Uncategorized Archives - Page 11 of 29 - Safety-Net Association of Pennsylvania

Medicaid Directors Seek Help With Hepatitis C Drugs

The combination of new cures for hepatitis C, the high cost of those cures, and the large population of low-income people suffering from the disease has the nation’s Medicaid directors asking for help from Congress.
“Medicaid programs have decades of experience providing care to medically complex patients, but Hepatitis C is the first real case where a very high per patient cost has been combined with a very large patient population needing treatment,” the National Association of Medicaid Directors declared in a recent news release.
To help them address the high cost of providing a new generation of drugs to the estimated one million Medicaid recipients with hepatitis C, Medicaid directors have asked Congress to introduce policies that reduce the prices of those drugs or give states bigger rebates for purchasing them, noting that states have neither “…the financial capacity to cover the full cost of these treatments” nor “…the clear statutory authority to effectively and efficiently administer the program.”
Pennsylvania is in the midst of examining its policies regarding authorizing the use of expensive drugs to treat Medicaid patients with hepatitis C and is expected to make those drugs more widely available in the near future.
Learn more about the challenges state Medicaid programs face when serving beneficiaries with hepatitis C and the help they seek from Congress in this news release from the National Association of Medicaid Directors.

PA Safety Net Admin2016-07-12T06:00:12+00:00July 12th, 2016|Pennsylvania Medicaid policy, Uncategorized|Comments Off

MACPAC Submits Annual Report to Congress

The non-partisan agency that advises Congress on Medicaid and Children’s Health Insurance Program issues has submitted its annual report to Congress.
In that report, the Medicaid and CHIP Payment and Access Commission offers an overview of historical federal spending on Medicaid, noting that Medicaid spending per beneficiary is growing slower than health care spending covered by Medicare and private insurance.
The MACPAC report also examines different approaches to Medicaid financing, including block grants, capped allotments, per capita limits, and more, reviewing the impact changes in Medicaid financing could have on care, state financing, providers, and state decision-making authority.
macpac In addition, MACPAC looks at the more than 100 different tools used at the state level to assess the functional capabilities of individuals who may be eligible for Medicaid-funded long-term services and supports.
For a closer look at what MACPAC had to say about these and other Medicaid- and CHIP-related issues, go here for a news release accompanying its annual report and a link to that report.

PA Safety Net Admin2016-06-24T06:00:11+00:00June 24th, 2016|Uncategorized|Comments Off

SNAP Asks Legislature for Help With State Budget

The Safety-Net Association of Pennsylvania has asked Pennsylvania’s General Assembly to restore all funding for Medicaid ob/nicu, burn center, and critical access hospital payments and not to increase current hospital assessments in Pennsylvania’s FY 2017 budget.
In SNAP’s view, maintaining vital Medicaid funding is critical to ensuring that hospitals in general, and safety-net hospitals in particular, can deliver quality health care services to the state’s growing Medicaid population while also investing in innovative ways to improve the quality and efficiency of health care for all Pennsylvanians.
See SNAP’s FY 2017 budget advocacy document here.

PA Safety Net Admin2016-06-22T06:00:53+00:00June 22nd, 2016|Uncategorized|Comments Off

Hepatitis C Treatment Challenges PA’s Medicaid Program

The cost of treating Medicaid patients who suffer from hepatitis C is posing a challenge to Pennsylvania’s Medicaid program.
As new, more expensive, but more effective hepatitis C drugs reach the market, the state’s costs for treating Medicaid patients with the disease have doubled since 2013.
Meanwhile, the state continues to consider at what point in the progression of their hepatitis C Medicaid patients should be offered the most expensive drugs.
Prescription Medication Spilling From an Open Medicine Bottle Current guidelines are evolving both in the state and nationally, with medical authorities and federal regulators weighing in with their views. Recently, an advisory committee to the Pennsylvania Department of Human Services offered its own recommendations for criteria for prescribing the most expensive drugs.
Learn more about the issue, the cost of treatment, and current Pennsylvania Medicaid policy on when hepatitis C patients must be offered the most expensive drugs and how that policy might be changing in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2016-06-14T11:23:40+00:00June 14th, 2016|Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Uncategorized|Comments Off

2015 Financial Performance Mixed for PA Hospitals

Most Pennsylvania acute-care hospitals fared well financially in 2015.
But not all of them.
According to a new report issued by the Pennsylvania Health Care Cost Containment Council, total acute-care hospital margins fell 0.01 percentage points in 2015 but operating margins rose 1.21 percentage points.
49 of the state’s 170 acute-care hospitals lost money on operations and 46 lost money overall.
phc4 Other highlights:

uncompensated care fell 8.6 percent
inpatient days declined for the eighth straight year
outpatient visits rose 2.5 percent
53.7 percent of net patient revenue came from inpatient care

Go here for a news release summarizing PHC4’s finding and go here to see the complete report Financial Analysis 2015: An Annual Report on the Financial Health of Pennsylvania Hospitals, which includes state-wide analyses and performance data on individual hospitals.

PA Safety Net Admin2016-06-03T06:00:51+00:00June 3rd, 2016|Uncategorized|Comments Off

Homeless Health Care Costs Driven More by Hospital Stays Than ER Visits

Extended hospital stays and not frequent visits to hospital emergency rooms constitute the greatest cost in caring for homeless Medicaid patients, a new analysis has found.
A review of 1100 homeless people served by the Boston Health Care for the Homeless Program found that while repeated visits to the ER do constitute a problem for caregivers, the cost of those visits is dwarfed by costs associated with the same patients spending long periods of time in the hospital.
According to the review, 30 percent of the group’s Medicaid costs were for hospital stays while only four percent were for ER services. The homeless frequently spend more time in the hospital because they are in such poor overall health.
In recent years, providers have focused much of their attention on frequent ER visitors – so-called “frequent flyers” or “super-utilizers” – but the experience of the Boston program suggests that conditions that lead to long periods of hospitalization among the homeless may need more attention as well.
Because of where they are located, Pennsylvania safety-net hospitals serve far more homeless patients than the typical hospital.
For a closer look at the Boston program and what its leaders learned, see this Boston Herald article.

PA Safety Net Admin2016-06-01T06:00:44+00:00June 1st, 2016|Pennsylvania safety-net hospitals, Uncategorized|Comments Off

Socio-Economic Factors Leading Cause in Pediatric Asthma Readmissions

African-American children suffering from asthma are readmitted to hospitals more often than other children primarily because of socio-economic factors, a new study published in JAMA Pediatrics has concluded.
In a study conducted in Cincinnati, according to the report, “Socioeconomic hardship variables explained 53% of the observed disparity” in readmissions among African-American children with asthma. The study also found that

A total of 80% of the observed readmission disparity between African American and white children could be explained after statistically balancing available biologic, environmental, disease management, access to care, and socioeconomic and hardship variables across racial groups.

These findings are especially relevant to Pennsylvania safety-net hospitals because the communities they serve often have especially large numbers of low-income and low-income African-American children.
Read more about the study, its findings, and its implications in the JAMA Pediatrics article “Explaining Racial Disparities in Child Asthma Readmission Using a Causal Inference Approach, “which can be found here.

PA Safety Net Admin2016-05-19T06:00:21+00:00May 19th, 2016|Uncategorized|Comments Off

Congressional Task Force Considers Medicaid Reforms

A House Energy and Commerce Committee group is looking at potential Medicaid reforms for 2017.
The task force, consisting entirely of Republican members, was created late last year to “… strengthen and sustain the critical program for the nation’s most vulnerable citizens.”
At a recent event at George Mason University, task force chairman Brett Guthrie (R-KY), cited continued high Medicaid spending as a reason to consider reform and noted that the degree to which the task force could tackle Medicaid in 2017 would depend on which party occupies the White House and controls Congress. He suggested that the task force would look for ways to prevent people from needing to choose between getting jobs and keeping health insurance. Among the potential legislative vehicles for reform, Guthrie said, are reauthorization of the Children’s Health Insurance Program and Medicare extenders.
Because they serve so many Medicaid and low-income patients, the task force’s deliberations will be of particular interest to Pennsylvania’s safety-net hospitals.
Learn more about the House Energy and Commerce Committee’s Medicaid Task Force here and about Rep. Guthrie’s remarks at the George Mason University forum here.

PA Safety Net Admin2016-05-13T06:00:47+00:00May 13th, 2016|Uncategorized|Comments Off

Patient Safety Authority Issues Annual Report

The Pennsylvania Patient Safety Authority has issued its 2015 annual report.
Go here for a news release summarizing the report and here for the report itself.

PA Safety Net Admin2016-05-12T06:00:39+00:00May 12th, 2016|Uncategorized|Comments Off

Affordability a Challenge for Many Newly Insured

Many Americans who have obtained private health insurance through the Affordable Care Act continue to have problems affording health care.
According to a Kaiser Family Foundation report based on focus groups six states, low-income individuals with new private insurance report continued problems with:

medical debt
affording care that is not covered by their insurance plans
handling out-of-pocket expenses, including deductibles
unexpected bills for treatment they thought was covered

Such patients pose a challenge for many Pennsylvania safety-net hospitals because of their inability to afford their co-pays and deductibles, leaving these hospitals with unexpected uncompensated care and bad debt. Because they care for more low-income patients than the average hospital, this is a bigger problem for the state’s safety-net hospitals.
For a closer look at how the study and focus groups were conducted and what they found, go here for the Kaiser Family Foundation report Is ACA Coverage Affordable for Low-Income People? Perspectives from Individuals in Six Cities.

PA Safety Net Admin2016-05-11T06:00:32+00:00May 11th, 2016|Affordable Care Act, Uncategorized|Comments Off

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