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

Increase Use of Value-Based Purchasing, HHS Told

A study performed for the U.S. Department of Health and Human Services calls for greater use of value-based purchasing in federal health care reimbursement policy.
The study, performed by the RAND Corporation, recommends developing a national value-based purchasing strategy; developing a more deliberate approach to evaluating the effectiveness of value-based purchasing efforts; and developing performance measures that support value-based purchasing approaches.
Such an approach could be a major challenge for Pennsylvania’s safety-net hospitals, according to a Harvard School of Public Health analysis that found that in the first year of Medicare’s value-based purchasing program, hospitals that served the largest numbers of low-income patients suffered the largest financial penalties from that program.
Read more about the RAND study in this Fierce Healthcare story and find the RAND study itself here. Read another Fierce Healthcare article about the impact of value-based purchasing on safety-net hospitals here.

PA Safety Net Admin2014-03-11T06:00:25+00:00March 11th, 2014|Uncategorized|Comments Off

State Seeks Restoration of Tobacco Money

Pennsylvania has gone to court to seek the restoration of more than $200 million in tobacco funds that it lost as a result of an arbitration ruling last year.
The money, from the national master tobacco settlement agreement, is used to make Tobacco Uncompensated Care Fund payments that are vital to the state’s safety-net hospitals. The purpose of the tobacco money is to help underwrite the cost of uncompensated care provided by hospitals that serve especially large numbers of uninsured patients.
Last year an arbitration panel ruled that the state had failed to collect the tobacco taxes owed to it as part of the national tobacco settlement agreement. In its suit attempting to overturn the arbitration decision, the state maintains that the state has, in fact, collected the taxes in a manner consistent with the settlement agreement and that the tobacco companies have significant overstated how much loose tobacco they sell in Pennsylvania.
Read more about the arbitration ruling that cost Pennsylvania more than $200 million in tobacco funds and the state’s efforts to overturn that ruling in this Philadelphia Inquirer article.

PA Safety Net Admin2014-03-10T06:00:24+00:00March 10th, 2014|Uncategorized|Comments Off

PA Relents on Medicaid Work-Search Requirement

One of the most controversial aspects of the Corbett administration’s proposal to expand the state’s Medicaid program was that every able-bodied adult of working age be required to demonstrate that they were pursuing employment.
On Thursday, the administration agreed to drop that proposal in the face of opposition from the Obama administration.
Instead, the Corbett administration will propose a one-year, voluntary, incentive-based pilot program requiring participants to document their work-search efforts. Like the original work-search requirement, this proposal will be subject to federal review.
Read more about this development in Pennsylvania’s pursuit of federal approval to expand its Medicaid program in this Lancaster Online article. Find a copy of Governor Corbett’s letter dropping the controversial component and proposing an alternative here.

PA Safety Net Admin2014-03-07T06:00:25+00:00March 7th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has released its February Health Law News newsletter.
The publication includes features on Governor Corbett’s recently proposed FY 2015 state budget; new state criteria for qualifying for PACE and PACENET, programs that help low-income seniors with the cost of prescription drugs; a clarification of state policy governing complaints and grievances about HealthChoices Medicaid managed care plans; and more.
Find the February edition of Health Law News here.

PA Safety Net Admin2014-03-06T06:00:37+00:00March 6th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

PA Submits Medicaid Plan to Feds

Yesterday the Corbett administration submitted a waiver application to the federal government requesting permission to expand the state’s Medicaid program as described in its “Healthy Pennsylvania” proposal.
The Pennsylvania proposal seeks to vary from the approach taken by most states expanding their Medicaid programs in accordance with the Affordable Care Act by directing the expansion population into private health insurance plans.
A draft waiver application, released in December, was the subject of public hearings throughout the state. The Safety-Net Association of Pennsylvania (SNAP) testified at one of those hearings and also submitted detailed written comments about the proposal; both can be found here.
The state’s waiver application, the December draft application, a summary of the application, and the written and oral comments about the proposed application submitted by interested parties can be found here, on the Pennsylvania Department of Public Welfare’s web site. Learn more about the proposal’s submission to the federal government and where it goes from here in this Ellwood City Ledger article and the reaction of some elected officials to the submission here.
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PA Safety Net Admin2014-02-20T06:00:20+00:00February 20th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

New Approaches to Serving Dual Eligibles Set to Launch

Provisions in the Affordable Care Act that encourage states to take new approaches to serving their dually eligible residents – low-income seniors eligible for both Medicare and Medicaid – will soon translate into new state programs.
Massachusetts has already launched such an initiative, a new California program will begin in May, and 17 additional states are scheduled to begin new efforts later this year and next.
New federal policies encourage state Medicaid programs to work with Medicare in service to their dually eligible population, with the states and Medicare sharing in the savings they produce. Currently, dually eligible patients constitute 15 percent of the Medicaid population but account for 40 percent of Medicaid’s costs and 20 percent of the Medicare population but 30 percent of Medicare’s costs.
Eighteen percent of Pennsylvania’s Medicaid population is dually eligible. The state is not among those with new dual eligibles programs preparing to launch.
How are states tackling this challenge? Learn more in this Stateline report.

PA Safety Net Admin2014-02-18T06:00:56+00:00February 18th, 2014|Pennsylvania Medicaid policy|Comments Off

First Round of Data on PA Health Insurance Sign-Ups

123,681 Pennsylvanians signed up for health insurance through the federally facilitated marketplace between October 1 and February 1, according to a new report from the U.S. Department of Health and Human Services.
Among Pennsylvanians who enrolled in new health insurance plans, 79 percent were eligible for financial assistance with their premiums and 56 percent are female while 44 percent are male.
Among those who enrolled in insurance plans through the marketplace, 26 percent are between the ages of 18 and 34; 15 percent are between the ages of 35 and 44; 22 percent are between 45 and 54; and 36 percent are between 55 and 64.
In all, the marketplace evaluated 286,926 Pennsylvanians for eligibility for subsidized insurance, Medicaid, and the Children’s Health Insurance Program (CHIP). 29,365 were found eligible for Medicaid or CHIP.
Learn more about the first round of Pennsylvanians who signed up for health insurance, including the types of plans they selected and more, in this Department of Health and Human Services report.

PA Safety Net Admin2014-02-14T06:00:26+00:00February 14th, 2014|Affordable Care Act|Comments Off

Healthy PA Could Affect FQHCs

The Corbett administration’s Healthy Pennsylvania health care reform and Medicaid expansion proposal could steer low-income patients away from the state’s federally qualified health centers (FQHCs) and reduce the payments those facilities receive for much of the care they deliver.
FQHCs have long provided medical care to uninsured people who had no other care options, but if Healthy Pennsylvania is adopted, many of those patients would become eligible for health insurance, whether Medicaid or subsidized by the federal government, and might choose other providers instead or might even find their FQHCs excluded from their new insurer’s provider network.
Learn more about the collision course FHQCs may find themselves on with Healthy PA in this Philadelphia Inquirer article.

PA Safety Net Admin2014-02-12T06:00:21+00:00February 12th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA to Submit Healthy Pennsylvania Application Soon

Pennsylvania will submit its “Healthy Pennsylvania” Medicaid expansion waiver application to the federal government in about two weeks, Governor Tom Corbett told a central Pennsylvania public radio station last week.
Once the state submits that application, according to the Harrisburg Patriot-News, “…the process should go quickly, he [Corbett] said, since the details have been worked out through ‘constant negotiations’ with federal officials at the Department of Health and Human Services.”
Read more about Governor Corbett’s radio appearance and his thoughts on Healthy Pennsylvania and Medicaid expansion in this Harrisburg Patriot-News report.

PA Safety Net Admin2014-02-10T06:00:26+00:00February 10th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

Corbett Budget Proposes Mixed Bag for Safety-Net Hospitals

Yesterday Pennsylvania Governor Tom Corbett unveiled his proposed FY 2015 budget – a mixed bag for the state’s safety-net hospitals.
The budget proposes increased spending for Medicaid services, compensates for the loss of federal Medicaid funding expected when the state’s Medicaid matching rate declines later this year, and proposes new funding to help develop clinics and encourage medical professionals to work in rural and underserved parts of Pennsylvania.
On the other hand, the budget proposes slight reductions in selected supplemental payments that are important to safety-net hospitals, counts on significant savings derived through the Healthy Pennsylvania program that has not yet been approved by the federal government, and assumes that the state will prevail in its appeal of an arbitration ruling that would severely reduce the funding the state uses to make tobacco uncompensated care payments to qualified hospitals.
SNAP has prepared a detailed summary of the budget proposal that addresses the aspects of the budget that are most important to safety-net hospitals. Interested parties may request a copy by hitting the “contact us” link in the upper right-hand corner of this screen.

PA Safety Net Admin2014-02-05T10:53:42+00:00February 5th, 2014|Healthy PA, Pennsylvania Medicaid policy|Comments Off

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