Affordable Care Act Archives - Page 10 of 15 - Safety-Net Association of Pennsylvania

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

MedPAC: Keep Paying More For Medicare Primary Care Services

The federal government should continue paying extra for primary care services provided to Medicare patients, Congress has been told by its chief advisor on Medicare payment policy.
According to the Medicare Payment Advisory Commission (MedPAC), the independent federal agency that advises Congress on Medicare payment matters, Medicare has long undervalued primary care services in comparison to specialty medical care, and in 2010 the Affordable Care Act introduced a ten percent bonus for primary care services provided to seniors through 2015.
With the expiration of that bonus coming in a little more than a year, MedPAC has told Congress it should seek to continue the practice but perhaps by making the additional payment on a per beneficiary basis rather than a per visit basis, to make such an approach part of the broader effort to discourage the volume provision of services and to encourage outcomes-oriented care.
In its June 2014 report to Congress, MedPAC also outlines how such a payment might work.
Pennsylvania’s safety-net hospitals all care for significant numbers of Medicare patients, including many low-income seniors.
Learn more about MedPAC’s overall recommendations, including this one involving Medicare primary care payments, in this MedPAC fact sheet. Find the entire MedPAC June 2014 report to Congress here.

PA Safety Net Admin2014-06-17T06:00:28+00:00June 17th, 2014|Affordable Care Act|Comments Off

Thousands in PA Await Word on Medicaid Eligibility

More than 60,000 Pennsylvanians are waiting to hear from the state about their application for Medicaid benefits.
The 60,000 are among more than 1.7 million people nation-wide who have applied for Medicaid are still waiting for a decision on their eligibility – some for as long as eight months.
More than half of those still waiting are in California while some live in states that, like Pennsylvania, have not expanded their Medicaid programs.
The delays have been attributed to problems transferring data received on the federal health insurance exchange to state governments, state programs overwhelmed with volume, technical problems in the states, and other reasons.
Many of those who still await word on their application for Medicaid benefits undoubtedly live in communities served by the state’s private safety-net hospitals.
Learn more about this problem, what is being done about it, and how it affects access to care in this Kaiser Health News article.

PA Safety Net Admin2014-06-10T06:00:52+00:00June 10th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

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

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

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

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

SNAPShots

SNAPShots

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

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