Pennsylvania safety-net hospitals Archives - Page 10 of 14 - Safety-Net Association of Pennsylvania

New Approach to Helping Patients With Complex Needs

Five foundations have joined forces to pursue new approaches to serving patients with complex medical needs.
The Commonwealth Fund, the John A. Hartford Foundation, the Peterson Center on Healthcare, the Robert Wood Johnson Foundation, and The SCAN Foundation engaged the Institute for Healthcare Improvement to identify promising ways of better serving patients with complex medical needs. Many such patients, the foundations believe, have adequate access to medical care yet struggle to find the coordination needed between medical, behavioral, and social services to stay well and avoid costly hospitalizations.
The group’s first public product is The Playbook, which it describes as

…a dynamic website that highlights the challenges facing adults with complex health and social needs and provides direction on how to meet those needs through a variety of resources that detail care models, policies, and more.

The Playbook offers a variety of resources to caregivers, such as an intensive outpatient care program toolkit, a quick reference to promising care models, recommendations for tailoring complex care management for high-need, high-cost patients, and more.
Serving patients with complex medical problems can be especially challenging for Pennsylvania safety-net hospitals because they often have so many such patients.
Find The Playbook here.

PA Safety Net Admin2016-12-16T06:00:46+00:00December 16th, 2016|Pennsylvania safety-net hospitals|Comments Off

Social Determinants and Health Care

Amid growing recognition that social factors play at least much a role in the health of communities as medical care, growing attention is being paid to how best to address those social determinants in a health care system.
With increasing use of alternative delivery models such as accountable care organizations, some approaches place health care at the heart of a hub-and-spoke model to address population health, supported by functions such as affordable housing, home health care, job training, and more. Another approach places community organizations at the hub of care models, with the health care system as a spoke feeding into that hub.
Socio-economic issues that affect the health of communities are among the biggest challenges Pennsylvania safety-net hospitals face – challenges that take them well beyond their ability to provide quality care to their patients.
A recent article on the Health Affairs Blog explores the hub-and-spoke approach to addressing the social determinants that play such a major role in population health. Go here to read the blog article “Defining The Health Care System’s Role In Addressing Social Determinants And Population Health.”

PA Safety Net Admin2016-12-01T06:00:04+00:00December 1st, 2016|Pennsylvania safety-net hospitals|Comments Off

A New Approach to Serving High-Cost, High-Need, High-Risk Medicaid Patients

A partnership consisting of a county government, a public hospital, a county-run Medicaid managed care plan, and a federally qualified health center, Hennepin Health is an accountable care organization that seeks to serve high-cost, high-need, high-risk Medicaid patients in the greater Minneapolis area.
Hennepin Health targets such individuals – all childless adults who became eligible for Medicaid when the state expanded its Medicaid program in 2011 – with the help of algorithms, identifies those most likely to incur high medical costs. It then offers a blend of social services, preventive care, and other services to address members’ medical conditions while bringing stability and order to their lives. Seventy-five percent of the program’s members are male, 70 percent are non-white, half lack stable housing, two-thirds suffer from mental illness, 80 percent have substance abuse problems, and 19 percent suffer from chronic pain.
These are the very kinds of patients typically served in especially high numbers by Pennsylvania safety-net hospitals.
The results of the program have been encouraging: the program has improved participants’ access to primary care, reduced emergency room visits, and stabilized the health of participants with chronic medical conditions. While hospitalizations have not declined, medical costs have fallen an average of 11 percent a year since 2012.
Led by the county government, Hennepin Health currently serves 12,000 members whose care is financed by Medicaid, with the county assisting with the cost of social services. All four ACO partners invested an initial $1.6 million for staff and data infrastructure and have assumed full financial risk for the venture.
Learn more about how one program is seeking to make a difference in the lives of high-risk, high-need patients while reducing high health care costs in the article “Hennepin Health: A Care Delivery Paradigm for New Medicaid Beneficiaries,” which can be found here, on the web site of The Commonwealth Fund.

PA Safety Net Admin2016-10-17T06:00:48+00:00October 17th, 2016|Pennsylvania safety-net hospitals|Comments Off

Perspective on Medicaid

A new report looks at how Medicaid has affected the health and health care of people throughout the country.
The Commonwealth Fund report “Understanding the Value of Medicaid” examines the impact of the Affordable Care Act’s expansion of Medicaid and notes that the program currently serves 73 million children, seniors, low-income working adults, and people with disabilities.
It also examines how Medicaid expansion has enhanced access to care and even given some people medical benefits comparable to those offered by private insurance.
Finally, the report notes that safety-net hospitals that serve especially large numbers of low-income patients now serve fewer uninsured patients and are better able to invest in new staff, clinics, and equipment, thereby enhancing the quality of care they deliver.
For a closer look at the impact Medicaid has on the American health care system, see this Commonwealth Fund report.

PA Safety Net Admin2016-10-14T06:00:35+00:00October 14th, 2016|Pennsylvania safety-net hospitals|Comments Off

New Study Questions 30-Day Readmissions as Measure of Hospital Quality

Hospital readmissions within 30 days of discharge may not be a good way of judging the quality of care hospitals provide, a new study suggests.
Seven days may be more like it.
According to a new study published in the journal Health Affairs, the impact of the quality of care a hospital provides appears to be most evident immediately upon patients’ discharge from the hospital.
Further, the study suggests,

… most readmissions after the seventh day postdischarge were explained by community- and household-level factors beyond hospitals’ control.

The researchers’ conclusion?

Shorter intervals of seven or fewer days might improve the accuracy and equity of readmissions as a measure of hospital quality for public accountability.

The findings call into question the approach employed by Medicare through its’ hospital readmissions reduction program. Some of the issues the study cites – community and household factors – are the very kinds of challenges that Pennsylvania’s safety-net hospitals face far more often than the typical community hospital in the state.
To learn more about how the study was performed and what its implications might be, go here to see the Health Affairs study “Rethinking Thirty-Day Hospital Readmissions: Shorter Intervals Might Be Better Indicators Of Quality Of Care.’

PA Safety Net Admin2016-10-12T06:00:20+00:00October 12th, 2016|Medicare, Pennsylvania safety-net hospitals|Comments Off

MACPAC Looks at Medicaid DSH

With Medicaid disproportionate share payments (Medicaid DSH) facing future reductions, the agency charged with advising Congress on Medicaid and Children’s Health Insurance payment and access matters is considering what changes the federal supplemental Medicaid payment program might need.
At a recent meeting in Washington, D.C., the Medicaid and CHIP Payment and Access Commission discussed the changing role and purpose of Medicaid DSH as more Americans obtain health insurance through private or public sources. MACPAC commissioners noted that hospital uncompensated care is falling, especially in states that have taken advantage of the Affordable Care Act to expand their Medicaid programs.
A new Medicaid DSH formula set to be used for FY 2018, based more heavily than the current formula on the number of uninsured people in individual states, is expected to result in larger-than-average reductions for hospitals in Medicaid expansion states.
Among the steps commissioners discussed were examining how hospitals use their Medicaid DSH funds; considering how any changes in the distribution of Medicaid DSH funds might affect other parts of states’ health care systems; and the role states should play in determining the allocation of Medicaid DSH funds.
Medicaid DSH funds are a vital source of support to help Pennsylvania safety-net hospitals care for their many uninsured patients.
For a closer look at the issue and MACPAC’s deliberations, see this CQ Roll Call article presented by the Commonwealth Fund.

PA Safety Net Admin2016-09-26T06:00:26+00:00September 26th, 2016|Affordable Care Act, Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

Federal Medicaid Per Capita Spending Limits?

As they have in the past, some members of Congress have suggested of late that Medicaid might benefit from being transformed into a program with limited spending per capita: that is, such an approach would limit the amount of money the federal government would provide to states on a per capita basis.
Such an approach would almost certainly have serious implications for Pennsylvania safety-net hospitals.
What issues would need to be addressed to develop such an approach? What data would be needed?
Earlier this year the chairmen of the Senate Finance Committee and the House Energy and Commerce Committee asked the U.S. Government Accountability Office to answer these and other questions. Now, the GAO has published its answers in a new report titled Key Policy and Data Considerations for Designing a Per Capita Cap on Federal Funding. Find that report here.

PA Safety Net Admin2016-09-16T06:00:12+00:00September 16th, 2016|Pennsylvania Medicaid laws and regulations, Pennsylvania safety-net hospitals|Comments Off

SNAP Comments on Proposed Medicaid DSH Regulation

The Safety-Net Association of Pennsylvania has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments.
In particular, SNAP opposes the manner in which CMS would treat payments from Medicare and third-party payers made on behalf of Medicaid-eligible individuals.
In SNAP’s view, the letter notes,

…the hospital-specific DSH limit has come to penalize the very hospitals that Medicaid DSH payments were designed to support.

The SNAP letter explains that

What concerns SNAP at this time is CMS’s apparent decision to rationalize and codify in regulations a narrower interpretation of the Medicaid DSH limit than what Congress described in section 1923(g) of the Social Security Act.

Read SNAP’s complete letter here.

PA Safety Net Admin2016-09-15T06:00:48+00:00September 15th, 2016|Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Journal Looks at Health Disparities

The journal Health Affairs looks at health disparities and social determinants of health in its Augusts 2016 issue.
The article “Evaluating Strategies For Reducing Health Disparities By Addressing The Social Determinants Of Health” looks at interventions that focus on social determinants of health, addresses how such interventions can reduce health disparities and improve population health, and considers the challenges to implementing such approaches. Find it here.
The article “Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research” also looks at health care disparities and how to address them, focusing on cardiovascular disease and cancer. Find it here.
Communities served by Pennsylvania’s safety-net hospitals usually suffer from the very health disparities policy-makers are currently working to address.

PA Safety Net Admin2016-09-01T06:00:22+00:00September 1st, 2016|Pennsylvania safety-net hospitals|Comments Off

CMS Proposes Medicaid DSH Rule

The Centers for Medicare & Medicaid Services has proposed a new rule that would clarify the basis for eligible hospitals’ Medicaid disproportionate share hospital payments (Medicaid DSH).
Individual hospitals’ Medicaid DSH payments are based on their uncompensated care costs and the rule clarifies that only uncompensated costs for Medicaid patients for whom hospitals receive no other payments, such as from Medicare, state or local governments, or third-party payers, would count toward their hospital-specific Medicaid DSH limit.
See the rule here. Interested parties have until September 15, 2016 to submit formal comments to CMS about its proposal.
Representatives of Pennsylvania safety-net hospitals who would like to know more about how this proposal might affect their hospital can use the “contact us” link on this screen to seek further information.