Pennsylvania Medicaid policy Archives - Page 16 of 44 - Safety-Net Association of Pennsylvania

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing.
In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts.
Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently chosen to serve the state’s Medicaid population through the HealthChoices physical health program.
For a closer look at Medicaid value-based purchasing, go here to read the National Association of Medicaid Directors’ issue brief “Medicaid Value-based Purchasing: What Is It & Why Does It Matter?”

PA Safety Net Admin2017-02-17T06:00:19+00:00February 17th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Changing Medicaid

House Chamber of the State House With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider.
Among them are:

giving states greater flexibility in the design and implementation of their own Medicaid programs
requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments
limiting benefits
employing incentives to encourage healthy behaviors

The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years.
Because Pennsylvania’s safety-net hospitals care for so many low-income and Medicaid patients, they could be affected by any major federal Medicaid policy changes far more than the typical Pennsylvania hospital.
Learn more about some of the options Congress will have as it looks at possible Medicaid reform in the Health Affairs Blog article “The Future Of Medicaid: When Improving Upon The Wheel, Start With Something Round,” which can be found here.

PA Safety Net Admin2017-02-16T06:00:00+00:00February 16th, 2017|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Governor Proposes FY 2018 Budget

On Tuesday Pennsylvania Governor Tom Wolf unveiled his proposed FY 2018 budget to the state’s General Assembly.
This budget proposal includes a number of provisions with potential implications for Pennsylvania’s safety-net hospitals.
The Safety-Net Association of Pennsylvania has prepared a detailed review of those provisions. Officials of safety-net hospitals who would like to receive a copy of this memo may request one by using the “contact us” link on the upper right-hand corner of this screen.
Find a news release from the governor’s office that outlines the proposed budget here and go here (scroll to the bottom of the screen) for links to budget overviews, the entire budget itself, the Wolf administration’s presentation on its plan to consolidate Pennsylvania’s Department of Human Services, Department of Health, Department of Aging, and Department of Drug and Alcohol Services into a single new Department of Health and Human Services, and other related materials.

PA Safety Net Admin2017-02-10T06:00:00+00:00February 10th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2018 budget|Comments Off

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2017 newsletter.
Included in this edition are stories about:

impending changes in the lineup of managed care providers that serve Medicaid participants in the state’s HealthChoices program for physical health services;
the status of the state’s implementation of its Community HealthChoices program of managed long-term services and supports for low-income, elderly Pennsylvanians who seek to continue living independently in the community;
the potential impact of a repeal of the Affordable Care Act on Pennsylvanians; and
Pennsylvania’s receipt of a Certified Community Behavioral Health Clinic demonstration grant from the federal government to improve services and care coordination for individuals on Medicaid or CHIP.

Go here for the latest edition of PA Health Law News.

PA Safety Net Admin2017-02-08T17:39:17+00:00February 8th, 2017|Affordable Care Act, HealthChoices PA, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Medicaid Directors Comment on Proposed Medicaid Pass-Through Regulation

Last November the Centers for Medicare & Medicaid Services proposed a new regulation governing the use of pass-through payments in state Medicaid managed care programs.
The National Association of Medicaid Directors submitted formal comments to CMS about that proposed regulation. See its comments here.

PA Safety Net Admin2017-01-11T06:00:13+00:00January 11th, 2017|Pennsylvania Medicaid policy|Comments Off

Expanded Access to Hep C Drugs Isn’t the Answer for Medicaid, Study Says

A new study suggests that greatly expanding access to new drugs that essentially “cure” Hepatitis C would cost Pennsylvania’s Medicaid program a great deal of money but save relatively few lives.
The study found that in many cases, Hepatitis C progresses so slowly that by the time many of the people who suffer from it truly need the new generation of expenses drugs they will be old enough for Medicare, which would leave the federal government, rather than the state, with the cost of paying for the treatment.
Prescription Medication Spilling From an Open Medicine Bottle Patient advocates maintain that all Medicaid beneficiaries with Hepatitis C should have access to the drugs and Pennsylvania’s Medicaid program appears to be on a path toward making that possible.
Learn more about the study and its findings in this Philadelphia Inquirer story.

PA Safety Net Admin2017-01-03T06:00:29+00:00January 3rd, 2017|Pennsylvania Medicaid policy|Comments Off

PA Health Law Project Newsletter

phlp The Pennsylvania Health Law Project has published its November-December 2016 newsletter.
Included in this edition are stories about a new effort to enroll children in the state’s Medicaid and Children’s Health Insurance Program, the new fees for Medicare Part A and Part B for 2017, a delay in the implementation of the state’s proposed Community HealthChoices program of managed long-term services and supports, and more.
Go here for the latest edition of PA Health Law News.

PA Safety Net Admin2016-12-28T06:00:04+00:00December 28th, 2016|Medicare, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Impact of “Repeal and Replace” on PA?

With the president-elect and congressional leaders vowing to repeal and replace the Affordable Care Act, the question arises about how such actions might affect Pennsylvania.
Health Benefits Claim Form That includes 680,000 Pennsylvanians who enrolled in the state’s Medicaid program after the reform law allowed for that program’s expansion, more than 400,000 people who signed up for insurance on the federal health insurance exchange, the state’s taxpayers who might be left with the bill for some or all of these costs if the reform law’s financial support were to disappear in the near future, and others.
The Pittsburgh Tribune-Review considers these and other questions and offers answers from some of those closest to the situation. See its story here.

PA Safety Net Admin2016-12-19T06:00:38+00:00December 19th, 2016|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

PA Improves Access to Contraceptives

Citing the challenges and risks associated with unplanned pregnancies that occur within two years of a delivery, Pennsylvania’s Medicaid program is making long-acting contraceptives more readily available to program participants.
Pennsylvania State Map Beginning on December 1, Medicaid will pay for long-acting contraceptives administered after delivery and also will increase payments to doctors who provide those contraceptives. Currently, those costs are generally borne by hospitals in the lump-sum payment Medicaid makes for deliveries.
Learn more about the state’s new policy for encouraging the use of contraceptives among Medicaid beneficiaries who have delivered babies in this Lancaster Online article.

PA Safety Net Admin2016-12-09T06:00:58+00:00December 9th, 2016|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off

Integrating Medicaid Supplemental Payments into Value-Based Purchasing

New health care delivery and reimbursement systems and new federal regulations will result in changes in how states deploy their Medicaid resources through supplemental payments in the coming years.
A new Commonwealth Fund report describes the kinds of supplemental Medicaid payments states currently make to hospitals – such as disproportionate share and upper payment limit payments – and notes the differing degree to which individual states use such supplemental payments.
It also describes how those supplemental payments may be restructured in the coming years to foster greater use of value-based purchasing and to reward achieving state-created quality goals through new delivery and reimbursement systems such as accountable care organizations, bundled payments, shared savings program, capitated arrangements, and shared risk.
Such changes have potentially serious implications for Pennsylvania safety-net hospitals – as SNAP members learned first-hand from state Medicaid director Leesa Allen when she met with them in November in Philadelphia to discuss the commonwealth’s plans for value-based purchasing and changes in Medicaid reimbursement.
Learn more about what the future may have in store for Medicaid supplemental payments in the Commonwealth Fund report Integrating Medicaid Supplemental Payments into Value-Based Purchasing.

PA Safety Net Admin2016-12-07T06:00:49+00:00December 7th, 2016|Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off

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