Pennsylvania Medicaid policy Archives - Page 26 of 43 - Safety-Net Association of Pennsylvania

IOM Releases Graduate Medical Education Report

‘’…there is an unquestionable imperative to assess and optimize the effectiveness of the public’s investment in GME (graduate medical education).”
So says the Institute of Medicine (IOM) in its new report Graduate Medical Education That Meets the Nation’s Health Needs.
The IOM also calls for “significant changes to GME financing and governance to address current deficiencies and better shape the physician workforce for the future.”
The report notes that government today, mostly through Medicare, plays the primary role in financing graduate medical education. It observes that while there is a common perception that the nation faces a shortage of physicians, simply increasing the number of residency slots that Medicare supports – a limit set in 1997 – without addressing geographic and specialty distribution issues will not solve the problem.
In the report, the IOM proposes six goals for improving GME financing.

Encourage production of a physician workforce better prepared to work in, help lead, and continually improve an evolving health care delivery system that can provide better individual care, better population health, and lower cost. 
Encourage innovation in the structures, locations, and designs of GME programs to better achieve Goal 1. 
Provide transparency and accountability of GME programs, with respect to the stewardship of public funding and the achievement of GME goals. 
Clarify and strengthen public policy planning and oversight of GME with respect to the use of public funds and the achievement of goals for the investment of those funds. 
Ensure rational, efficient, and effective use of public funds for GME in order to maximize the value of this public investment. 
Mitigate unwanted and unintended negative effects of planned transitions in GME funding methods.

To fulfill these goals, the report offers three specific recommendations:

Investing strategically: Maintain Medicare GME funding at its current level, but modernize payment methods to reward performance, ensure accountability, and incentivize innovation in the content and financing of GME. The current Medicare GME payment system should be phased out. 
Building an infrastructure to facilitate strategic investment: Establish a two-part governance infrastructure for federal GME financing. A GME Policy Council in the Office of the Secretary of the Department of Health and Human Services should oversee policy development and decision making. A GME Center within the Centers for Medicare & Medicaid Services should function as an operations center with the capacity to administer payment reforms and manage demonstrations of new payment models. 
Establishing a two-part Medicare GME fund: Allocate Medicare GME funds to two distinct subsidiary funds—a GME Operational Fund to finance ongoing residency training activities and a Transformation Fund to finance development of new programs, infrastructure, performance methods, payment demonstrations, and other priorities identified by the GME Policy Council.

Graduate medical education is an important issue for the Pennsylvania safety-net hospitals that also are teaching hospitals. The state’s Medicaid program is an important source of medical education funding for these hospitals as well.
To learn more about why the study was undertaken, what problems it sought to address, what the IOM learned, and what it proposed, follow this link to the IOM’s web site and the complete report as well as a report summary.

PA Safety Net Admin2014-08-01T06:00:22+00:00August 1st, 2014|Pennsylvania Medicaid policy|Comments Off

GAO Questions State Medicaid Financing

States are now financing more than a quarter of their share of Medicaid expenditures with money from sources other than state general funds, according to a new study by the Government Accountability Office (GAO).
According to the GAO, 26 percent of state share of Medicaid funding comes from taxes on health care providers, transfers from local governments and local government providers, and other sources. Such funding, the GAO noted, shifts additional Medicaid costs to the federal government.
Pennsylvania uses such funding mechanisms, including its gross receipts tax on Medicaid managed care organizations and state-wide and Philadelphia hospital assessments.
Exacerbating this problem, the GAO reports, is that the Centers for Medicare & Medicaid Services (CMS), which oversees Medicaid, does not assure that it receives complete and accurate data on funding sources from the states, leaving CMS without a complete understanding of how states are financing their Medicaid expenditures. In the report, the GAO recommends a stronger CMS effort to gather such data – a recommendation that CMS did not accept.
Learn more about the GAO study “States Increased Reliance on Funds From Health Care Providers and Local Governments Warrants Improved CMS Data Collection” by finding the complete report and a summary here, on the GAO web site.

PA Safety Net Admin2014-07-31T06:00:42+00:00July 31st, 2014|Pennsylvania Medicaid policy|Comments Off

Keep Medicaid Pay Boost, Docs Ask Congress

Physician groups and other health care organizations are asking Congress to continue the increase in Medicaid payments that primary care providers have been receiving for nearly two years.
The pay raise, mandated by the Affordable Care Act, was instituted to help induce more primary care providers to serve Medicaid patients in anticipation of the reform law’s significant expansion of Medicaid eligibility. That pay raise, which brings Medicaid rates up to the level of Medicare rates and is paid for entirely by the federal government, expires at the end of 2014.
Now, primary care physicians have written to the leaders of the Senate Finance Committee and the House Energy and Commerce Committee asking them to extend the raises and add ob/gyns to providers eligible for the enhanced payments.
See their letter here.

PA Safety Net Admin2014-06-30T13:00:37+00:00June 30th, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

SNAP Warns of Challenges Ahead

As Pennsylvania lawmakers contemplate the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania has issued a new position paper reminding those officials of the challenges the state’s private safety-net hospitals face in the current environment and the need for adequate, stable funding as they tackle those challenges.
Among those challenges are low-income patients with distinct needs, major cuts in federal Medicare payments that especially target safety-net hospitals, and powerful economic forces marshaled by government, insurers, and others that seek to compel hospitals to deliver care in different ways, be paid differently for their efforts, align their incentives differently with other providers, and invest heavily in information technology.
Pennsylvania’s safety-net hospitals are prepared to do all these things, but to achieve such progress, they need financial stability and predictability: they need to know that their Medical Assistance funding will not be at risk as the state experiences various budget challenges.
Read SNAP’s perspective on these issues in its new position paper, “Pennsylvania’s Safety-Net Hospitals: The Need for Stable and Predictable Funding Amid Increasing Challenges,” which can be found here, on SNAP’s web site.

PA Safety Net Admin2014-06-30T06:00:31+00:00June 30th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Protect Uncompensated Care Payments, SNAP Tells State Officials

Although only 25 percent of the state’s acute-care hospitals, Pennsylvania’s private safety-net hospitals account for 45 percent of the $1 billion in uncompensated care those hospitals provide to uninsured Pennsylvanians every year.
And now, as the governor and legislature consider the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania is urging those officials to preserve state payments that help qualified hospitals with those uncompensated care costs and enable them to continue constituting the core of Pennsylvania’s health care safety net.
Tobacco Uncompensated Care Fund payments are supplemental state payments to hospitals that provide significant amounts of uncompensated care; they are underwritten by proceeds from the national master tobacco settlement of 1998 and matched by the federal government. As lawmakers work on the state’s FY 2015 budget, SNAP is urging them to expend available FY 2014 funding already authorized for this purpose and not to use FY 2015 tobacco settlement funding for any purpose other than what was prescribed in Act 71 of 2013.
These views and background information on the role private safety-net hospitals play in caring for low-income, Medicaid-covered, and uninsured Pennsylvanians are addressed in a new SNAP position paper, “The Importance of Preserving Uncompensated Care Payments.” Find that position paper here.

PA Safety Net Admin2014-06-27T06:00:37+00:00June 27th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

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

SNAP Speaks Out on PA Budget Issues

In a series of three new position papers, the Safety-Net Association has laid out the case for why Pennsylvania needs to fund its Medicaid program adequately in the state’s upcoming 2015 fiscal year.
The first paper, “Pennsylvania Safety-Net Hospitals: Economic Engines Driving Pennsylvania Communities,” documents the degree to which safety-net hospitals not only provide significant numbers of jobs but also offer higher wages than other hospitals and other Pennsylvania employers.
The second paper, “The Importance of Preserving Uncompensated Care Payments,” notes that Pennsylvania’s safety-net hospitals, just 25 percent of the state’s acute-care hospitals, provide nearly 50 percent of the $1 billion worth of uncompensated care hospitals in the state provide every year. The state helps underwrite some of those costs through Tobacco Uncompensated Care fund payments – proceeds of the national tobacco settlement of 1998 – but that funding is now in jeopardy.
And the third paper, “The Need for Stable and Predictable Funding Amid Increasing Challenges,” outlines the enormous and at times conflicting pressures that government and others are exerting on hospitals and explains that while safety-net hospitals look forward to these challenges, they need stable and predictable Medicaid funding to help them rise to the occasion.
SNAP issues these papers as lawmakers in Pennsylvania struggle with an FY 2014 revenue shortfall of more than $500 million and an anticipated shortfall of another $880 million in the coming 2015 fiscal year.
See SNAP’s three new position papers here.

PA Safety Net Admin2014-06-20T06:00:20+00:00June 20th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Late Budget for PA?

Pennsylvania’s constitution calls for the state to adopt a budget for the next fiscal year by June 30, the end of its fiscal year, but it is looking more and more as if the legislature and governor will miss that deadline this year.
Although budgets typically come easily when the same party controls the governor’s mansion and both chambers of the General Assembly, the state’s revenue shortfall, a structural deficit that will carry over into next year, and the introduction of additional issues into the budget process appear to be slowing progress toward adopting a spending plan for the state’s 2015 fiscal year.
To reinforce the notion that June 30 may come and go without a budget adopted, state Senate majority leader Dominic Pileggi recently told members of his Republican caucus to put their fourth of July celebration plans on hold because their work for the legislative season may not be done.
At stake for Pennsylvania’s safety-net hospitals is funding for the state’s Medicaid program. The budget includes numerous items that may prove tempting for officials to prune in search of money to close the current revenue shortfall. Most tempting may be millions in Tobacco Uncompensated Care Fund revenue frozen by the Corbett administration last year in response to an arbitrator’s decision to reduce the state’s proceeds from the national tobacco settlement.
Tobacco Uncompensated Care funds help underwrite some of the $1 billion in charity care Pennsylvania’s hospitals provide annually – more than 40 percent of it provided by the 25 percent of acute-care hospitals in the state that are safety-net hospitals. The Safety-Net Association of Pennsylvania (SNAP) is conveying its concern about the possibility of reducing this funding to legislators.
Learn more about the potential delay in adopting a state budget in this PA Politics report and this York Dispatch article.

PA Safety Net Admin2014-06-18T06:00:38+00:00June 18th, 2014|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|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

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