Pennsylvania safety-net hospitals Archives - Page 11 of 20 - Safety-Net Association of Pennsylvania

Socio-Economic Status Affects Health, Study Shows

A new study by California state public health officials has concluded that demographic factors have a major influence on individuals’ health.
Among the factors specifically cited in the study are education, employment status, gender identity, race and ethnicity, income, and sexual orientation.
In Portrait of Promise: The California Statewide Plan to Promote Health and Mental Health Equity, the California Department of Public Health’s Office of Health Equity identifies and describes the socio-economic factors that influence health status and proposes interventions for overcoming those challenges.
SNAP has long pointed to such challenges as one of the chief distinctions between Pennsylvania’s safety-net hospitals and other hospitals in the state.
See the California report here.

PA Safety Net Admin2015-09-08T06:00:44+00:00September 8th, 2015|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized|Comments Off

GAO Looks at Behavioral Health Options

Access to behavioral health services can be a challenge for low-income adults, so the U.S. Government Accountability Office (GAO) recently looked into those challenges.
In a new report, the GAO examined how many low-income adults have behavioral health problems, where they can go to receive the care they need – including whether there are differences in those options depending on whether the state in which the reside has expanded its Medicaid program – how Medicaid expansion states are providing coverage for behavioral health for newly eligible beneficiaries, and how obtaining Medicaid coverage affects the ability of such individuals to get the care they seek.
Access to behavioral health care can be an especially major challenge in the low-income communities typically served by Pennsylvania’s safety-net hospitals.
Read about the GAO’s findings in the report Options for Low-Income Adults to Receive Treatment in Selected States, which you can find here.

PA Safety Net Admin2015-07-24T06:00:04+00:00July 24th, 2015|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Graduate Medical Education: Boon or Bane for Hospitals’ Bottom Line?

Do hospitals make money on graduate medical education? Do they lose money subsidizing positions above and beyond the funding they receive for completing the training of the next generation of doctors? Are there other benefits hospitals reap from medical education training programs – and are those benefits worth the cost?
This is an important question for the many Pennsylvania safety-net hospitals that also are teaching hospitals.
Crain’s Detroit Business has taken a look at some of the surprisingly complex considerations that go into answering what seem like very simple questions. Go here for its report “Hospitals say they subsidize graduate medical education, but cost-benefit unknown.”

PA Safety Net Admin2015-07-23T06:00:32+00:00July 23rd, 2015|Medicare|Comments Off

Report on Public Health and Health Care

The Institute of Medicine (IOM) has published a report summarizing its February workshop that explored the relationship between public health and health care.
According to the IOM, the workshop

… was designed to discuss and describe the elements of successful collaboration between health care and public health organizations and professionals; reflect on the five principles of primary care–public health integration (which can be applied more broadly to the health care–public health relationship): shared goals, community engagement, aligned leadership, sustainability, and data and analysis; and explore the “elephants in the room” when public health and health care interact: what are the key challenges and obstacles and what are some potential solutions, including strengths both sides bring to the table. The workshop presentations reflected on collaboration in four contexts: payment reform, the Million Hearts initiative, hospital – public health collaboration, and asthma control.

Because of the nature of the communities they serve and the work they do, Pennsylvania safety-net hospitals are often important parts of public health efforts throughout the commonwealth.
Find the IOM report Collaboration between Health Care and Public Health: Workshop Summary here.

PA Safety Net Admin2015-07-01T06:00:05+00:00July 1st, 2015|Uncategorized|Comments Off

Feds Propose New Medicaid Managed Care Regs

The Centers for Medicare & Medicaid Services (CMS) has proposed its first major changes in regulations governing Medicaid managed care in more than a decade.
In a 653-page draft regulation published on Monday, CMS proposes imposing a medical-loss ratio on Medicaid managed care plans; establishing new standards for adequate provider networks; partially lifting the ban on payments to institutions for mental diseases; pursuing greater transparency in rate-setting; and new quality initiatives that mirror those of Medicare and the federal marketplace.
In addition, the proposed regulation calls for new marketing guidelines for Medicaid managed care plans, improved access to information for Medicaid beneficiaries, and new program integrity measures. It also proposes better aligning the governance of CHIP with Medicaid, new requirements for managed long-term services and supports, and new tools for fostering delivery system reform at the state level.
With virtually all Medicaid recipients in Pennsylvania now enrolled in managed care plans, this regulation will be significant for the state’s safety-net hospitals.
Interested parties have until July 27 to submit comments to CMS about the proposals.
To learn more about this major regulatory proposal, see this Kaiser Health News article; find the regulation here; and see this CMS fact sheet on the draft regulation.

PA Safety Net Admin2015-05-28T06:00:35+00:00May 28th, 2015|Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Post-Mortem on the Medicaid Primary Care Fee Bump

The Affordable Care Act required state Medicaid programs to raise their fees for primary care services to the same level as Medicare rates, with the federal government shouldering the full cost of the difference. The rationale for the increase was that with millions of additional Americans expected to enroll in Medicaid in the coming years, a rate increase would encourage more primary care physicians to serve Medicaid patients because historically, many choose not to do so because of what they believe to be inadequate payments.
That two-year Medicaid primary care fee bump ended on December 31, 2014. Sixteen states and the District of Columbia felt the increase was beneficial enough to extend it using their own resources. Pennsylvania is not among the states that continued paying the enhanced rates.
The question of whether the fee increase accomplished its objective and is worth re-establishing remains unanswered. The brief nature of the experiment – only two years – and the delays many states experienced before they started paying the enhanced rates left little time for meaningful research. One quantitative analysis suggests the rate increase helped, there have been several more qualitative approaches to research, and some studies remain under way.
Because they care for so many more Medicaid patients than the typical hospital, the adequacy of Medicaid payments has long been of special concern to Pennsylvania safety-net hospitals.
For a closer look at the Affordable Care Act’s Medicaid primary care fee bump, how it worked, its impact, and its future, see the new health policy brief “Medicaid Primary Care Parity” here, on the web site of the journal Health Affairs.

PA Safety Net Admin2015-05-15T06:00:54+00:00May 15th, 2015|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

New 340B Rules Expected Soon

The federal Health Resources and Services Administration (HRSA) is expected to release new rules governing its section 340B prescription drug discount pricing program in the near future.
The new rules have long been in development and were in the verge of being published late last year when the agency decided to try another approach to addressing some of the program’s problems, but now, new draft guidelines are being reviewed by the White House Office of Management and Budget (OMB) in anticipation of being published soon in the Federal Register.
The 340B program, which provides discounts on prescription drugs to hospitals and others that serve large numbers of low-income patients, has encountered controversy in recent years with providers complaining about the lack of transparency in drug manufacturers’ prices and the manufacturers claiming that the program’s benefits are being extended to some patients who do not qualify for the assistance.
The 340B program is a vital resource for most Pennsylvania safety-net hospitals.
To learn more about the program and what might be expected when the new rules are proposed, see this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2015-05-13T06:00:39+00:00May 13th, 2015|Pennsylvania safety-net hospitals|Comments Off

Looking at Payment and Delivery System Reform

Last fall the Robert Wood Johnson Foundation brought together grant recipients and national experts to talk about health care payment and delivery system reform design and implementation issues.
Now, the foundation has released a brief paper that addresses what the experts consider to be the three greatest challenges in the pursuit of such reform:

Aligning alternative payments with clinician compensation
Considering social determinants of health in payment reform models
Repurposing hospital resources

The paper also takes a look at whether health care payments should be subject to risk adjustment to reflect the social and economic barriers to better health and care that some patients face. This is an important issue for Pennsylvania’s safety-net hospitals because of the significant numbers of low-income patients they serve.
These issues and more are addressed in greater detail in the new paper “Three Emerging Challenges for Sustained Payment and Delivery System Reform,” which can be found here.

PA Safety Net Admin2015-04-14T06:00:13+00:00April 14th, 2015|Uncategorized|Comments Off

Medicare-Medicaid Coordination Office Reports to Congress

The federal agency created by the Affordable Care Act to facilitate better coordination of federal benefits for those eligible for both Medicare and Medicaid has issued its annual report on its activities to Congress along with a number of recommendations for future policy changes.
In addition to reporting on its work over the past year, the Medicare-Medicaid Coordination Office recommended that Congress consider legislation to:

Create a pilot to expand the PACE program (Programs of All-Inclusive Care for the Elderly) to people between the ages of 21 and 55.
Ensure retroactive Medicare Part D coverage for newly eligible low-income beneficiaries.
Establish an integrated appeals process for dually eligible (Medicare and Medicaid) enrollees.
Allow for federal/state coordinated review of duals special need plan marketing materials.

The report also identified three areas the agency intends to explore further in the coming year:

Coverage standards for overlapping Medicare and Medicaid benefits.
Cost-sharing rules for qualified Medicare beneficiaries.
Quality measures and Medicare-Medicaid enrollees.

Because they serve so many low-income, dually eligible patients, Pennsylvania’s safety-net hospitals often have a considerable stake in this office’s efforts.
Find the Medicare-Medicaid Coordination Office’s complete report to Congress here.

PA Safety Net Admin2015-04-10T06:00:12+00:00April 10th, 2015|Uncategorized|Comments Off

MACPAC Looks at Value-Based Purchasing in Medicaid

At a recent meeting of the Medicaid and CHIP Payment and Access Commission (MACPAC), the agency’s staff made a presentation on how different states are pursuing value-based purchasing in their Medicaid programs.
The presentation focused on current efforts in three states: Connecticut, Maryland, and Oklahoma, describing the policy approach those states have taken, the models they employ, the implementation challenges they have faced, and how they evaluate the effectiveness of their efforts.
Because they care for so many Medicaid patients, Pennsylvania’s safety-net hospitals have a special interest in new approaches to paying for Medicaid services.
Find the MACPAC presentation here.

PA Safety Net Admin2015-04-09T06:00:12+00:00April 9th, 2015|Pennsylvania safety-net hospitals|Comments Off

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