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

Report Questions Fairness of Medicare Quality and Incentive Programs

A draft technical report by the National Quality Forum has called into question the fairness of Affordable Care Act Medicare programs that seek to provide financial incentives to hospitals that meet selected quality care standards and penalize those that fail to meet those standards.
According to the report, which was commissioned by the Obama administration, these programs unfairly penalize hospitals that care for especially large numbers of low-income seniors – hospitals like those that belong to the Safety-Net Association of Pennsylvania.
The report notes, according to the New York Times, that

Low-income people may be unable to afford needed medications or transportation to doctor’s offices and clinics, the panel said. If they have low levels of formal education or literacy, they may have difficulty understanding or following written instructions for home care and the use of medications. In addition, the clinics and hospitals they use may lack the resources and high tech equipment needed to diagnose and treat illnesses.

Among the programs cited for this problem are Medicare’s value-based purchasing program and its hospital readmissions reduction program.
Read more about the programs’ challenges, as well as the views of those who believe the programs are working as intended and should not be adjusted, in this New York Times article. Go here, to the National Quality Forum’s web site, for a direct link to the study, titled “Risk Adjustment for Socioeconomic Status or Other Sociodemographic Factors.”

PA Safety Net Admin2014-04-28T10:41:20+00:00April 28th, 2014|Affordable Care Act, Safety-Net Association of Pennsylvania|Comments Off

Medicaid Enrollment Up in PA

Pennsylvania’s Medicaid enrollment has risen by 18,000 since October 1 even though the state did not expand its eligibility criteria as authorized by the Affordable Care Act.
Instead, the enrollment increase is being attributed to what is commonly called “the woodwork effect:” people who were unaware that they already were eligible for Medicaid, were led to explore their insurance options by all of the attention the Affordable Care Act has received in recent months, and subsequently learned that they were eligible for Medicaid.
For a closer look at the woodwork effect, how it has affected Medicaid enrollment in Pennsylvania and elsewhere, and the enrollment increase’s financial implications for the state, see this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-04-23T06:00:08+00:00April 23rd, 2014|Affordable Care Act, Health care reform|Comments Off

Mackereth Explains Healthy PA Rationale

Last week, Pennsylvania Department of Public Welfare Secretary Beverly Mackereth met with the editorial board of the York Daily Record to talk about Healthy Pennsylvania, the Corbett administration’s proposal to expand the state’s Medicaid program using private insurers instead of an expansion of the state’s existing Medicaid program.
Among other things, Mackereth described why the administration chose to move in the direction it ultimately went.
Read a summary of that discussion here, on the web site of the York Daily Record.

PA Safety Net Admin2014-04-21T11:41:18+00:00April 21st, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Four in PA Congressional Delegation Question Medicaid Waiver Request

Four members of Pennsylvania’s congressional delegation have written to the Centers for Medicare & Medicaid Services (CMS) to question a specific aspect of the state’s Medicaid waiver application.
In a letter to CMS deputy director Cindy Mann, House members Allyson Schwartz, Robert Brady, Chaka Fattah, and Matt Cartwright urge the federal agency to determine whether the state’s proposed approach to Medicaid expansion would “unacceptably limit beneficiaries’ access to family planning services.”
See their letter here.

PA Safety Net Admin2014-04-17T14:44:48+00:00April 17th, 2014|Healthy PA, Pennsylvania Medicaid policy, Uncategorized|Comments Off

Public Comments on PA Medicaid Expansion Plan: Thumbs Down

Most of the people who submitted formal comments to the federal government about Pennsylvania’s plan to expand its Medicaid program wrote in opposition to the proposal.
The proposal, part of the Corbett administration’s “Healthy Pennsylvania” plan, calls for the state to use federal Medicaid funds to purchase private health insurance for people newly eligible for Medicaid.
According to a Community Legal Services of Philadelphia review completed two days before the April 11 submission deadline, 95 percent of those who expressed an opinion about the proposal opposed it, three percent supported it, and two percent offered mixed views.
The Safety-Net Association of Pennsylvania submitted formal comments expressing support for the Medicaid expansion proposal. SNAP’S comments can be found here.
Read a report about the comments, including why various groups did or did not support the proposal, in this Philadelphia Inquirer article.

PA Safety Net Admin2014-04-17T06:00:23+00:00April 17th, 2014|Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

PA Recoups Tobacco Money in Court Ruling

A Philadelphia court has restored $120 million of Pennsylvania’s share of the annual proceeds from the master settlement that tobacco manufacturers entered into with state governments in 1998.
Last year, an arbitration panel ruled that Pennsylvania had failed to enforce selected tax collection requirements properly and reduced the state’s share of the settlement proceeds by $180 million. The state appealed the ruling, and last week the court restored $120 million of the $180 million reduction mandated by the arbitration panel.
Pennsylvania uses the proceeds of the tobacco settlement for a number of purposes, including to make Tobacco Uncompensated Care Fund payments to hospitals that serve especially large numbers of uninsured patients and to underwrite clinical, health services, and biomedical research under the state’s Commonwealth Universal Research Enhancement Program (CURE).
Tobacco Uncompensated Care Fund payments are a vital source of support for many Pennsylvania safety-net hospitals.
Learn more about the tobacco funding issue, the court’s ruling, and the implications of that ruling in this Allentown Morning Call article.

PA Safety Net Admin2014-04-15T06:00:29+00:00April 15th, 2014|Medicaid supplemental payments|Comments Off

Deadline for Commenting on PA Medicaid Expansion Proposal Approaches

The deadline for interested parties to submit formal comments to the federal government about Pennsylvania’s request for a waiver from selected federal Medicaid requirements in expanding its Medicaid program is this Friday, April 11 at 6:00 a.m.
Interested parties may submit their comments here.
Safety-net hospitals interested in submitting comments are invited to borrow from SNAP’s comment letter, which can be found here.

PA Safety Net Admin2014-04-08T06:00:37+00:00April 8th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Lack of Transportation Benefit in PA Medicaid Proposal Hurts, Critics Say

Pennsylvania’s application for a waiver from selected federal Medicaid requirements includes a request for permission to eliminate transportation services for Medicaid recipients.
And that hurts, some critics say.
The private insurance plans in which newly eligible Medicaid recipients would enroll under the state’s proposed Medicaid expansion plan would not be required to offer medical transportation to low-income recipients, and one critic of the state’s proposal told the Pittsburgh Post-Gazette that “Entitlement to health services is meaningless if you can’t access it.”
Read more about medical transportation, other so-called wraparound benefits, and how the Medicaid expansion component of the state’s Healthy Pennsylvania plan treats them in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2014-04-07T11:50:30+00:00April 7th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

SNAP Endorses PA Medicaid Expansion

The Safety-Net Association of Pennsylvania has endorsed Pennsylvania’s application for a waiver from selected federal Medicaid requirements so the state can expand its Medicaid program as envisioned under the Affordable Care Act.
Instead of expanding its current Medicaid program, however, the Corbett administration proposes that the newly eligible purchase approved private insurance plans, with the state to pay the premiums. This is part of the administration’s Healthy Pennsylvania proposal.
In endorsing the waiver application in a letter to Health and Human Services Secretary Kathleen Sebelius, SNAP expressed particular support for its proposal to create a Healthy Pennsylvania Safety Net Pool that would include an Uncompensated Care Pool and/or a Delivery System Reform Incentive Pool. The additional funding associated with such pools, SNAP believes, would help safety-net hospitals address the distinct needs of the low-income communities such hospitals serve.
See the letter of endorsement here, on the SNAP web site.

PA Safety Net Admin2014-04-04T09:53:00+00:00April 4th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

Healthy PA, Medicaid Expansion in Jeopardy?

Pennsylvania Governor Tom Corbett has publicly expressed concern over whether the federal government will approve the state’s attempt to expand its Medicaid program under terms made possible by the federal health care reform law.
Both Corbett and Department of Public Welfare Secretary Beverly Mackereth have suggested that negotiations between the state and federal officials have not been going well.
The state submitted an application for a waiver from selected federal Medicaid requirements in February and has modified its proposal once since then, withdrawing a controversial mandatory job-search requirement. The application is currently undergoing a period of open public comment while state and federal officials negotiate its terms.
Under the Corbett administration’s Healthy Pennsylvania proposal, the state would expand Medicaid eligibility as envisioned under the federal Affordable Care Act but instead of simply opening up its current Medicaid program to the newly eligible, it would underwrite their enrollment in private health insurance plans chosen by those individuals.
Learn more about the latest developments in the state’s attempt to take Medicaid expansion in a decidedly different direction in this Philadelphia Inquirer article.

PA Safety Net Admin2014-04-03T08:54:11+00:00April 3rd, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

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