Uncategorized Archives - Page 6 of 29 - Safety-Net Association of Pennsylvania

SNAP Comments on Proposed Federal Managed Care Reg

The Safety-Net Association of Pennsylvania has submitted formal comments to the Centers for Medicare & Medicaid Services in response to CMS’s proposed changes in federal Medicaid managed care regulations.

Safety-Net Association of Pennsylvania logo SNAP’s letter addressed three aspects of the proposed regulation: payment rate ranges, directed Medicaid payments, and Medicaid pass-through payments. The overall theme underlying SNAP’s comments was that the proposed changes represent positive steps but could be taken further to provide additional flexibility for Pennsylvania’s Medicaid program to take stronger steps to ensure the ability of Pennsylvania safety-net hospitals to serve their communities.

SNAP expressed support for CMS’s restoration of the use of actuarial rate ranges in setting Medicaid managed care rates but urged CMS to make those rate ranges even broader or even eliminate them provided that negotiated rates still meet formal criteria for actuarial soundness.

SNAP endorsed CMS’s expanded parameters for the use of Medicaid directed payments through managed care but encouraged CMS to expand those parameters even further than it has proposed.

And SNAP called on CMS to restore the ability of states to use pass-through payments in Medicaid managed care programs, as they can do through Medicaid fee-for-service programs, so long as those payments remain actuarially sound.

Learn more about SNAP’s perspective by reading the association’s comment letter to CMS in response to the proposed Medicaid managed care regulation.

PA Safety Net Admin2019-01-18T17:52:53+00:00January 18th, 2019|Uncategorized|Comments Off

ED Myths Exposed

Hospital building The uninsured do not use emergency rooms more than the insured.
And the expansion of health insurance coverage increases rather than decreases ER use.
So concludes the new Health Affairs study “The Uninsured Do Not Use the Emergency Department More – They Use Other Care Less.” Find the study here.

PA Safety Net Admin2017-12-13T06:00:10+00:00December 13th, 2017|Uncategorized|Comments Off

The Value-Based Payment Modifier: Program Outcomes and Implications for Disparities

Physicians who serve large numbers of low-income patients are more likely to incur penalties under Medicare value-based purchasing programs.
So concludes a new study in Annals of Internal Medicine.
According to the report,

Performance differences between practices serving higher- and those serving lower-risk patients were affected considerably by additional adjustments, suggesting a potential for Medicare’s pay-for-performance programs to exacerbate health care disparities.

This result is based on a study of the Medicare Value-Based Payment Modifier program, which no longer operates, but could have implications for other programs that seek to reward or penalize practitioners based on the outcomes they produce.
Such findings could lead practitioners to avoid serving such patients so they can avoid penalties, which in turn could jeopardize access to care in some communities. That, in turn, could have implications for Pennsylvania safety-net hospitals and the communities they serve.
Learn more about the study, its findings, and its implications by going here to see the Annals of Internal Medicine report “The Value-Based Payment Modifier: Program Outcomes and Implications for Disparities.”

PA Safety Net Admin2017-12-07T06:00:27+00:00December 7th, 2017|Medicare, Pennsylvania safety-net hospitals, Uncategorized|Comments Off

New PA Website With Resources for Seniors and the Disabled

Pennsylvania has launched a new website called Pennsylvania Link to Community Care to help seniors and people with disabilities find resources to help them address the challenges they face in their lives.
The site, a collaboration between the state’s Human Services and Aging departments, lists services in 12 categories: advocacy, behavioral health, employment, finance, health care, housing, in-home services, legal, meals, protection from abuse, support groups, and transportation. It also provides information to and links about programs, organizations, and services.
To learn more, see this state news release about the new site or go here to see the Pennsylvania Link to Community Care site itself.

PA Safety Net Admin2017-11-28T06:00:26+00:00November 28th, 2017|Uncategorized|Comments Off

Diabetes Admissions Up in PA

Hospital admissions for diabetes rose 13 percent in Pennsylvania between 2000 and 2016. While admissions among older Pennsylvanians declined, the rate for younger people under the age of 45 increased 38 percent over that period of time.
Diabetes admissions in Pennsylvania resulted in $205 million in payments to hospitals in 2016, but according to the Pennsylvania Health Care Cost Containment Council, about 86 percent of 2016 adult admissions could have been prevented with more timely and appropriate care and disease management.
Learn more about the prevalence of diabetes admissions in Pennsylvania in the new PHC4 research brief
“Pennsylvania Hospital Admissions for Diabetes,” which can be found here.

PA Safety Net Admin2017-11-23T06:00:14+00:00November 23rd, 2017|Uncategorized|Comments Off

PA Delays New Long-Term Care Program

The Pennsylvania Department of Human Services will delay for six months the introduction of its Community HealthChoices program in southeastern Pennsylvania.
The program’s implementation in the five-county Philadelphia area, scheduled to begin on July 1, 2018, has been pushed back to January 1, 2019.
Preparations are currently under way to launch Community HealthChoices in 14 southwestern Pennsylvania counties on January 1, 2018.
Community HealthChoices is a new state program of managed long-term services and supports for Pennsylvanians over the age of 55 who are eligible for both Medicare and Medicaid.
Learn more about the program’s delay in southeastern Pennsylvania in this Philadelphia Inquirer article.

PA Safety Net Admin2017-11-07T10:18:34+00:00November 7th, 2017|Pennsylvania Medicaid policy, Uncategorized|Comments Off

PHC4 Reports on Hospital Performance

The Pennsylvania Health Care Cost Containment Council has released its annual report on hospital performance for discharges between October of 2015 and September of 2016.
The report, which details the performance of all of the state’s acute-care hospitals and some children’s and specialty hospitals, looks at hospital-specific outcomes for 16 individual medical conditions and surgical procedures.
Among the measures reported by PHC4 are number of cases, risk-adjusted mortality, risk-adjusted 30-day readmissions, and case-mix-adjusted average hospital charges.
Among its findings, PHC4 reported that mortality and readmission rates decreased in most categories and did not increase significantly in any.
The PHC4 report comes in different volumes for different parts of the state. Find a description of the reports, a summary of their findings, and the three reports themselves here, on PHC4’s web site.

PA Safety Net Admin2017-10-27T06:00:30+00:00October 27th, 2017|Uncategorized|Comments Off

Survey Says: More Than One in Four Underinsured

28 percent of insured adults under the age of 64 were uninsured in 2016, according to a Commonwealth Fund survey.
The survey also found that:

More than half of the uninsured are insured through their employer.
Nearly one in four insured through their employer are underinsured.
More than one in four Medicaid recipients were underinsured.
Half of the underinsured report problems paying their medical bills.
Individuals with higher deductibles are more likely to report problems paying their medical bills.
More than 45 percent of the underinsured report skipping care they need because of cost.
Low-income people and those with chronic health problems are more likely to be underinsured.

Learn more about the survey’s findings, its implications, and possible means of addressing these problems in the Commonwealth Fund report How Well Does Insurance Coverage Protect Consumers from Health Care Costs?, which can be found here.

PA Safety Net Admin2017-10-25T06:00:08+00:00October 25th, 2017|Uncategorized|Comments Off

A New Twist on Telehealth

Residents of urban areas often have the same access-to-care problems as rural residents, although the latter receive far more attention.
So concludes a new report published on the Health Affairs Blog.
According to the analysis, urban and rural residents have similar access problems – and among urban residents, the problems in some instances are even greater. One distinction:

…while rural America has access problems because there are not enough doctors, urban America has access problems because there are not enough appointments.

One potential solution to this problem, the report suggests, is focusing on access instead of geography and making telehealth services more available to rural and urban residents alike. To date, most telehealth efforts have focused on serving residents of rural areas only.
Doctor giving patient an ultrasound Pennsylvania has safety-net hospitals in both urban and rural areas and many of the communities they serve have access-to-care problems that might benefit from greater access to telehealth services.
Learn more about the issue and this new perspective in the article “Giving Urban Health Care Access Issues The Attention They Deserve in Telemedicine Reimbursement Policies,” which can be found here, on the Health Affairs Blog.