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

More Than Better Pay Needed to Lure Docs to Medicaid

Primary care physicians want more than better reimbursement as an inducement to serve more Medicaid patients.
They also want simpler administrative procedures, faster payment, and lower costs associated with treating those patients.
These findings come from a survey of primary care physicians in Washington state.
Recruiting more primary care physicians to serve Medicaid patients is more important than ever because many states will be taking advantage of Affordable Care Act incentives to expand eligibility for their Medicaid programs.
The survey results and more can be found in the article “Physicians May Need More Than Higher Reimbursements to Expand Medicaid Participation: Findings From Washington State,” which was published in the September 2013 edition of the journal Health Affairs. Find that article here.

PA Safety Net Admin2013-09-18T06:00:34+00:00September 18th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Corbett Presents Health Care, Medicaid Proposal

Pennsylvania Governor Tom Corbett has unveiled a new “Healthy PA” proposal that includes the means through which the state would extend Medicaid coverage to approximately 520,000 additional people.
The new Medicaid recipients, instead of enrolling in the state’s traditional Medicaid program, would purchase their health insurance through the state’s health insurance exchange, a creation of the Affordable Care Act.
Funding for the new recipients would come almost entirely from the federal government, also through the Affordable Care Act.
Pennsylvania has long been one of the states that has resisted expanding its Medicaid population – a decision made optional by the Supreme Court after a challenge to the 2010 reform law’s constitutionality.
Read a summary of the Healthy PA plan, and find a link to the plan itself here, on the state’s own web site.

PA Safety Net Admin2013-09-17T06:00:26+00:00September 17th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Reform Will Give Medicaid Population a New Look

Once the Affordable Care Act’s Medicaid expansion is implemented, the Medicaid population as a whole will be younger, whiter, healthier, and more male but also more likely to smoke and drink to excess than it is today.
That is the conclusion reached by in a new report published in the Annals of Family Medicine.
This means that spending per recipient may not be as great for new Medicaid recipients as it is for current beneficiaries and that a different patient population may need different approaches to addressing different health challenges.
Learn more about the study and its implications in the article “Potential Adult Medicaid Beneficiaries Under the Patient Protection and Affordable Care Act Compared With Current Adult Medicaid Beneficiaries, which can be found here , on the web site of the journal Annals of Family Medicine.

PA Safety Net Admin2013-09-13T06:00:10+00:00September 13th, 2013|Affordable Care Act, Health care reform|Comments Off

Legislature to Participate in PA Medicaid Expansion Talks

The Corbett administration plans to spend the coming weeks bringing the state legislature into it Medicaid expansion deliberations.
While the administration reportedly has been working to develop a Medicaid expansion program that meets its own requirements for financial responsibility and will pass federal muster, it has been doing so largely without consulting with the state legislature, which has been in recess since early July. While legislative approval is not needed for most aspects of Medicaid expansion, Department of Public Welfare Secretary Bev Mackereth told the Pittsburgh Post-Gazette that the administration will begin consulting with the legislature.
Medicaid expansion, originally mandated by the Affordable Care Act, was made optional for states by a Supreme Court decisions. Only about half of the states have definitively acted to expand their programs, and while Pennsylvania officials previously expressed strong opposition to expansion, they now appear on course to unveil an expansion proposal this fall.
Read more about the administration’s latest efforts, and its intention to involve the legislature, in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2013-09-11T06:00:19+00:00September 11th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Gap in Reform Law Could Leave Many Low-Income People Uninsured

When the Supreme Court gave states discretion over whether to expand their Medicaid programs under the Affordable Care Act, it unintentionally created a gap in potential coverage options for many low-income people that may leave many of those people without affordable health insurance.
According to a new report from the Commonwealth Fund, the 2010 reform law anticipated that everyone with incomes below 133 percent of the federal poverty level would be covered by Medicaid. Individuals and families with incomes between 133 percent and 399 percent of the federal poverty level could use new federal subsidies to help purchase private health insurance.
In states that are not expanding their Medicaid programs, people with incomes between 133 percent and 399 percent of the federal poverty level will still be able to take advantage of federal premium subsidies. People with incomes less than 133 percent of the federal poverty level but who do not qualify for their state’s Medicaid program – qualification criteria vary from state to state – will not be eligible for the same subsidies as many who earn more than them because the reform law assumed that all such individuals would be covered by Medicaid.
According to the Commonwealth Fund, this unanticipated gap in the reform law means that as many as 42 percent of people who suffer from periodic or chronic lack of insurance and who live in states that are not expanding their Medicaid programs will not benefit in any way from Affordable Care Act insurance reforms.
Pennsylvania is one of the states in which this problem will occur because the state is not expanding its Medicaid program. It almost certainly will require Pennsylvania’s safety-net hospitals to provide more uncompensated care than originally expected when the reform law was enacted.
Read more about the unintended consequences of the Supreme Court’s decision and the choice by some states not to expand their Medicaid programs in In States’ Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, a new report from the Commonwealth Fund.

PA Safety Net Admin2013-09-09T06:00:22+00:00September 9th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

Hospitals in states that expand their Medicaid programs under provisions of the Affordable Care Act should see a reduction in their uncompensated care once people begin applying for Medicaid benefits.
That will not be happening in Pennsylvania, however, because the state is not expanding eligibility for its Medicaid program.
In states that do expand their programs, hospitals will continue to lose money serving Medicaid patients because Medicaid payments seldom cover the cost of the services hospitals provide. Demand for Medicaid services will grow in these states, moreover, as more people become eligible for benefits and some who have not had regular access to care for years begin to use their new benefits to address long-standing medical problems.
Recent published reports suggest that the Corbett administration is working on an expansion plan, to be negotiated with the federal government, and that this plan may be revealed to the public this fall.
Michigan became the most recent state to decide to take advantage of the Affordable Care Act and expand its Medicaid program. For a look at how Medicaid expansion will affect hospitals in that state, see this Detroit Free Press article .

PA Safety Net Admin2013-09-04T13:40:02+00:00September 4th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Inching Closer to Medicaid Expansion

Pennsylvania state officials are working on a proposal to expand Medicaid eligibility in the state as provided for in the Affordable Care Act.
But newly eligible Pennsylvanians would not participate in the state’s current Medicaid program.
Speaking to a rotary club in York, Department of Public Welfare Secretary Bev Mackereth told her audience that because the state lacks confidence in the willingness of the federal government to continue funding care for new Medicaid enrollees, the state is developing a plan to present different Medicaid options to newly eligible people.
State officials continue to negotiate the terms of such a program with the federal government and anticipate submitting their proposal to the federal government in the near future. If approved, they do not anticipate launching such an initiative until at least January of 2015.
Read more about the state’s plans in this Calkins Media report.

PA Safety Net Admin2013-08-30T06:00:24+00:00August 30th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

PA Gets Navigation Money

Pennsylvania has received $2.7 million in Affordable Care Act money to help individuals and families navigate the health insurance exchange that the federal government will operate for the state beginning on January 1, 2014.
The money will be divided among five groups that will help individuals figure out how to take advantage of the new health insurance exchange and obtain any insurance premium subsidies for which they may be eligible.
The five groups receiving the federal money are Resources for Human Development, the Pennsylvania Association of Community Health Centers, Mental Health America, the Pennsylvania Mental Health Consumers’ Association, and the Cardon Healthcare Network.
Learn more about the federal money, why it is being spent, and how it will be used in this PA Independent article .

PA Safety Net Admin2013-08-23T06:00:12+00:00August 23rd, 2013|Affordable Care Act|Comments Off

Insurance Subsidies Will Be Common

Nearly half of all individuals and families expected to turn to health insurance exchanges for insurance policies under the Affordable Care Act will be entitled to federal subsidies to help pay their premiums.
Those subsidies will average more than $5500 per family and cover two-thirds of a premium’s overall cost.
These subsidies will be critical for Pennsylvania’s safety-net hospitals, which currently find themselves providing significant amounts of uncompensated care to low-income but working individuals and families that cannot afford health insurance today.
These were among the findings of a recent Kaiser Family Foundation analysis. Read more about the analysis and the future that awaits individuals and families in the new individual health insurance market in this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-08-22T06:00:31+00:00August 22nd, 2013|Affordable Care Act|Comments Off

PA Posts FY 2013 Medicaid DSH Eligibility

The Pennsylvania Department of Public Welfare has published a notice in the Pennsylvania Bulletin listing all hospitals eligible for Medicaid disproportionate share adjustments (Medicaid DSH) during the state’s 2013 fiscal year. See the Pennsylvania Bulletin notice here .