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Healthy PA Road Show Visits Philadelphia

The process of taking public input on Governor Corbett’s Healthy Pennsylvania Medicaid expansion and health care reform proposal continued last Friday with a hearing in Philadelphia.
Among those who testified before Department of Public Welfare Secretary Beverly Mackereth and other state officials were representatives of Project Home, the Cover the Commonwealth Campaign, the Disability Rights Network of Pennsylvania, the Health Federation of Philadelphia, the Pennsylvania Health Care Association, Jefferson Health System, and Mercy Health System, the newest member of the Safety-Net Association of Pennsylvania (SNAP).
Read more about the hearing and the testimony offered in this Philadelphia Business Journal report.
The hearing was the third of six schedule sessions.  Hearings already have been held in Erie and Pittsburgh; a hearing is scheduled for today, January 6, in Scranton; and hearings also will be held on January 7 in Altoona and January 9 in Harrisburg.  SNAP president Michael Chirieleison will testify in Harrisburg and SNAP also will submit extensive written comments about the Healthy Pennsylvania proposal.

2014-01-06T06:00:49+00:00January 6th, 2014|Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on Healthy PA Road Show Visits Philadelphia

Medicaid Applications Flowing From DC to PA

Pennsylvania is now receiving Medicaid applications from the federal government’s health insurance marketplace website.
Health Benefits Claim FormImprovements in the healthcare.gov web site have enabled the federal government to begin sending data about Medicaid-eligible applicants to a number of states, including Pennsylvania.  Until now, the data had been promised but technical problems prevented the federal government from fulfilling that promise.
Read more about the process of transforming visitors to the healthcare.gov into Pennsylvania Medicaid applicants in this Reading Eagle article.

2013-12-26T06:00:04+00:00December 26th, 2013|Health care reform|Comments Off on Medicaid Applications Flowing From DC to PA

Health Insurance Jam Easing for Pennsylvanians

The much-troubled healthcare.gov web site through which people can obtain individual and family health insurance policies has apparently improved enough that Pennsylvanians are starting to find their way into the exchange in pursuit of the insurance they seek.
Health Benefits Claim FormIn November, according to the U.S. Department of Health and Human Services, nearly 10,000 Pennsylvanians obtained insurance through the federal site; 74,000 submitted applications for policies that would cover 137,000 people (applicants and family members); 100,000 established eligibility but have not yet selected a plan; 40,000 established eligibility for insurance premium subsidization; and 6800 were found eligible for Medicaid or CHIP.
Read more about Pennsylvanians and their November experiences seeking Affordable Care Act-mandated health insurance in this Centre Daily Times report.

2013-12-16T06:00:53+00:00December 16th, 2013|Affordable Care Act|Comments Off on Health Insurance Jam Easing for Pennsylvanians

Delay in Switch From CHIP to Medicaid

The federal government is permitting Pennsylvania to delay shifting children currently enrolled in the state’s Children’s Health Insurance Program (CHIP) into Medicaid.
The state has objected to such a transition, which is mandated by the Affordable Care Act, and is in the process of attempting to negotiate a compromise with federal officials.  Those federal officials have agreed to delay the required transition until they have an opportunity to review the state’s new proposal, which should be delivered later this week.
Learn more about this issue in this article in The (Cumberland County) Sentinel.

2013-12-10T06:00:51+00:00December 10th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Delay in Switch From CHIP to Medicaid

PA Seeks Federal OK for Medicaid Expansion

The Corbett administration is asking the federal government to authorize the expansion of the state’s Medicaid program to serve another 500,000 people.
Healthy Pennsylvania, the reform plan unveiled by the Corbett administration in September, calls for expanding eligibility for Medicaid as envisioned in the federal Affordable Care Act but providing coverage to newly eligible individuals through private insurers
Under the plan, most newly eligible recipients would select state-subsidized insurance through the federal health insurance marketplace and receive the same benefits as regular commercial customers.
Healthy Pennsylvania also calls for streamlined benefits packages, enrollee premiums, and a work search requirement.
The formal unveiling of the plan is linked to the state’s application to the federal government for a waiver from selected federal Medicaid requirements.  While states routinely request such waivers, each waiver is subject to individual scrutiny and negotiation between the state and federal governments after a period of public comment at the state level.
To learn more about the Healthy Pennsylvania proposal, see this Philadelphia Inquirer article.  The administration also has published a description of its proposed application for the federal waiver, including information about how interested parties may comment on the proposal, in the Pennsylvania Bulletin; that notice can be found here.  The complete draft waiver application can be found here.

Feds Find Temporary Way to Overcome Medicaid Enrollment Problem

The problems plaguing the beleaguered healthcare.gov web site continue to make it difficult for people to find new health insurance, but a new approach devised by the federal government will make it easier for Medicaid applicants to overcome this problem.
While the Centers for Medicare & Medicaid Services (CMS) was having trouble sending completed Medicaid and CHIP applications to the states, it continued sending them basic data from Medicaid and CHIP applications on a weekly basis primarily to help them gauge possible interest in Medicaid enrollment.  Now, it is telling states they can use this limited data to enroll such individuals in their Medicaid programs without complete applications.
This process is expected to facilitate enrollment in states that have chosen to expand eligibility for their Medicaid programs.  To date, Medicaid enrollment has been one of the brightest aspects of the troubled launch of the Affordable Care Act’s insurance expansion.  While Pennsylvania is not expanding its Medicaid program at this time, the process could facilitate the enrollment of so-called woodwork applicants:  people who are already eligible for Medicaid and never enrolled but have been drawn to do so by all of the attention the Medicaid expansion and Affordable Care Act have received.
To learn more about the CMS workaround to this problem, read this Kaiser Health News report or read the letter CMS sent to state Medicaid directors describing how this process will work.

2013-12-05T06:00:58+00:00December 5th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off on Feds Find Temporary Way to Overcome Medicaid Enrollment Problem

Enough Docs to Go Around?

With nine million people expected to enroll in Medicaid in the coming year, questions are arising about whether there will be enough physicians to serve them.
Across the country there has long been a shortage of physicians, and especially specialists, willing to serve Medicaid patients because of how poorly most state Medicaid programs pay those doctors.  Now, with more people than ever expected to become insured by Medicaid, it is not clear whether the existing physician pool will be able to serve them very effectively.
The Affordable Care Act anticipated this problem and included a two-year increase in Medicaid payments to physicians, a move designed to raise Medicaid rates to the same level as those paid by Medicare.  But states have been slow to make these payments, which were expected to begin last January, and physicians recognize that this will only be a temporary raise.  As a result, fewer physicians than expected have agreed to serve Medicaid patients.
Doctor listening to patientWhether this might pose a problem for Pennsylvania and its safety-net hospitals could depend on whether Governor Tom Corbett’s “Healthy Pennsylvania” proposal is fully implemented and the state expands Medicaid enrollment through the private health insurance market.  One of the selling points of the Healthy Pennsylvania proposal has been that working through private insurers, rather than Medicaid managed care organizations or the state itself, should result in better payments for health care providers, thereby making those providers more willing to serve Medicaid patients.
See this New York Times article for a look at these and other questions related to the upcoming Medicaid expansion and the ability of the medical community to meet an unprecedented demand for care.

2013-12-03T06:00:13+00:00December 3rd, 2013|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Enough Docs to Go Around?

Enrolling Homeless in Medicaid Poses Challenges, Offers Hope

Enrolling the homeless in Medicaid poses numerous logistical challenges for government, providers, and caregivers but also offers the prospect of improving the lives of those who gain access to care.
Many low-income, homeless adults will be eligible for Medicaid for the first time in states that expand Medicaid eligibility under the Affordable Care Act, but enrolling them in the program can be difficult:  they can be hard to find, hard to convince to apply, and hard to enroll because they lack such basics as a mailing address and telephone number.
Yet bringing health care to such individuals could greatly improve their lives and perhaps help address their homelessness by ending the financial stresses that resulted in homelessness or improving their health to the point where they qualify for housing services.
Health Benefits Claim FormWhile Pennsylvania still has not expanded its Medicaid program, it now appears to be on a cautious path toward doing so in the near future.  If it does, enrolling the homeless in Medicaid also offers the prospect of the state’s safety-net hospitals receiving Medicaid reimbursement for the care they provide to such patients, typically through their emergency departments.
Learn more about the challenges of enrolling the homeless and Medicaid and the benefits of Medicaid eligibility for the homeless in this New York Times article.

2013-11-26T06:00:25+00:00November 26th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off on Enrolling Homeless in Medicaid Poses Challenges, Offers Hope

Safety-Net Hospitals Bear Brunt of Medicare Penalties

Hospitals that serve the largest proportion of low-income patients are suffering the greatest financial penalties under Medicare’s value-based purchasing program.
Collectively, hospitals that serve the most low-income patients are seeing their Medicare payments reduced 0.09 percent during year two of the Medicare program while hospitals that serve the fewest low-income patients have seen their Medicare payments rise 0.06 percent, according to a new study by a Harvard School of Public Health professor.
Medicare’s value-based purchasing program, mandated by the Affordable Care Act, bases penalties and bonuses on 24 quality measures.
Financial paperworkIn Pennsylvania, 45 percent of the state’s hospitals received bonuses while 53 percent were penalized; both figures are the same as the national averages.  The average bonus for Pennsylvania hospitals was 0.24 percent – the national average – while the average penalty was 0.20 percent, slightly lower than the national average of 0.26 percent.
The author of the study suspects that the performance of safety-net hospitals may be suffering from the manner in which their patients are responding to the patient satisfaction survey that is one of the determining factors in evaluating hospital performance.
For a closer look at the study and its findings, see this Kaiser Health News report.

2013-11-22T06:00:26+00:00November 22nd, 2013|Affordable Care Act, Health care reform|Comments Off on Safety-Net Hospitals Bear Brunt of Medicare Penalties

400,000 Fall Into PA Insurance Gap

400,000 Pennsylvanians currently fall into a gap between eligibility for the state’s Medicaid program and qualifying for health insurance subsidies through the state’s health insurance marketplace.
Under the Affordable Care Act, states were to expand eligibility for their Medicaid programs while the federal government would provide partial subsidies for low-income people who remained ineligible for Medicaid but were unlikely to be able to afford health insurance without such assistance.
Harrisburg, PA capital buildingBut when the Supreme Court made Medicaid expansion optional for states, many people fell into a new insurance gap that was not anticipated when the 2010 reform law was written.  Approximately half of the 50 states have expanded their Medicaid programs as the law expected, but in the half that did not, millions remain in this gap, earning too much money to qualify for Medicaid but not enough to be able to afford health insurance.
Among those millions are 400,000 Pennsylvanians because the commonwealth has not decided to move forward and expand its Medicaid program.  Currently, state officials are exploring such expansion through a new “Healthy Pennsylvania” initiative and are negotiating possible terms for expansion with the federal government.
Learn more about Pennsylvania’s insurance gap, who is in it, why it exists, and why it is a candidate to disappear sometime in the future in this Philadelphia Inquirer article.

2013-11-20T06:00:19+00:00November 20th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Uncategorized|Comments Off on 400,000 Fall Into PA Insurance Gap
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