SNAP’s Perspective on PA’s Budget

The state budget passed in Harrisburg last week represents both a victory for Pennsylvania’s safety-net hospitals and an affirmation of the manner in which the Safety-Net Association of Pennsylvania (SNAP) has pursued its advocacy on behalf of the state’s safety-net hospitals.
Safety-Net Association of Pennsylvania logoUnder this budget, and despite still-difficult economic times, safety-net hospitals came away almost entirely unharmed by state spending cuts.
The genesis of this success can be traced back to February, when Governor Corbett unveiled his proposed budget.  After years of SNAP’s vigorous advocacy that emphasized urging state officials to direct the state’s scarce resources to their primary partners in caring for Medical Assistance patients – Pennsylvania’s private safety-net hospitals – this year’s budget proposal did exactly that.  Instead of the usual proposals to cut Medicaid disproportionate share (Medicaid DSH) and other supplemental payments that only safety-net hospitals receive, the administration proposed spreading the potential financial pain to all hospitals, as exemplified by its original proposal to cut fee-for-service hospital base rate payments four percent while leaving the most critical supplemental payments untouched.
This proposal gave every hospital in the state, not just safety-net hospitals, a stake in opposing the proposed cuts.  This brought the entire hospital industry together to oppose those cuts.  This unified effort proved successful – vindication, we believe, of SNAP’s long-time approach to advocating the distinct interests of Pennsylvania’s safety-net hospitals.

Safety-Net Hospitals Await Medicaid DSH Cuts

Across Pennsylvania, safety-net hospitals are bracing for major cuts in their Medicaid disproportionate share (DSH) payments starting in FY 2014, when a provision of the Affordable Care Act requiring such cuts takes effect.
Under the Affordable Care Act, the number of uninsured patients hospitals treat is expected to decline as health insurance becomes more affordable and accessible, theoretically reducing hospitals’ need for Medicaid DSH revenue.  Under the reform law, federal spending on Medicaid DSH will be slashed $18 billion over six years.
Historically, Medicaid DSH has been viewed as a program to help hospitals that treat especially large numbers of uninsured and Medicaid patients.  The cut will be implemented, however, before it is clear how many currently uninsured people will purchase health insurance – and at a time when the number of Medicaid patients safety-net hospitals serve is expected to rise significantly, not fall, when the Affordable Care Act’s new criteria for Medicaid eligibility take effect.
The scheduled cut in Medicaid DSH payments is of particular concern to the Safety-Net Association of Pennsylvania (SNAP) and Pennsylvania’s private safety-net hospitals.
Read more about the anticipated reduction of Medicaid DSH payments and its implications for safety-net hospitals in this CQ report presented by the Commonwealth Fund.

2012-06-13T06:00:48+00:00June 13th, 2012|Health care reform, Medicaid supplemental payments, Safety-Net Association of Pennsylvania|Comments Off on Safety-Net Hospitals Await Medicaid DSH Cuts

Newspaper Joins Call for Restoring Newborn Payments

Last month, Pennsylvania’s Medical Assistance program stopped paying hospitals for the inpatient care they provide to healthy babies newly born to Medical Assistance-covered mothers.  The hospital industry – including the Safety-Net Association of Pennsylvania (SNAP) – immediately expressed opposition to this new policy and has continued to seek the restoration of these payments as the state legislature considers Pennsylvania’s fiscal year 2013 budget.
Now, the Pittsburgh Post-Gazette has weighed in on this issue – on the side of the hospital industry and the low-income patients it serves – with an editorial entitled “Dropping the baby:  DPW is wrong to cut newborns’ hospital care.”  Read that editorial here.

2012-06-11T06:00:13+00:00June 11th, 2012|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania|Comments Off on Newspaper Joins Call for Restoring Newborn Payments

Forum on Safety-Net Hospitals

Health care reform presents a number of challenges to safety-net hospitals.  Recently, the Alliance for Health Reform and the Commonwealth Fund hosted a forum, “The Health of Safety-Net Hospitals:  How are They Faring?  What’s the Outlook?” to discuss these challenges.
Among the issues addressed in the forum were the financial challenges safety-net hospitals face in the coming years as a result of health care reform and implementation of the Affordable Care Act; the response of safety-net hospitals to these challenges; the special challenges safety-net hospitals face as a result of social, economic, and environmental conditions in the communities they serve; and proposed changes in some of the payments safety-net hospitals have long counted upon to help underwrite the care they provide to their uninsured, underinsured, and publicly insured patients.
These are the very issues that confront the the Safety-Net Association of Pennsylvania (SNAP) and private safety-net hospitals everywhere.
Visit the Alliance for Health Reform’s web site to learn more about the forum.  Available there are the participants’ PowerPoint presentations; videos and podcasts of the proceedings; and links to various source materials.  This can be found here.

2012-06-08T06:00:19+00:00June 8th, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off on Forum on Safety-Net Hospitals

Maternity Payment Cut Takes Effect

The Medical Assistance cut in fee-for-service inpatient payments for the care of normal newborns took effect on June 1.
According to the Department of Public Welfare (DPW), the payment reduction brings Pennsylvania into line with what other states’ Medicaid programs pay for such care.  According to hospital industry representatives, Pennsylvania hospitals still lose money on Medicaid deliveries and now will lose more.
This policy will be especially damaging to Pennsylvania’s safety-net hospitals.  Although only one-third of the state’s acute-care hospitals, safety-net hospitals perform two-thirds of all Medicaid deliveries according to the March 2012 report “Pennsylvania’s Safety-Net Hospitals:  Vital Providers, Vital Employers” prepared by the Safety-Net Association of Pennsylvania.
Read more about the state’s new policies, how it will affect hospitals, and how hospitals are responding to it in this Pittsburgh Post-Gazette articleHospital building.

2012-06-06T06:00:00+00:00June 6th, 2012|Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Maternity Payment Cut Takes Effect

Readmissions and Poverty

At a time when Medicare and many state Medicaid programs are attempting to penalize hospitals when patients are readmitted shortly after they were discharged, researchers have found that some of those readmissions are linked to factors beyond hospitals’ control.
According to research presented recently at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions 2012, differences in regional readmission rates are more closely tied to socioeconomic factors and access to care than they are to hospitals’ performance.
Researchers found that nine percent of regional variation in hospital readmission rates can be tied to patients’ poverty.  Access to care, based on the availability of doctors and hospital beds, can be tied to 17 percent of regional variation in readmission rates.
The Safety-Net Association of Pennsylvania (SNAP) has long maintained that the low-income patients safety-net hospitals serve in especially large numbers come to them fundamentally sicker than typical hospital patients and require more resources and more effort to treat.  This research appears to support this contention.
Read more about the research in this news releaseHospital building from the American Hospital Association.

2012-05-14T09:25:32+00:00May 14th, 2012|Safety-Net Association of Pennsylvania|Comments Off on Readmissions and Poverty

Readmissions Report

The Pennsylvania Health Care Cost Containment Council (PHC4) has issued a new report on hospital readmissions.
Health care reform efforts at both the state and federal levels have targeted avoidable hospital readmissions as major causes of rising health care costs.   In issuing the report, PHC4 notes that not all readmissions are preventable.
Preventing readmissions is a particular challenge for Pennsylvania safety-net hospitals because of the difficulties many low-income patients have complying with their post-discharge medical instructions.
Read more about the report and download Hospital Readmissions in Pennsylvania 2010 hereHospital, on the PHC4 web site.

2012-05-02T06:00:37+00:00May 2nd, 2012|Health care reform, Safety-Net Association of Pennsylvania|Comments Off on Readmissions Report

Welcome to the New SNAP Web Site!

Safety-Net Association of Pennsylvania logoWelcome to the new web site of the Safety-Net Association of Pennsylvania.  Here you can learn more about SNAP:  who we are, what we stand for, the issues that are important to us, and how we advocate the interests of the private, acute-care hospitals that play the greatest role in caring for low-income Pennsylvanians.
We invite you to spend some time exploring our site and to return often.  In this space we will present information relevant to anyone who is interested in the state’s safety-net hospitals, the Pennsylvania Medicaid program that insures so many of their patients, and how public policy in Harrisburg and Washington, D.C. affects the ability of these safety-net hospitals to serve their communities.

2012-04-24T14:16:43+00:00April 24th, 2012|Safety-Net Association of Pennsylvania|Comments Off on Welcome to the New SNAP Web Site!
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