to explore how states set the rates they pay managed care organizations to serve Medicaid patients.
The initiative consists of two parts: first, CMS is examining the adequacy of the process states employ to set their rates – a process that affects the adequacy of the rates themselves; and second, it is drafting updated Medicaid managed care regulations.
Because Pennsylvania safety-net hospitals serve so many Medicaid patients, this effort could have a future impact on the payments they receive for serving these patients.
Learn more about this new undertaking in this Kaiser Health News report.

PA Safety Net Admin2014-05-29T06:00:25+00:00May 29th, 2014|Pennsylvania Medicaid policy|Comments Off

Hospitals Reconsidering Charity Care Policies?

In the wake of Affordable Care Act policies that enhance access to health insurance, hospitals around the country are beginning to take a second look at their charity care policies.
Some are charging co-pays to uninsured patients; others are moving the line at which they provide free or subsidized care.
Such practices are not occurring in great numbers and do not yet constitute a trend, but they do reflect a growing concern among hospitals that some of their uninsured patients have options they are choosing not to exercise.
The New York Times has taken a look at a few hospitals that have reconsidered their long-time charity care policies. Read its report here.

PA Safety Net Admin2014-05-27T10:23:53+00:00May 27th, 2014|Affordable Care Act|Comments Off

PHC4 Issues Report on Hospital Financial Performance

The Pennsylvania Health Care Cost Containment Council (PHC4) has issued its annual report on the financial performance of the state’s acute-care hospitals.
Among the highlights:

The state-wide average operating margin of hospitals fell from 5.73 percent in FY 2012 to 4.69 percent in FY 2013.
Uncompensated care rose 5.41 percent, to more than $1 billion, and up from an average of 2.72 percent of hospital net patient revenue in FY 2012 to 2.81 percent in FY 2013.
35 percent of hospitals reported negative operating margins.
22 percent reported negative operating margins over the latest three-year period.

Find the complete PHC4 report here.

PA Safety Net Admin2014-05-22T09:20:26+00:00May 22nd, 2014|Uncategorized|Comments Off

No Observation Rate Yet for PA Medicaid

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin continuing its current payment methodology under the state’s Medicaid program but noting that it still has not developed an observation rate for the program.
Last year the state indicated that it wanted to establish such an observation rate, but it has not yet done so. The new notice states that

The Department also announced its intent to establish an observation rate for hospital cases for which an inpatient admission is not medically necessary, but medical observation of a patient is required. The Department received multiple public comments concerning an intended observation rate. At this time, the Department plans to develop a payment policy and rates for observation services and will provide an opportunity for public comment in a future notice of intent.

At the time the state expressed an interest in developing an observation rate, the Safety-Net Association of Pennsylvania wrote to the Department of Public Welfare expressing support for the concept. Read SNAP’s letter here.
Find the entire Pennsylvania Bulletin notice here.

PA Safety Net Admin2014-05-19T06:00:51+00:00May 19th, 2014|Pennsylvania Bulletin, Pennsylvania Medicaid policy|Comments Off

Safety-Net Hospital Finances Falling Behind Other Hospitals

While most hospitals have recovered from the worst of the recession, safety-net hospitals that were already weak before the recession now find a growing financial gap between themselves and other hospitals.
So reports the new study “Hospital Financial Performance in the Recent Recession and Implications for Institutions That Remain Financially Weak,” which was published in the May edition of Health Affairs.
According to a news release about the study,

About 28 percent of the safety-net hospitals were financially weak in 2006. While their financial performance dipped in 2008, these institutions rebounded by 2011. However, the financial gap between the safety-net hospitals and the non-safety-net hospitals continues to widen in terms of their total profit.

The release also notes the implications of this financial struggle:

On the one hand, financially weak and safety-net hospitals continue to keep their doors open. On the other hand, these institutions remain in precarious financial positions that could compromise their ability to invest in innovations or quality improvement activities that may provide value for patients.

Learn more about the study in this news release or find the study itself here, on the web site of the publication Health Affairs.

PA Safety Net Admin2014-05-14T06:00:04+00:00May 14th, 2014|Uncategorized|Comments Off

PA Seeks Insurer Bids for Medicaid Expansion

In anticipation of the possibility of receiving approval from the federal government to expand its Medicaid program, the Corbett administration is soliciting bids from insurers interested in serving the state’s Medicaid expansion population.
The market for those insurers: approximately 600,000 people who would become eligible for Medicaid and free to choose from among eligible insurers.
The Corbett administration has taken a sometimes-controversial approach to Medicaid expansion, seeking to underwrite premiums to private insurers for those newly eligible for Medicaid coverage. For months the administration has been negotiating the terms of its proposed Healthy Pennsylvania Medicaid expansion plan with the federal government, and the decision to seek bids in anticipation of a possible January 1, 2015 launch of Medicaid expansion is viewed as a sign that those negotiations are going well.
Read about this latest development in Pennsylvania’s bid to expand its Medicaid program through a private market option in this Philadelphia Inquirer article. Find the state’s request for applications for insurers interested in serving the Medicaid expansion population here.

PA Safety Net Admin2014-05-09T06:00:34+00:00May 9th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Study Points to Risk of DSH Cuts

A new study suggests that future cuts in Medicare disproportionate share (Medicare DSH) and Medicaid DSH payments could pose problems for hospitals that serve large numbers of uninsured patients.
According to a new report in the journal Health Affairs,

Such cuts in government funding of uncompensated care could pose challenges to some providers, particularly in states that have not adopted the Medicaid expansion or where implementation of health care reform is proceeding slowly.

Medicare DSH and Medicaid DSH payments help underwrite the uncompensated care hospitals provide to their uninsured patients. These payments are a vital source of revenue for Pennsylvania’s safety-net hospitals and Pennsylvania is among the states that have not yet adopted Medicaid expansion.
Even after Affordable Care Act reforms take effect, 25 to 30 million Americans are expected to remain uninsured. Medicare DSH payments are expected to decline $22.1 billion between now and 2019 and Medicaid DSH payments, temporarily delayed by two separate actions of Congress, are expected to decline $17.1 billion through 2020.
Learn more about the Health Affairs study in this Washington Post article and find the study itself here, on the web site of Health Affairs.

PA Safety Net Admin2014-05-07T06:00:01+00:00May 7th, 2014|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

SNAPShots

SNAPShots

About PA Safety Net Admin

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us