Pennsylvania safety-net hospitals Archives - Safety-Net Association of Pennsylvania

Advocates Seek More State Staff for Medicaid Eligibility Redeterminations

With the continuous Medicaid eligibility that marked the COVID-19 pandemic coming to an end on April 1 and roughly one-third of the 3.6 million Pennsylvanians enrolled in Medicaid thought to be in jeopardy of losing their coverage, health care advocates are asking the state to invest in more staff to help current participants submit the paperwork needed to retain their coverage as part of what has become known as “Medicaid unwinding.”

In a letter signed by representatives of the Pennsylvania Health Law Project, the Pennsylvania Health Access Network, the Pennsylvania Partnership for Children, and others, advocates noted that the county assistance offices that will play a major role in this process are already understaffed and need more help if deserving Pennsylvanians are to avoid falling through the Medicaid eligibility cracks. The state has acknowledged the staffing problems at its county assistance offices.

PHE-Phase1-Newsletter-HalfPage-Banner-MA-Renewal

The advocates also have asked the state to publish more information about Medicaid eligibility redetermination and to extend Medicaid and Children’s Health Insurance Program (CHIP) eligibility for children for another year.

A troubled Medicaid unwinding effort would be a troubling development for Pennsylvania’s safety-net hospitals because those hospitals care for especially large numbers of low-income and Medicaid-covered patients and could face the possibility of finding themselves serving significantly more uninsured and underinsured patients than they already do – without reimbursement for that care.

Learn more about the challenges inherent in the Medicaid eligibility redetermination effort and what the advocates seek from the state in the WESA-FM radio article “With major Medicaid changes ahead, advocates want to see increased staffing for assistance offices.”

jsteinbock2023-02-27T18:49:43+00:00February 28th, 2023|COVID-19, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

SNAP Hospitals Benefit From New PA Health Care Funding

While a recent Pennsylvania law will result in all hospitals receiving supplemental funding to help with employee recruitment and retention, SNAP member hospitals will receive a little something extra.

Safety-Net Association of Pennsylvania logo Pennsylvania Act 2, passed earlier this year, appropriates $225 million in federal money and the state has earmarked a portion of that money for hospitals based on how many beds they have. Hospitals that serve especially high proportions of Medicaid patients, however, will receive funding over and above the amount targeted to them based on bed count alone.

All Safety-Net Association of Pennsylvania members – hospitals distinguished by their service to especially large numbers of low-income Pennsylvanians – will receive a portion of these additional resources.

All hospitals and other selected providers will share $100 million of the $225 million total; this portion will be distributed on a per-bed basis. Pennsylvania safety-net hospitals, along with critical access hospitals and inpatient and residential behavioral health facilities, also will receive part of a separate, larger pool of $110 million.

Over the years, SNAP has consistently urged state officials to provide additional funding to Pennsylvania safety-net hospitals that care for especially high proportions of Medicaid and uninsured patients. In this situation, state officials did exactly that.

Learn more about the $225 million appropriation and how it will be distributed from this Wolf administration news release and this list of funding recipients, which includes all SNAP members.

jsteinbock2022-03-25T13:10:50+00:00March 25th, 2022|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Hospitals, Insurers, City Launch Health Equity Effort

The pursuit of health equity is the subject of a new collaboration between health systems – including Pennsylvania safety-net hospitals – health insurers, and city government in Philadelphia.

The new effort, dubbed “Accelerate Health Equity,” will seek to bring “…together organizations across the region to produce tangible improvement in health inequities, and ultimately achieve measurable, positive changes in health outcomes in Philadelphia.” Among the participants in the endeavor are AmeriHealth Caritas, Children’s Hospital of Philadelphia, the City of Philadelphia, Drexel University, Independence Blue Cross, Jefferson Health, Main Line Health, Penn Medicine, Philadelphia College of Osteopathic Medicine, Temple Health, and Trinity Health Mid-Atlantic.

The group envisions its approach to pursuing health equity and addressing social determinants of health as consisting of three components:

Launching Pilot Programs: Individual pilot programs tied to identified areas that impact health outcomes.
Measuring Progress: A publicly available digital health equity dashboard based on data provides an in-depth view of 16 health equity challenge areas and will also track progress of pilot programs.
Collaborating to Scale: Pilot programs will be evaluated and information will be disseminated to inform health and service providers and quickly scale successful pilot programs to expand their reach and impact.

The 16 health equity challenges the group intends to tackle at the start are:

behavioral health
cardiovascular health
colorectal cancer
community violence
COVID-19
digital access
food access
housing access
maternal and infant health
neighborhood conditions
obesity and diabetes
primary care access
racism and discrimination in health care
socioeconomic disadvantage
specialty care access
substance abuse and abuse

Learn more about this new approach to addressing health equity in an urban environment in the Philadelphia Inquirer article “Philly hospitals and key insurers plan novel effort with the city to improve health equity;” from the Accelerate Health Equity web site, which identifies the venture’s participants and leadership and offers additional information; and from an introductory video.

jsteinbock2022-03-21T18:06:50+00:00March 22nd, 2022|health equity, Pennsylvania safety-net hospitals|Comments Off

Vaccination Rates Low Among Medicaid Recipients

Individuals enrolled in Medicaid are less likely to have received COVID-19 vaccines than the population as a whole, according to a recently published report.

Among the possible reasons for this low rate, observers speculate, is greater vaccine hesitancy among low-income individuals (as identified in a nation-wide survey), less flexible work schedules, and economic barriers such as lack of transportation or child care.

This can pose a special challenge for Pennsylvania safety-net hospitals because the communities they serve have more Medicaid beneficiaries than the typical community.

Learn more about the extent of the problem around the country and what state Medicaid programs are doing to encourage more Medicaid beneficiaries to roll up their sleeves and get vaccinated in the Roll Call article “Medicaid beneficiaries less likely to get COVID-19 shots.”

jsteinbock2021-07-07T20:30:43+00:00July 8th, 2021|Coronavirus, COVID-19, Pennsylvania safety-net hospitals|Comments Off

SNAP Asks PA Delegation to Co-Sponsor, Support 340B Bill

SNAP has asked members of Pennsylvania’s congressional delegation to co-sponsor and support bills (H.R. 3203 and S. 773) that would temporarily enable Pennsylvania safety-net hospitals and others already eligible for the 340B prescription drug discount program to remain eligible for the program despite short-term changes in their admissions patterns brought about by the COVID-19 pandemic.

Because of the manner in which the COVID-19 pandemic affected hospital admissions, some hospitals that have been eligible to participate in the 340B program could lose that eligibility for what is, in effect, a one-year anomaly. The proposed bills would temporarily enable current 340B participants to retain their eligibility for the program until hospitals’ inpatient volume returns to normal and they can demonstrate whether they still meet the criteria to continue participating in the program.

340B has long been a vital tool through which Pennsylvania safety-net hospitals receive significant discounts on the prescription drugs their low-income patients need, enabling these hospitals and other eligible providers to stretch scarce resources in services to the communities that depend on them.

jsteinbock2021-06-15T17:52:15+00:00June 15th, 2021|340b, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Change Atop PA’s Department of Human Services

Teresa Miller is out and Meg Snead will be in as Pennsylvania’s new Secretary of the Department of Human Services.

In separate news releases the Wolf administration announced that Miller, who has led DHS since 2015, “will be moving on to a new opportunity outside Pennsylvania” and leave her job at the end of April and that she will be replaced by Meg Snead, who currently serves as the governor’s Secretary of Policy and Planning.

Snead’s nomination is subject to confirmation by the state Senate.

The Secretary of the Department of Human Services is important to SNAP members and Pennsylvania safety-net hospitals because the state’s Medicaid program is administered by that department’s Office of Medical Assistance Programs.

Learn more about Miller’s departure here and about Snead’s nomination here.

PA Safety Net Admin2021-03-25T06:00:37+00:00March 25th, 2021|Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should:

extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the extended postpartum coverage period will receive an enhanced 100 percent federal matching rate;
extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income; and
require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.

Commissioners then turned their attention to Medicaid estate recovery policies that affect beneficiaries using long-term services and supports (LTSS). Commissioners on Friday approved recommendations to:

make estate recovery optional rather than required;
allow states with managed long-term services and supports to pursue recovery based on the cost of services where it is less than the capitation payment paid to a managed care plan; and
direct the Secretary of the U.S. Department of Health and Human Services (HHS) to establish minimum hardship waiver standards, including a minimum estate value threshold for estate recovery.

Next, the Commission considered recommendations for countercyclical financing adjustments in Medicaid. This would allow federal financial stimulus to be directed to states more quickly during economic downturns and provide states with greater budget predictability. The Commission approved a recommendation that Congress should adopt a statutory mechanism to amend the Social Security Act to provide an automatic Medicaid countercyclical financing model, using the prototype developed by the U.S. Government Accountability Office as the basis. The Commission also recommended this policy change should include:

an eligibility maintenance of effort requirement for the period covered by an automatic countercyclical financing adjustment;
an upper bound of 100 percent on countercyclical adjusted matching rates; and
exclusion of countercyclical adjusted federal matching rate from services and populations that receive special matching rates (e.g., for the new adult group) or are otherwise capped or have allotments (e.g., disproportionate share hospital payments, territories).

After a break on Thursday, Commissioners discussed a draft chapter for the March 2021 report on design considerations for creating a new program for dually eligible beneficiaries and reviewed a report to Congress by the U.S. Secretary of Health and Human Services (HHS) on Medicaid housing supports for individuals with substance use disorder (SUD). The Commission plans to send a letter to HHS and leadership of relevant congressional committees commenting on the Secretary’s report to Congress on Medicaid housing supports for people with SUD who are experiencing or at risk of homelessness.

Next, Commissioners heard a panel discussion on the outlook for state budgets and the implications for Medicaid with Emily Blanford, program principal at the National Conference of State Legislatures; Shelby Kerns, executive director for the National Association of State Budget Officers; and Susie Perez Quinn, government affairs director for the National Governors Association. * The day ended with a presentation on value-based payment for maternity services.

On Friday, Commissioners heard a panel discussion on how Medicaid serves people with intellectual or developmental disabilities with Sharon Lewis, a principal at Health Management Associates; Melissa Stone, director of Arkansas’ Division of Developmental Disabilities Services; and Elizabeth Weintraub, a senior advocacy specialist at the Association of University Centers on Disabilities. * Additional sessions focused on a congressionally mandated MACPAC study of non-emergency medical transportation (NEMT), which will be included in the June 2021 report to Congress. In addition, Commissioners heard a new analyses of care integration for dually eligible beneficiaries, and a discussion of potential new models for payment and coverage of high-cost specialty drugs. The meeting concluded with a discussion of mental health parity in Medicaid.

Supporting the discussion were the following briefing papers:

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program. Find its web site here.

PA Safety Net Admin2021-02-02T06:00:35+00:00February 2nd, 2021|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

GAO: CMS Should Pay More Attention to States’ Financing of Medicaid

The federal government does not adequately monitor how states finance their Medicaid programs.

It also lacks a sufficiently clear understanding of how they pay providers of Medicaid-covered services.

These are among the conclusions in a new study on Medicaid financing and payments by the U.S. Government Accountability Office.

According to the GAO report,

GAO estimated that states’ reliance on provider taxes and local government funds decreased states’ share of net Medicaid payments (total state and federal payments) and effectively increased the federal share of net Medicaid payments by 5 percentage points in state fiscal year 2018. It also resulted in smaller net payments to some providers after the taxes and local government funds they contribute to their payments are taken into account. While net payments are smaller, the federal government’s contribution does not change. This effectively shifts responsibility for a larger portion of Medicaid payments to the federal government and away from states.

To address this challenge, the GAO urged CMS to collect more complete and consistent information about both state financing of their Medicaid programs and the manner in which states pay Medicaid providers. CMS neither agreed nor disagreed with the GAO’s recommendation.

Such a study could have implications for Pennsylvania safety-net hospitals because of the state’s growing dependence on provider taxes to fund its Medicaid programs in recent years.

Learn more about what the GAO found and recommended in its new report “Medicaid: CMS Needs More Information on States’ Financing and Payment Arrangements to Improve Oversight.”

PA Safety Net Admin2020-12-15T06:00:16+00:00December 15th, 2020|Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

SNAP Asks PA Delegation for COVID-19 Aid

SNAP has written to Pennsylvania’s congressional delegation to request additional COVID-19 legislation between now and the end of the year to help Pennsylvania safety-net hospitals respond to the health care and financial challenges posed by the pandemic.

In its letter, SNAP asked Congress for:

additional funding for the Provider Relief Fund for assistance to hospitals;
extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and
the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states.

Read SNAP’s message to Congress.

PA Safety Net Admin2020-12-08T06:00:24+00:00December 8th, 2020|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

The October 2020 MACPAC meeting opened with a panel discussion on restarting Medicaid eligibility redeterminations when the public health emergency ends. It included Jennifer Wagner, director of Medicaid eligibility and enrollment at the Center on Budget and Policy Priorities; René Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services; and Lee Guice, director of policy and operations at the Department for Medicaid Services, Kentucky Cabinet for Health and Family Services.

After a break, Commissioners heard a panel discussion with Kevin Prindiville, executive director at Justice in Aging; Mark Miller, executive vice president of healthcare at Arnold Ventures; and Charlene Frizzera, senior advisor at Leavitt Partners, on creating a new program for dually eligible beneficiaries. Later, staff presented preliminary findings from a mandated report on non-emergency medical transportation. The day concluded with a report on nursing facility acuity adjustment methods.

On Friday, the day began with a session on access to mental health services for adults in Medicaid. It was followed by a related panel discussion on mental health services with Sandra Wilkniss, director of complex care policy and senior fellow at Families USA; Melisa Byrd, senior deputy director for the District of Columbia Department of Health Care Finance; and Dorn Schuffman, director of the CCBHC Demonstration Project at the Missouri Department of Mental Health.

Next, the Commission considered the merits of extending Medicaid coverage for pregnant women beyond 60 days postpartum. Staff then provided an update on a statutorily required analysis of disproportionate share hospital (DSH) allotments, as well as an analysis of addressing high-cost drugs and the challenges they present to Medicaid.

The meeting concluded with comment on the Secretary’s report to Congress on Reducing Barriers to Furnishing Substance Use Disorder (SUD) Services Using Telehealth and Remote Patient Monitoring for Pediatric Populations under Medicaid. The Commission decided to send a letter to Congress and the Secretary commenting on this report.

Supporting the discussion were the following briefing papers:

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program. Find its web site here.

PA Safety Net Admin2020-11-17T15:00:47+00:00November 5th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

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