Safety-Net Association of Pennsylvania Archives - Page 7 of 9 - Safety-Net Association of Pennsylvania

Feds Offer New Carrot to Promote Medicaid Expansion

In their desire to persuade states to expand their Medicaid programs as called for in the Affordable Care Act, federal officials are now suggesting that states could use new federal Medicaid funds to enable Medicaid-eligible people to purchase private insurance.
Even though this was not envisioned in the health reform law, the prospect of making greater use of the private sector appears to be appealing to many Republican governors who have otherwise been reluctant to commit their states to expanding their Medicaid programs.
Pennsylvania has no current plans to expand Medicaid eligibility, although there appears to be growing interest in doing so throughout the state. Expansion would add approximately 500,000 people to the state’s Medicaid rolls, many of whom would be served by safety-net hospitals. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the commonwealth.
Read more about how this idea came about, why many states find it appealing, how it would work, and what the potential challenges are in this New York Times article .

PA Safety Net Admin2013-03-27T06:00:31+00:00March 27th, 2013|Health care reform, Safety-Net Association of Pennsylvania|Comments Off

Sequestration Could Hit Southeastern PA Hospitals Hard

Hospitals in southeastern Pennsylvania could lose $50 million in patient revenue a year if the scheduled sequestration of federal spending takes effect on March 1.
At that time, all Medicare payments to hospitals would be cut two percent.
In addition, hospitals in that region could lose another $41 million from a comparable cut in National Institutes of Health (NIH) spending.
Safety-net hospitals located in southeastern Pennsylvania would suffer a significant proportion of both of these cuts. Members of the Safety-Net Association of Pennsylvania (SNAP) located in this region include the Albert Einstein Medical Center, Hahnemann University Hospital, the Hospital of the University of Pennsylvania, Pennsylvania Hospital, Penn Presbyterian Medical Center, St. Christopher’s Hospital for Children, The Children’s Hospital of Philadelphia, and Thomas Jefferson University Hospital.
To learn more about how sequestration could affect one group of Pennsylvania safety-net hospitals, see this Philadelphia Inquirer article .

PA Safety Net Admin2013-02-27T06:00:15+00:00February 27th, 2013|Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 5 of 7

Other Medical Assistance Issues

Pennsylvania Governor Tom Corbett recently unveiled his proposed state FY 2014 budget. When he did, members of the Safety-Net Association of Pennsylvania (SNAP) immediately received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about Medical Assistance issues not addressed in parts one through four of this series.
The proposed budget calls for a number of other changes in Medical Assistance spending, including:

New spending of $55.9 million in total funds for what has been labeled a “public-private collaboration project” under the outpatient budget that is offset by a $28.5 million savings within the same budget line.
Savings in the inpatient, outpatient, and capitation (managed care/HealthChoices) budget lines associated with “audit enhancements.”
Savings associated with the state outsourcing its third-party liability functions, including payment recovery.
A doubling of state spending on information technology to bring Pennsylvania’s Medical Assistance eligibility systems and technology up to the requirements of the Affordable Care Act.
An increase of $27 million for mental health services and $3.2 million for state mental health services block grant funding
A savings of more than $8 million associated with instituting premiums for so-called loophole children who participate in the state’s PH-95 program for selected Pennsylvanians with autism.

Tomorrow: The Children’s Health Insurance Program (CHIP)

PA Safety Net Admin2013-02-18T06:00:10+00:00February 18th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 4 of 7

Medical Assistance Supplemental Payments

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about Medical Assistance supplemental payments.
Governor Corbett has proposed no change in the state’s spending on OB/NICU, burn center, and trauma center payments. Because of the reduction in the state’s federal medical assistance percentage (FMAP, or the rate at which the federal government matches state Medicaid spending), total payments to hospitals in each of these programs stands to decline 1.7 percent.
The total amount available for tobacco uncompensated care payments is slated for a 3.3 percent decrease, from $56.5 million to $54.7 million. This reflects two factors: a 1.7 percent decrease in money available from the tobacco settlement fund and the state’s reduced FMAP rate.
While total funding for physician practice plans is slated for an 18.9 percent decrease, this appears to reflect a decision to remove from this category one hospital that was added to the group last year. This would mean funding for physician practice plans would remain the same – as it would for academic medical center disproportionate share hospital payments (DSH).
Critical access hospital payments have been targeted for a $500,000 cut in state funds.
Inpatient DSH, outpatient DSH, medical education, and Community Access Fund payments do not have their own line-items in the proposed budget and therefore cannot be specifically identified in that budget. Traditionally, however, when an administration is contemplating changes in these payments, it indicates so in the programmatic revision commentary section of the budget document. In the case of these four payments that are so vital to so many Pennsylvania safety-net hospitals, they were not mentioned in the programmatic revision commentary.
Next Monday: Other Medical Assistance Issues

PA Safety Net Admin2013-02-15T06:00:49+00:00February 15th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 3 of 7

Hospital Assessment Revenue

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about revenue from the state-wide and Philadelphia hospital assessments.
The proposed budget assumes $633 million in revenue from the state-wide hospital assessment and another $148 million from the Philadelphia hospital assessment. While the revenue anticipated from the Philadelphia assessment appears to be in line with prior years’ collections, the revenue associated with the state-wide assessment appear to be greater than in the past. It is unclear whether this apparent increase reflects the state’s intention either to increase its share of assessment revenue or to raise the assessment rate.
Tomorrow: Medical Assistance Supplemental Payments

PA Safety Net Admin2013-02-14T06:00:06+00:00February 14th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 State Budget: Part 2 of 7

The Major Medical Assistance Spending Categories

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over a seven-day period, SNAP presents in this space the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals. Today, SNAP takes a look at what the proposed budget says about the major Medical Assistance spending categories.
The proposed budget calls for what on the surface appear to be sizeable decreases in state funds available for Medical Assistance inpatient and outpatient funding – a decrease of 44.9 percent in inpatient and 31.6 percent in outpatient funding. What this actually represents, however, is the state’s continued shift toward greater use of managed care through its expanded HealthChoices program, which has been budgeted for a 5.7 percent increase in funding. Overall, the combined changes in the inpatient, outpatient, and capitation lines of the proposed budget represent a 1.4 percent decrease in the amount of state money available for physical health services.

Click on the accompanying chart to see the proposed changes in the state’s funding allocations for the major categories of Medical Assistance physical health spending from FY 2013 to FY 2014.
Tomorrow: Hospital Assessment Revenue

PA Safety Net Admin2013-02-13T06:00:22+00:00February 13th, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania|Comments Off

The Proposed FY 2014 Pennsylvania State Budget: Part 1 of 7

The Big Picture

Last Tuesday, Pennsylvania Governor Tom Corbett unveiled his proposed state FY 2014 budget. Later that day, members of the Safety-Net Association of Pennsylvania (SNAP) received a comprehensive memo outlining the governor’s budget proposal with an emphasis on the issues that matter most to the state’s 61 private safety-net hospitals.
Over the next seven business days, SNAP will present the highlights of the governor’s budget, again with an emphasis on Medical Assistance and other matters of special interest to Pennsylvania’s safety-net hospitals.
The following is a schedule of the remaining six parts of this overview:

Today: the big picture underlying the proposed budget.
In this proposed budget, the Department of Public Welfare (DPW) projects a three percent increase in Medical Assistance enrollment and caseload in FY 2014. Overall, the DPW budget calls for $14.2 billion in total spending on Medical Assistance – a decrease of less than half a percent from the current fiscal year’s available funding.
While some of the proposed changes in the budget are spending decisions, others reflect a reduction in the state’s federal medical assistance percentage, or FMAP (the rate at which the federal government matches state Medicaid spending), which will fall from its current 54.28 percent to an estimated 53.52 percent during FY 2014. Consequently, in some cases, lower payments would reflect a reduced federal contribution rather than a state decision to reduce those payments.
The major themes of next year’s proposed Medical Assistance budget appear to be a continued state-wide expansion of the HealthChoices Medical Assistance managed care program and expanded access to community-based services for individuals with intellectual disabilities and the elderly.
The budget does not provide for the Medicaid expansion envisioned in the Affordable Care Act. Governor Corbett has conveyed to the federal government that he will not expand Medicaid eligibility at this time but his document states that such expansion will be the subject of further analysis and public discussion.
Tomorrow: The Major Medical Assistance Spending Categories

PA Safety Net Admin2013-02-12T06:00:58+00:00February 12th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off

PA Says No to Medicaid Expansion (For Now)

Pennsylvania Governor Tom Corbett has at least temporarily closed the door to the Medicaid expansion envisioned in the Affordable Care Act.
On the same day that he presented his proposed state budget for the 2014 fiscal year, Mr. Corbett wrote to U.S. Health and Human Services Secretary Kathleen Sebelius, explaining that

At this time, and without serious reforms, it would be financially unsustainable for Pennsylvania taxpayers, and I cannot recommend a dramatic Medicaid expansion.

See Governor Corbett’s letter to Secretary Sebelius here.
At the same time, however, the governor did not rule out the possibility of a change of heart sometime in the future. His proposed budget document explains that

At this time, analysis continues on the financial sustainability related to potential expansion of the Medicaid program. The Department of Public Welfare continues to have a dialogue with the U.S. Department of Health and Human Services (HHS) in an effort to obtain clarification and answers on a number of issues, including whether essential reforms of the Medicaid program can be accomplished to improve the health of our citizens and the effectiveness of the program. The department is currently reviewing the recently released proposed regulations on eligibility and benefits from HHS. While due diligence continues, no decision has been made at this time.

The administration intends to engage in an informed dialogue with the public and the legislature on whether expansion of the Medicaid program is prudent, affordable and the right choice for the commonwealth. When a final decision is made, it will be done in consultation with the Legislature and it may require modifications to be made and accounted for in the budget.

The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.

PA Safety Net Admin2013-02-07T06:00:12+00:00February 7th, 2013|Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

Proposed State Budget: Implications for PA Safety-Net Hospitals

Yesterday, Pennsylvania Governor Tom Corbett unveiled his proposed FY 2014 budget in a speech to the state’s General Assembly.
The Safety-Net Association of Pennsylvania (SNAP) has prepared a detailed summary of the budget proposal with an emphasis on provisions of particular importance to the state’s safety-net hospitals. To receive a copy of this memo, please contact SNAP at info@pasafetynet.org.

PA Safety Net Admin2013-02-06T06:00:23+00:00February 6th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off

States Finding it Hard to Say No to Federal Medicaid Money

While many of the nation’s governors have ideological problems with many aspects of the Affordable Care Act, it appears that more of them are preparing to accept one major facet of the bill with which they particularly disagree: Medicaid expansion.
When the law passed, the mandatory expansion of Medicaid eligibility was one of its most controversial aspects and encountered a great deal of resistance from many governors. When the Supreme Court ruled last year that the mandate was unconstitutional, many governors indicated that they would decline the now-optional Medicaid expansion.
But as the time for implementing the Medicaid expansion draws closer, more governors are concluding that the lure of millions, and even billions, of “free” federal Medicaid matching dollars is too hard to resist.
In addition, some governors are concerned about appearances if they turn down the federal Medicaid money while a clause in the reform act would enable legal immigrants in their state to receive health insurance premium subsidies while other low-income residents remain ineligible for those subsidies and uninsured.
Pennsylvania Governor Tom Corbett has not yet announced his decision on whether the state will expand its Medicaid program but appears to be leaning against such an expansion. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the commonwealth.
Read about the challenges governors face in refusing the federal Medicaid money in this RealClearPolitics article and about the immigration twist on the issue in this Washington Post report .

PA Safety Net Admin2013-01-28T06:00:29+00:00January 28th, 2013|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

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