Pennsylvania safety-net hospitals Archives - Page 8 of 14 - Safety-Net Association of Pennsylvania

SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

The federal government should give states the option of monitoring Medicaid disproportionate share payments (Medicaid DSH) to hospitals through prospective DSH limit calculations rather than through retroactive DSH audits.

SNAP recently shared this view with the House Ways and Means Committee’s Health Subcommittee in response to that subcommittee’s request for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.

According to SNAP, retroactive DSH audits are cumbersome, burdensome, and expensive, give rise to many disputes and appeals, and in the end yield results very similar to much simpler prospective DSH limit calculations performed by the very state governments that distribute Medicaid DSH funds.

See SNAP’s comments to the Ways and Means Committee here.

PA Safety Net Admin2017-08-29T17:00:02+00:00August 29th, 2017|Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off

Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices.

So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program.
The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient.
Pennsylvania safety-net hospitals serve far more high-risk patients than the typical hospital.
Learn more these findings and how they were reached in the study “Association of Practice-Level Social and Medical Risk With Performance in the Medicare Physician Value-Based Payment Modifier Program,” which can be found here, on the web site of the Journal of the American Medical Association.

PA Safety Net Admin2017-08-03T09:13:01+00:00August 3rd, 2017|Medicare, Pennsylvania safety-net hospitals|Comments Off

ACA Reduced Disparities in Access to Care

The Affordable Care Act has reduced socioeconomic disparities in access to health care in the U.S.
According to a new study published in the journal Health Affairs,

Health care access for people in lower socioeconomic strata improved in both states that did expand eligibility for Medicaid under the ACA and states that did not. However, gains were larger in expansion states. The absolute gap in insurance coverage between people in households with annual incomes below $25,000 and those in households with incomes above $75,000 fell from 31 percent to 17 percent (a relative reduction of 46 percent) in expansion states and from 36 percent to 28 percent in nonexpansion states (a 23 percent reduction). This serves as evidence that socioeconomic disparities in health care access narrowed significantly under the ACA.

Addressing socioeconomic barriers to access to care has long been one of the major roles Pennsylvania safety-net hospitals play in their individual communities.

Learn more about how the study was conducted and what it revealed in the article “The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access,” which can be found here, on the Health Affairs web site.

PA Safety Net Admin2017-08-03T06:00:10+00:00August 3rd, 2017|Affordable Care Act, Pennsylvania safety-net hospitals|Comments Off

Congress Looks at 340B Program

Last week the House Energy and Commerce Committee took a look at the 340B prescription drug discount program, which requires pharmaceutical companies to sell discounted drugs for outpatient use to hospitals that care for especially large numbers of low-income patients.
The previous week, the Centers for Medicare & Medicaid Services issued a proposed Medicare regulation calling for significant reductions in Medicare payments for such drugs.
The hearing touched on the CMS proposal to reduce Medicare payments for 340B drugs, the high prices of prescription drugs, the 340B program’s growth over the years, the possibility that the program is being abused by hospitals and clinics, and more.

The 340B program is an essential tool in the efforts of Pennsylvania safety-net hospitals to help the many low-income residents of the communities they serve.

Learn more about the hearing and the issues raised during it this Kaiser Health News report.

PA Safety Net Admin2017-07-25T06:00:27+00:00July 25th, 2017|Medicare, Pennsylvania safety-net hospitals, Uncategorized|Comments Off

Medicaid Enrollees: Access and Quality Are Good

Medicaid beneficiaries are generally satisfied with their access to care and the quality of care they receive.
Or so reports a new study based on results of the federal Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for December of 2014 to July of 2015.
According to the survey, nearly half of Medicaid patients rated their overall care 7.9 or greater on a scale of 10; 84 percent reported that they had been able to receive all of the care they needed over the past six months; and most were generally satisfied with the coverage. Relatively few reported problems finding providers willing to accept their Medicaid coverage.
Survey results generally were slightly more positive in Medicaid expansion states than in non-expansion states.
Pennsylvania safety-net hospitals serve especially large numbers of Medicaid patients.
Learn more about how Medicaid beneficiaries view the quality and accessibility of the care they receive in the JAMA Internal Medicine report “What Enrollees Think of Medicaid | Health Care Reform,” which can be found here.

PA Safety Net Admin2017-07-12T14:02:19+00:00July 12th, 2017|Pennsylvania safety-net hospitals|Comments Off

SNAP Joins Others in Letter to PA Senators

SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians.
Safety-Net Association of Pennsylvania logo Among the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections.
See the complete letter here.

PA Safety Net Admin2017-06-13T06:00:29+00:00June 13th, 2017|American Health Care Act, Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

New Book Addresses Social Risk Factors in Medicare

In the new book, the National Academies of Sciences, Engineering, and Medicine addresses the question of what social risk factors might be worth considering in Medicare value-based payment programs and how those risk factors might be reflected in value-based payments.
The book, the culmination of a five-part NASEM process, focuses on five social risk factors:

socio-economic position
race, ethnicity, and cultural context
gender
social relationships
residential and community context

Addressing such factors in Medicare value-based payments, the book finds, can help achieve four important goals:

reduce disparities in access, quality, and outcomes
improve the qualify and efficiency of care for all patients
foster fair and accurate reporting
compensate provides fairly

Doing so also can help prevent five types of unintended consequences from a failure to address social risk factors in Medicare payment policy:

providers avoiding patients with social risk factors
reducing incentives to improve the quality of care for patients with social risk factors
underpaying providers that serve disproportionately large numbers of patients with social risk factors
a perception of different medical standards for different populations
obscuring disparities in care and outcomes

The kinds of patients these social risk factors seek to identify are precisely those served by Pennsylvania safety-net hospitals in far greater numbers than other community hospitals throughout the state.
Learn more about social risk factors and their potential role in Medicare value-based payment policy in the new book Accounting for Social Risk Factors in Medicare Payment, which can be downloaded free of charge here, from the web site of the National Academies of Sciences, Engineering, and Medicine.

PA Safety Net Admin2017-05-24T13:10:08+00:00May 24th, 2017|Pennsylvania safety-net hospitals|Comments Off

Hospital Uncompensated Care Down

As was surely expected, reforms introduced through implementation of the Affordable Care Act have driven down uncompensated care costs for many hospitals.
How much?
A new study published by the Commonwealth Fund offers the following findings:

uncompensated care declines in expansion states are substantial relative to profit margins;
for every dollar of uncompensated care costs hospitals in expansion states had in 2013, the Affordable Care Act erased 41 cents by 2015; and
Medicaid expansion reduced uncompensated care burdens for safety-net hospitals that are not made whole by Medicaid disproportionate share payments (Medicaid DSH).

Learn more, including how the decline in uncompensated care costs affected different kinds of hospitals in different kinds of states, in the report “The Impact of the ACA’s Medicaid Expansion on Hospitals’ Uncompensated Care Burden and the Potential Effects of Repeal,” which can be found here, on the Commonwealth Fund’s web site.

PA Safety Net Admin2017-05-16T06:00:57+00:00May 16th, 2017|Affordable Care Act, Pennsylvania safety-net hospitals|Comments Off

To Require Work or Not to Require Work

That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants.
In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act. Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement.
Does the lack of a work requirement encourage people in Medicaid expansion states to withdraw from the workforce?
Is a work requirement a way to raise the income of beneficiaries just enough to cost them their Medicaid eligibility?
Are there jobs available for beneficiaries if such a requirement were to be imposed?
And aren’t many able-bodied Medicaid beneficiaries already working?
This issue is of particular interest to Pennsylvania safety-net hospitals because they serve such large numbers of Medicaid patients.
The Urban Institute looks at these and other Medicaid work-related issues in the new paper “Rationale for Medicaid work requirements not supported by evidence.” Find that paper here.

PA Safety Net Admin2017-04-05T06:00:54+00:00April 5th, 2017|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

CMS Clarifies Medicaid DSH Rule

Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs. This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit.
According to CMS,

This rule clarifies federal requirements regarding the treatment of third party payers in determining the hospital-specific Medicaid DSH payment limit, which is set by statute as a hospital’s “uncompensated costs” incurred in providing hospital services to Medicaid and uninsured patients.

The final rule makes clearer our existing policy that uncompensated costs include only those costs for Medicaid eligible individuals that remain after accounting for all payments received by or on behalf of Medicaid eligible individuals, including Medicare and other third party payments. This is consistent with the statutory requirements governing Medicaid DSH and applicable limits.

All Pennsylvania safety-net hospitals receive Medicaid DSH payments.
See the full rule here.

PA Safety Net Admin2017-04-04T06:00:05+00:00April 4th, 2017|Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

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