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DPW Says Fiscal Office Understates Cost of Medicaid Expansion

The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania.
According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated with increased federal matching funds for General Assistance recipients.
DPW also maintains in the letter that the IFO incorrectly assumes that new enrollment will take place gradually instead of  fairly quickly once expansion begins; underestimates the number of new “woodwork” enrollees – individuals already eligible for Medicaid who will enroll in the program because of all the attention the eligibility expansion will receive; and prematurely assumes continued income from the gross receipts tax on Medicaid managed care organizations before the federal government has had an opportunity to decide whether the state will be permitted to continue levying that tax.
Read about the letter in this Philadelphia Business Journal article or download the letter itself here.

2013-05-22T06:00:40+00:00May 22nd, 2013|Pennsylvania Medicaid policy, Pennsylvania state budget issues, Uncategorized|Comments Off on DPW Says Fiscal Office Understates Cost of Medicaid Expansion

PA Seeks Fair Share for Fair Care

Pennsylvania is asking the federal government to continue full funding of the health insurance program for hard-to-insure people created under the Affordable Care Act.
PA Fair Care currently provides health insurance for 6900 Pennsylvanians with medical conditions that usually make health insurance too expensive for them to purchase.  The federal government allocated $5 billion for the program, but even though nation-wide enrollment is less than one-third of what the Obama administration estimated, the program has expended most of its initial appropriation and the federal government has asked states to stop enrolling new members and shift existing members into the federal version of the program or risk liability for costs the federal government will no longer subsidize.
Read more about PA Fair Care, why the program is in trouble, and what the state and federal government are trying to do about it in this Pittsburgh Post-Gazette reportDoctor listening to patient.

2013-05-20T06:00:44+00:00May 20th, 2013|Uncategorized|Comments Off on PA Seeks Fair Share for Fair Care

Nurses Seek Nurse-to-Patient Staffing Ratio Law

HospitalPennsylvania’s nurses have rallied in Harrisburg for legislation to establish legal guidelines for nurse-to-patient staffing ratios in the state.
The proposal supported by the Pennsylvania State Nurses Association calls for individual hospitals to establish their own guidelines on a unit-by-unit basis.
The most recent nurse staffing bill in the Pennsylvania General Assembly was referred to the House Committee on Health in the fall of 2011.
Read more about the nurses’ rally in Harrisburg and their objectives in this Central Penn Business Journal article.

2013-04-25T06:00:44+00:00April 25th, 2013|Uncategorized|Comments Off on Nurses Seek Nurse-to-Patient Staffing Ratio Law

PA Ranks Low in Public Health Spending, Study Finds

Pennsylvania ranks 43rd of the 50 states in public health spending, according to a new report issued by the Robert Wood Johnson Foundation and the organization Trust for America’s Health.
While the median annual public health expenditure per capita nation-wide is $27, Pennsylvania spends only $14 per capita on public health.
Public health encompasses such functions as protecting the water and food supplies, inspecting restaurants, promoting good health, guarding against environmental hazards, and tracking the spread of infectious diseases.
Read more about the state’s role in public health and why Pennsylvania rates so poorly compared to other states in this Allentown Morning Call articlePennsylvania State Map.

2013-04-10T06:00:44+00:00April 10th, 2013|Uncategorized|Comments Off on PA Ranks Low in Public Health Spending, Study Finds

CHIP Enrollment Down in PA

Participation in Pennsylvania’s Children’s Health Insurance Program (CHIP) has fallen by nearly 100,000 children since mid-2011.
Much of the decline is being attributed to a reduction in the state’s marketing of the program in recent years.  Additional money for marketing is included in Governor Corbett’s proposed FY 2014 budget.
Read more about the extent of the fall in CHIP enrollment and why it has occurred in this Philadelphia Inquirer article.

2013-04-08T06:00:13+00:00April 8th, 2013|Uncategorized|Comments Off on CHIP Enrollment Down in PA

Medicare Penalties Hurt Safety-Net Hospitals More, Some Argue

HospitalPenalties imposed on hospitals deemed to have excessive readmissions of Medicare patients may disproportionately target safety-net hospitals, some health care experts maintain.
Such penalties are part of Medicare’s hospital readmissions reduction program.
According to the recent New York Times article “Hospitals Question Medicare Rules on Readmissions,” “…health policy experts and hospital executives say the penalties, which went into effect in October, unfairly target hospitals that treat the sickest patients or the patients facing the greatest socioeconomic challenges.”  The article goes on to cite a recent report in the New England Journal of Medicine, noting that “Large academic medical centers and so-called safety-net hospitals are bearing the brunt of the new policy, and the authors warn that the penalties could make it even harder for hospitals struggling to care for those patients with the highest needs.”
Read the Times article here.

2013-04-05T06:00:29+00:00April 5th, 2013|Uncategorized|Comments Off on Medicare Penalties Hurt Safety-Net Hospitals More, Some Argue

ER Overuse May be Overstated

The common perception that many hospital emergency rooms are significantly overused by people not suffering genuine medical emergencies may not be accurate according to a new report published in the Journal of the American Medical Association.Hospital building
According to the study “Comparison of Presenting Complaint vs. Discharge Diagnosis for Identifying ‘Nonemergency’ Emergency Department Visits,” many ER patients who turn out not to be suffering genuine medical emergencies present with virtually the same symptoms as patients who are suffering true emergencies.   This suggests that it may be unreasonable in at least some cases for patients to determine whether their medical problems genuinely require emergency assistancePennsylvania’s safety-net hospitals typically experience very high emergency room utilization.
Overuse of hospital emergency rooms is frequently cited as a major cause of rising health care costs.
Read more about these latest findings in this New York Times blog entry and find the JAMA study here.

2013-04-03T06:00:54+00:00April 3rd, 2013|Uncategorized|Comments Off on ER Overuse May be Overstated

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress.
The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report.
First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid.
And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than the program’s limit to retain their Medicaid eligibility for several additional months.
The MACPAC report also includes analyses of several issues involving services for dually eligible (Medicare and Medicaid) individuals.
Because Pennsylvania’s safety-net hospitals serve so many Medicaid, CHIP, and dually eligible patients, MACPAC’s recommendations and analyses can be especially important to them.
Find the MACPAC March 2013 report here.

2013-03-25T06:00:01+00:00March 25th, 2013|Uncategorized|Comments Off on MACPAC Reports to Congress

New Medicare Program Readmitted for Additional Work

Medicare’s new hospital readmissions reduction program has itself been readmitted for extra work after the federal government concluded that faulty calculations have resulted in inaccurate penalties and payments.
The Centers for Medicare & Medicaid Services (CMS) has announced that as part of a recent reexamination of hospitals’ performance under the program, more than 1200 hospitals were overpenalized and more than 200 will have to pay larger penalties than they were originally assessed.
The readmissions reduction program is being credited with a decrease in Medicare hospital readmissions across the country.  At the same time, however, a report in the New England Journal of Medicine suggested that the program will penalize hospitals that care for especially poor and sick patients.  MedPAC, the independent federal agency that advises Congress on Medicare reimbursement issues, recently expressed similar concerns.
Read more about the technical problems the program has encountered, the successes for which it is being credited, and the concerns that some people still have about it in thisHospital Kaiser Health News report.

2013-03-21T06:00:44+00:00March 21st, 2013|Uncategorized|Comments Off on New Medicare Program Readmitted for Additional Work

Bill Would Create New Residency Positions

Doctor listening to patientA new bill before Congress would create 15,000 new Medicare-sponsored medical residency spots – the first such new positions in 15 years.
Half of those slots would be for physicians training for careers in primary care.
The bill, which has bipartisan sponsorship, would cost between $9 billion and $10 billion over the next 10 years.
Medical residents play a major role in caring for low-income and uninsured patients in many Pennsylvania safety-net hospitals.
Read more about the possibility of new medical residency slots in this article from The Hill.

2013-03-18T06:00:44+00:00March 18th, 2013|Uncategorized|Comments Off on Bill Would Create New Residency Positions
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