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Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing.
In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing:  what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts.
Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently chosen to serve the state’s Medicaid population through the HealthChoices physical health program.
For a closer look at Medicaid value-based purchasing, go here to read the National Association of Medicaid Directors’ issue brief “Medicaid Value-based Purchasing:  What Is It & Why Does It Matter?”

2017-02-17T06:00:19+00:00February 17th, 2017|Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Medicaid Directors Look at Value-Based Purchasing

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2017 newsletter.
Included in this edition are stories about:

  • impending changes in the lineup of managed care providers that serve Medicaid participants in the state’s HealthChoices program for physical health services;
  • the status of the state’s implementation of its Community HealthChoices program of managed long-term services and supports for low-income, elderly Pennsylvanians who seek to continue living independently in the community;
  • the potential impact of a repeal of the Affordable Care Act on Pennsylvanians; and
  • Pennsylvania’s receipt of a Certified Community Behavioral Health Clinic demonstration grant from the federal government to improve services and care coordination for individuals on Medicaid or CHIP.

Go here for the latest edition of PA Health Law News.

2017-02-08T17:39:17+00:00February 8th, 2017|Affordable Care Act, HealthChoices PA, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on Pennsylvania Health Law Project Newsletter

Pennsylvania Health Law Project Releases Monthly Newsletter

The Pennsylvania Health Law Project has published the April 2016 edition of Health Law News, its monthly newsletter.
phlpIncluded in this edition are articles about a new, faster process the state has introduced for people to enroll in Medicaid; the awarding of contracts to managed care organizations to participate in the state’s HealthChoices program; an update on the Community HealthChoices program that will help nursing home-eligible seniors remain independent in the community; new funding for the state’s “Money Follows the Person” demonstration program; and more.
Find the latest edition of Health Law News here.

2016-05-06T06:00:03+00:00May 6th, 2016|HealthChoices PA, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off on Pennsylvania Health Law Project Releases Monthly Newsletter

DHS Secretary Describes Initiatives

In an op-ed piece in the Scranton Times-Tribune, Pennsylvania Department of Human Services Secretary Ted Dallas has outlined his organization’s major achievements of 2015 and its plans for 2016.
ted dallasAmong them are the state’s expansion of its Medicaid program and its plans to establish new contracts with HealthChoices managed care organizations that seek to shift the program’s emphasis from volume of care to value and outcomes through greater use of accountable care organizations (ACOs), bundled payments, patient-centered medical homes, and other value-based initiatives.
Find Secretary Dallas’s commentary here.

2016-01-04T11:40:53+00:00January 4th, 2016|HealthChoices PA, Pennsylvania Medicaid policy|Comments Off on DHS Secretary Describes Initiatives

DHS Explains Latest Medicaid Initiatives

pa dhsThe Pennsylvania Department of Human Services describes two recent steps to improve the delivery of health care to low-income Pennsylvanians – the introduction of its new “Community HealthChoices” program and the re-bidding of managed care organization contracts for its HealthChoices physical health program – in the latest edition of its newsletter The Impact.
Find that edition here.

2015-09-29T06:00:21+00:00September 29th, 2015|HealthChoices PA, Pennsylvania Medicaid policy|Comments Off on DHS Explains Latest Medicaid Initiatives

439,000 Added to PA Medicaid Rolls

150,000 Pennsylvanians have enrolled in Medicaid since the Wolf administration officially launched its HealthChoices expansion on April 27.
Added to the 289,000 who enrolled during the Corbett administration’s Healthy Pennsylvania program, that means about 439,000 Pennsylvanians have obtained Medicaid coverage since the state expanded its Medicaid program as authorized by the 2010 federal health care reform law.
To learn more about the latest Medicaid enrollments, their financial impact on the state, and how the HealthChoices expansion works, see this Wolf administration news release.

2015-07-27T06:00:19+00:00July 27th, 2015|Affordable Care Act, HealthChoices PA, Healthy PA|Comments Off on 439,000 Added to PA Medicaid Rolls

State Shares Preliminary Thoughts on HealthChoices Procurement

In anticipation of releasing a request for proposals later this year seeking health insurers interested in participating in Pennsylvania’s HealthChoices program for Medicaid beneficiaries, the state’s Department of Human Services (DHS) issued a request for information (RFI) in late May seeking input from stakeholders and interested parties on what the state might do through its next generation of HealthChoices contracts to improve the program and its delivery of care.
Now that the deadline for submitting comments has passed, DHS has released a new document that shares the comments offered most frequently by those who responded to the RFI along with brief descriptions of some of the changes the department is considering when it solicits bids for HealthChoices managed care plans later this year.
Find the original May RFI here, SNAP’s response to that RFI here, and the recent DHS follow-up document here.

2015-07-02T06:00:19+00:00July 2nd, 2015|HealthChoices PA, Pennsylvania Medicaid policy|Comments Off on State Shares Preliminary Thoughts on HealthChoices Procurement

SNAP Calls for HealthChoices Improvements

The Safety-Net Association of Pennsylvania has urged Pennsylvania’s Department of Human Services to pursue transformative innovation in the state’s HealthChoices Medicaid managed care program.
Safety-Net Association of Pennsylvania logoIn particular, SNAP has called on DHS to create regional health collaboratives consisting of both insurers and providers to work together to deliver better, more coordinated care to Pennsylvania’s Medicaid population.
SNAP also recommended that the state finance innovation by implementing a Delivery System Reform Incentive Payments program, better known as DSRIP, to fund innovation in the state’s  Medicaid program.
SNAP’s suggestions came in response to a request for information issued by the state seeking recommendations for how to improve the HealthChoices program in anticipation of the state’s plan to rebid HealthChoices managed care contracts later this year.
See the state’s request for information here and find SNAP’s comment letter here.

2015-06-29T06:00:03+00:00June 29th, 2015|HealthChoices PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off on SNAP Calls for HealthChoices Improvements

PA Issues Bulletin on Medicaid Expansion

The Pennsylvania Department of Human Services (DHS) has issued a new Medical Assistance Bulletin on the state’s expansion of its Medicaid program via the HealthChoices managed care program.
Bookshelf with law booksThe bulletin notifies providers of the introduction of a new adult benefit package that applies to all adult Medicaid recipients in the state, highlighting some of the major changes in benefits from past packages.  It also provides information about the state’s plan for a phased transition from the current private care option (PCO) insurance plans to HealthChoices plans over the coming months.
See DHS Medical Assistance Bulletin 99-15-05 here.

2015-04-30T06:00:10+00:00April 30th, 2015|HealthChoices PA, Medical Assistance Bulletin, Pennsylvania Medicaid policy|Comments Off on PA Issues Bulletin on Medicaid Expansion

PA Completes First Phase of Medicaid Transition

Last weekend Pennsylvania’s Department of Human Services (DHS) formally moved more than 121,000 people from the Corbett administration’s Healthy Pennsylvania Medicaid expansion program to the Wolf administration’s expansion of the state’s long-time HealthChoices Medicaid managed care program.
Those who were shifted had enrolled in Healthy Pennsylvania private coverage option (PCO) plans before the end of calendar year 2014.  In the next few days they will receive written notification of the shift.  All will receive the same Medicaid benefits:  a basic adult benefit package.
Individuals will no longer be able to enroll in PCO plans, and over the next few months more than 137,000 Pennsylvanians still in PCO plans will be shifted into HealthChoices plans in stages with completion expected by September 1.
For more information about the continued transition from Healthy Pennsylvania to HealthChoices, see this news release from the governor’s office.

2015-04-28T06:00:43+00:00April 28th, 2015|HealthChoices PA, Healthy PA, Pennsylvania Medicaid policy|Comments Off on PA Completes First Phase of Medicaid Transition
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