Affordable Care Act Archives - Page 14 of 16 - Safety-Net Association of Pennsylvania

Medicare Reveals First Results of Quality Program

Slightly more than half of all U.S. hospitals will receive enhanced payments from Medicare and slightly fewer than half will see their payments reduced slightly as a result of the first reporting period for Medicare’s new value-based purchasing program.
The largest bonus will be awarded to Treasure Valley Hospital, in Utah. Each of its Medicare payments will rise 0.83 percent. The largest penalty will be assessed to Auburn Community Hospital, in Syracuse, which will see its Medicare payments reduced 0.9 percent. Two-thirds of all hospitals will see their payments rise or fall less than 0.25 percent.
Medicare’s value-based purchasing program, created by the Affordable Care Act, seeks to enhance provider accountability for the care they deliver. Seventy percent of a hospital’s score is based on its performance according to 12 basic standards of care and the rest of the score is based on the results of patient satisfaction surveys.
The program will be expanded in the coming years to encompass more standards of care. A companion program, based on Medicare readmissions within 30 days of patient discharge, is already under way and rewarding top performance and penalizing underperforming hospitals.
According to the figures released, 51 percent of Pennsylvania hospitals will receive bonuses through the value-based purchasing program and 49 percent will be penalized. Between the two programs – the value-based purchasing program and the readmissions reduction program – 20 percent of Pennsylvania hospitals will see a net increase in payments and the remaining 80 percent either broke even or will see their payments reduced.
Read more about the quality program in this Kaiser Health News report , which also offers links to lists of the results for every hospital in the country for both the Medicare value-based purchasing and readmissions reduction programs.

PA Safety Net Admin2012-12-31T06:00:30+00:00December 31st, 2012|Uncategorized|Comments Off

GAO Finds Problems With Medicaid DSH Payments

The U.S. Government Accountability Office (GAO) is now reviewing audits of states’ Medicaid disproportionate share payments (Medicaid DSH) to hospitals and is raising questions about states’ compliance with federal requirements for those payments.
Based on its analysis of state Medicaid DSH audits, GAO found that states are making Medicaid DSH payments to hospitals that exceed those hospitals’ uncompensated care costs and are inaccurately calculating those hospital uncompensated care costs. The GAO also found that states are not always targeting their Medicaid DSH payments to the hospitals that provide the most uncompensated care.
States are required to submit audits and data as a condition of receiving Medicaid DSH funds from the federal government. Currently, the Centers for Medicare & Medicaid Services (CMS) is not acting on the information it receives but will begin doing so after a transition period that ends when 2014 audits are completed. In anticipation of that time, GAO is reviewing the information CMS receives for state compliance with six federal standards for Medicaid DSH payments.
This data also may eventually be used to help implement the Medicaid DSH payment reduction mandated under the Affordable Care Act.
According to the report, Pennsylvania did not provide some of the required data, so in several instances in which the document provides specific information about individual state performance, it has nothing about Pennsylvania. It does note, however, that in FY 2007, six hospitals in the state received Medicaid payments greater than their Medicaid costs.
Because Pennsylvania’s safety-net hospitals care for so many uninsured and low-income patients and receive higher Medicaid DSH payments than other hospitals, they are far more dependent on these payments than other hospitals and will need to watch this situation closely in the future.
Learn more about GAO’s examination of Medicaid DSH payments – why it is undertaking this review, what it found, and how its findings may be used in the future – in the report More Transparency of and Accountability for Supplemental Payments are Needed, which can be found here , on GAO’s web site.

PA Safety Net Admin2012-12-28T06:00:33+00:00December 28th, 2012|Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy|Comments Off

Corbett Explains ‘No’ Decision on Health Exchanges

In an op-ed piece in Sunday’s Philadelphia Inquirer, Pennsylvania Governor Tom Corbett presented the reasons he decided to let the federal government develop the state’s health insurance exchange – a key part of the Affordable Care Act – instead of having his own administration develop the exchange.
Read Governor Corbett’s op-ed piece here .

PA Safety Net Admin2012-12-24T11:08:31+00:00December 24th, 2012|Health care reform|Comments Off

HHS Nixes Partial Medicaid Expansion

States must opt into the Affordable Care Act’s Medicaid expansion or opt out, the federal government has informed the nation’s governors. They may not implement a partial expansion.
That was the message conveyed to governors by Kathleen Sebelius, Secretary of the U.S. Department of Health and Services (HHS).
The Medicaid expansion, made mandatory in the 2010 health care reform law, has been the subject of much debate since the Supreme Court ruled the mandate unconstitutional in June and instead left the decision on whether to expand to the individual states. Some governors have already declared that their states will expand their Medicaid programs, some have announced that they will not, and many still have not decided.
Pennsylvania is among the states that have not yet announced whether they will expand their Medicaid programs, although Governor Tom Corbett has signaled that he is reluctant to incur the additional costs that expansion would involve. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion.
Read more about this latest decision from HHS in this Washington Post article and read an FAQ that HHS sent to governors regarding both Medicaid expansion and the operation of health insurance exchanges here.

PA Safety Net Admin2012-12-11T11:19:30+00:00December 11th, 2012|Health care reform, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

Decision Time Looms for PA, Other States On Medicaid Expansion

The time for states to decide whether they will expand their Medicaid programs in accordance with the Affordable Care Act is fast approaching.
With the Medicaid expansion due to begin in 2014, thirteen states seem likely to opt out, 14 appear ready to expand, and the rest are still on the fence.
Among the major concerns of states still deciding are the cost of expansion and their concern that the federal government, currently scheduled to assume almost all of the cost of expansion, may at some point decide to shift more of expansion’s costs to state governments.
Pennsylvania is among the undecided states, but comments in recent months by Governor Corbett suggest that he is leaning against Medicaid expansion in the commonwealth. The Safety-Net Association of Pennsylvania (SNAP) supports that expansion.
Read more about the deliberations taking place in state capitals across the country, and the questions with which elected officials are wrestling, in this Washington Post article .

PA Safety Net Admin2012-12-07T06:00:28+00:00December 7th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Corbett: Not Enough Info to Decide on Exchange

Pennsylvania cannot decide whether to operate its own health insurance exchange or allow the federal government to operate an exchange for the state until it gets more information from the federal government about the regulations governing exchanges, how much they will cost to operate, and what a partnership with the federal government might look like.
That’s the message Pennsylvania Governor Tom Corbett conveyed last week.
Health insurance exchanges are among the most important components of the Affordable Care Act. States have until December 14 to inform the federal government whether they will operate their own exchange and Pennsylvania is one of ten states that still had not made this decision.
Read more about Governor Corbett’s thoughts on health insurance exchanges and the additional information he seeks before deciding in this PA Independent article .

PA Safety Net Admin2012-12-05T06:00:55+00:00December 5th, 2012|Health care reform|Comments Off

Governors Will Give In On Medicaid Expansion, Experts Predict

Lured by billions of dollars in federal money, governors resisting the Affordable Care Act’s Medicaid expansion option will eventually give in and expand their states’ Medicaid programs as provided for in the 2010 health care reform law.
Or so predict several experts who participated in a recent health policy forum in Washington, D.C.
Some may not do so right away, the experts warned, but the financial benefits of expanding their Medicaid programs and capturing billions in federal Medicaid matching money will eventually become too much to resist.
Pennsylvania is among many states still not committed to Medicaid expansion. In recent public statements, Governor Tom Corbett has suggested that the state cannot afford to spend the additional money expansion would require.
Read more about the policy forum and the experts’ predictions in this Politico article .

PA Safety Net Admin2012-12-03T06:00:59+00:00December 3rd, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Cost of Medicaid Expansion Would be Minimal for PA

Expanding Pennsylvania’s Medicaid program as envisioned in the Affordable Care Act would cost Pennsylvania $1.96 billion over the ten years beginning in FY 2013, according to a new report released by the Kaiser Family Foundation.
While that price tag may seem steep, it is only 1.4 percent more than the additional money the state would spend if it declines to expand its Medicaid program as the 2010 health care reform law envisioned.
Expanding Medicaid would spur a 52 percent increase in the number of Pennsylvanians with health insurance. Without the Medicaid expansion, the number of insured would rise 28.9 percent because of other Affordable Care Act provisions.
Pennsylvania’s safety-net hospitals would benefit greatly from the expansion of Medicaid in the state. Many of the uninsured patients they currently serve would almost certainly become eligible for Medicaid under such an expansion.
Learn more about how Medicaid expansion would affect Pennsylvania in this Central Penn Business Journal article. The Kaiser Family Foundation study on which it is based can be found here .

PA Safety Net Admin2012-11-29T11:41:24+00:00November 29th, 2012|Health care reform, Pennsylvania Medicaid policy|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

Will PA Expand Medicaid Program?

With President Obama re-elected and Congress unlikely to repeal the Affordable Care Act, Pennsylvania officials now face a major decision: will they expand the state’s Medicaid programs as the law originally intended?
The original health care reform law made that expansion mandatory, but earlier this year, the Supreme Court left the expansion decision to individual states. While some governors have already declared their intention to expand their Medicaid programs and others have announced that they will not, Pennsylvania Governor Tom Corbett has not yet announced a decision.
Why would the state choose to expand its Medicaid program, considering that it will end up costing taxpayers more money? On the other hand, why would it choose to leave billions of federal dollars on the table?
Because they serve so many low-income, uninsured patients who might benefit from an easing of Medicaid eligibility criteria, Pennsylvania’s private safety-net hospitals have a major stake in this decision.
Read more about the decision now facing the Corbett administration in this CQ HealthBeat article presented by the Commonwealth Fund. For a closer look at the Pennsylvania perspective, read this PA Independent article .