Uncategorized Archives - Page 27 of 29 - Safety-Net Association of Pennsylvania

Medicaid at Risk in Fiscal Cliff Talks

If Medicaid is a health care program for at-risk low-income people, it appears that Medicaid itself is at risk during the current fiscal cliff talks in Washington, D.C.
While Medicaid was left untouched by last year’s sequestration bill, it is now viewed by growing numbers of policy-makers as a potential source of savings to help stave off the fiscal cliff.
Several aspects of Medicaid, in particular, appear to be vulnerable in the coming weeks. They include Medicaid provider taxes, which are incurring growing opposition in Washington and which, if ratcheted back, could save more than $25 billion; supplemental payments for Medicaid primary care providers, scheduled to take effect on January 1, which if eliminated would save $13 billion; better management of dual eligibles, which could save $12 billion; and medical equipment spending, where a competitive bidding program similar to that currently being introduced for Medicare could save $5 billion.
While all of these cuts would hurt Pennsylvania’s safety-net hospitals, those hospitals would particularly be affected by any reduction in either the rate at which the federal government matches the state’s Medicaid expenditures or in its ability to levy provider taxes, which are a key contributor to the financial foundation of the state’s Medicaid program.
Learn more about how Medicaid figures in the current fiscal cliff talks and how policy-makers are increasingly looking to Medicaid for savings in this Politico article .

PA Safety Net Admin2012-12-17T06:00:28+00:00December 17th, 2012|Uncategorized|Comments Off

Safety-Net Hospitals and Readmissions

Safety-net hospitals are 30 percent more likely to have readmission rates that exceed the national average – always a problem, but a greater problem than ever now that Medicare is penalizing hospitals for readmissions through its new Hospital Readmissions Reduction Program.
A recent Commonwealth Fund study quantified the degree to which safety-net hospitals’ readmissions exceed national averages, citing as the reason for those reasons that

Safety-net hospitals care for a disproportionate share of vulnerable populations who are low-income, uninsured, underinsured, or on Medicaid. They have substantially higher rates of chronic health problems, disability, mental illness, and substance abuse, compared with the general population. Safety-net hospital patients also have disproportionate personal and social needs that adversely affect their health and act as barriers to accessing and fully benefiting from care. These include homelessness, unsafe housing, and unstable employment. In particular, vulnerable populations are more likely to lack social support systems (e.g., family members at home) and housing stability, which contribute to a disproportionate risk of readmission after hospital discharge.

The report also offers strategies to help safety-net hospitals reduce their readmissions and avoid the Medicare financial penalties they now face for those readmissions.
Find “Higher Readmissions at Safety-Net Hospitals and Potential Policy Solutions” here , on the web site of The Commonwealth Fund.

PA Safety Net Admin2012-12-13T06:00:01+00:00December 13th, 2012|Uncategorized|Comments Off

Uncompensated Care Up, Margins Down in Western PA

Uncompensated care rose more than five percent for hospitals in western Pennsylvania while operating margins fell slightly during the fiscal year that ended on June 30.
Hospitals reported more patients unable to pay their bills and lower reimbursements as more procedures move to an outpatient basis and more inpatient care is accorded “observation day” status.
Read more about the results of a survey of 56 hospitals conducted by the Hospital Council of Western Pennsylvania in this Pittsburgh Post-Gazette article.

PA Safety Net Admin2012-12-12T06:00:57+00:00December 12th, 2012|Uncategorized|Comments Off

Corbett Hints at No PA Medicaid Expansion

Without explicitly ruling out expansion of the state’s Medicaid program, which is now an optional part of the federal health care reform law, Pennsylvania Governor Tom Corbett has hinted broadly that the state may not be prepared to spend the additional money such an expansion would necessitate.
“I don’t think there’s any way we can absorb this,” the governor told the Pennsylvania Press Club, speaking of the Medicaid expansion that is a major part of the 2010 Affordable Care Act.
Read more about what those costs would be, and the challenges the state would face in expanding its Medicaid program, in this PA Independent article.

PA Safety Net Admin2012-11-23T06:00:34+00:00November 23rd, 2012|Pennsylvania Medicaid policy, Uncategorized|Comments Off

Mixed Financial Results for PA Non-Acute-Care Hospitals

Margins were up for Pennsylvania rehabilitation hospitals and down for free-standing psychiatric hospitals in 2011.
This news comes from the Pennsylvania Health Care Cost Containment Council (PHC4), which has just released its latest report, Financial Analysis 2011 – Volume Three, which details the financial performance of rehabilitation, free-standing psychiatric, long-term care acute, and specialty hospitals in Pennsylvania in 2011.
Among other interesting findings, Pennsylvania’s Medical Assistance program accounted for 54.9 percent of patient revenue at the state’s 19 psychiatric hospitals.
Find the report, a news release announcing its publication, and the data from the report available as an Excel file here , on the council’s web site.

PA Safety Net Admin2012-11-19T06:00:00+00:00November 19th, 2012|Uncategorized|Comments Off

MedPAC Mulls Outpatient Payments

MedPAC members continue to debate whether equalizing the payments for outpatient services delivered in physicians’ offices and in hospital outpatient facilities and departments makes for good public policy. Currently, hospitals receive additional payments for outpatient evaluation and management (E&M).
Some commissioners and advocates argued at MedPAC’s November 2 meeting that the federal government should pay for Medicare services based on the services themselves, not on where they are provided. Others maintained that hospitals have inherently greater costs because of the additional service capacity they bring and that it is appropriate for Medicare to help pay for that capacity because it enables hospitals to meet the needs of many Medicare patients.
This is an important issue for many Pennsylvania safety-net hospitals. In recent years, many of these hospitals have invested heavily in developing their capacity to serve more patients on an outpatient basis.
MedPAC (Medicare Payment Advisory Commission) advises Congress on Medicare reimbursement issues. Its recommendations, while considered influential, are not binding on Congress.
Learn more about this issue in this article from CQ HealthBeat as presented by the Commonwealth Fund. In addition, the presentation that MedPAC’s staff made to commission members can be downloaded here, from MedPAC’s web site.

PA Safety Net Admin2012-11-07T06:00:14+00:00November 7th, 2012|Uncategorized|Comments Off

DPW Issues Prior Authorization Bulletins

The Pennsylvania Department of Public Welfare has issued two new Medical Assistance Bulletins addressing prior authorization for specific prescription drugs: one for botulinum toxins and the other for angiotensin modulator combinations .

PA Safety Net Admin2012-11-01T10:22:04+00:00November 1st, 2012|Uncategorized|Comments Off

Number of Uninsured in PA Unchanged

The number of uninsured Pennsylvanians is not growing. According to data released by the U.S. Census Bureau, about one out of every eight Pennsylvanians under the age of 65 was uninsured in 2010-2011, roughly the same number as in 2008-2009. 16.2 percent under the age of 65 were covered by Medicaid in 2010-2011, the same as 2008-2009 but up sharply over previous years.
Find more data about the uninsured in Pennsylvania, those living below the federal poverty level, and those covered by Medicaid in this Central Penn Business Journal article .

PA Safety Net Admin2012-09-21T06:00:14+00:00September 21st, 2012|Uncategorized|Comments Off

Parts of Central PA Feature High Uninsured Rate, Low Access to Care

Five counties in central Pennsylvania currently suffer from a high rate of uninsured residents and limited access to medical care.
According to an assessment commissioned by three mid-state hospitals, one out of every 3.5 residents in the surveyed counties lack health insurance, compared to one in 10.4 Pennsylvanians overall.
The assessment covered Cumberland, Dauphin, Lebanon, Perry, and northern York counties.
Read more about the assessment, and find a direct link to the assessment, in this Central Penn Business Journal article .

PA Safety Net Admin2012-09-18T10:35:01+00:00September 18th, 2012|Uncategorized|Comments Off

Sequestration Could Cost Health Care Jobs in PA

Unless Congress reverses the sequestration of $2 billion in Medicare funding by the end of 2012, that cut in federal Medicare spending could result in the loss of nearly a half-million health care jobs across the country in 2013 alone.
And more than 37,000 of those lost health care jobs could be in Pennsylvania.
So says a new report sponsored by the American Hospital Association, the American Medical Association, and the American Nurses Association.
The cuts are mandated by the Budget Control Act, which Congress adopted late last year. While discussions are under way in Congress to block or delay implementation of the sequestration cuts in Medicare, defense, and other spending areas, it is not clear at this time whether those efforts will succeed.
It also is not clear what cuts the federal government will make to save the required $2 billion.
Any large-scale job losses associated with reduced federal Medicare spending would no doubt hit Pennsylvania’s safety-net hospitals hard because of the large numbers of Medicare patients they serve and their already-thin operating margins.
Download the report describing the impact of the $2 billion Medicare sequestration on health care employment here and read more about the prospects for health care jobs in Pennsylvania in this Pittsburgh Business Times report.

PA Safety Net Admin2012-09-14T06:00:31+00:00September 14th, 2012|Uncategorized|Comments Off

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