Pennsylvania safety-net hospitals Archives - Page 17 of 20 - Safety-Net Association of Pennsylvania

SNAP Comments on Observation Rate Proposal

The Safety-Net Association of Pennsylvania has submitted a formal comment letter to the state’s Department of Public Welfare in response to the department’s expressed interest in establishing an observation rate in the state’s Medical Assistance fee-for-service program.
DPW expressed this interest in a June 29 Pennsylvania Bulletin notice.
SNAP supports the creation of an observation rate, and in its letter it outlines how it believes DPW should go about developing a rate that is fair to hospitals.
Safety-net hospitals have a special interest in this issue because observation rate candidates enter hospitals through their emergency rooms and safety-net hospitals typically have among the busiest emergency rooms in the communities they serve.
Read SNAP’s observation rate comment letter here .

PA Safety Net Admin2013-07-23T16:12:30+00:00July 23rd, 2013|Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

DSH Delay Bill Picks Up Co-Sponsors

A bill that would delay implementation of Medicaid disproportionate share (Medicaid DSH) and Medicare DSH payment cuts for two years now has 46 co-sponsors in the U.S. House of Representatives.
H.R. 1920, the DSH Reduction Relief Act of 2103, would delay for two years the DSH cuts mandated by the Affordable Care Act.
The rationale underlying the proposal is that between some states choosing not to expand their Medicaid programs as the reform law envisioned and the delay in imposing the mandate for businesses to help their employees with health insurance, the expected rise in the rate of insurance will be slower than expected and hospitals that care for especially large numbers of low-income patients will have a greater need for DSH revenue than originally anticipated.
Because they serve so many more low-income patients than the typical acute-care hospital and Pennsylvania is not among the states planning to expand eligibility for Medicaid, the state’s safety-net hospitals are especially interested in this issue and have conveyed their support for the bill both to Congress and to the administration.
Read more about the proposed DSH delay bill and its prospects for passage in this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-07-19T06:00:20+00:00July 19th, 2013|Health care reform|Comments Off

Low-Income Patients Prefer Hospital ERs

Even when they have health insurance, many low-income patients prefer receiving care in hospital emergency rooms rather than private physician offices or clinics.
According to a new study published in the journal Health Affairs, low-income patients cite convenience, cost, and quality as reasons for their preference.
These findings emerge at a time when government and insurers are working hard to find ways to reduce overuse of costly hospital emergency room services.
Emergency room overuse is especially a problem for many of Pennsylvania’s safety-net hospitals, which often have among the busiest emergency facilities in the regions they serve.
Read more about the new study in this report from the Robert Wood Johnson Foundation and find the study itself here, on the Health Affairs web site.

PA Safety Net Admin2013-07-16T06:00:59+00:00July 16th, 2013|Uncategorized|Comments Off

Closer Scrutiny Needed for Medicaid Managed Care?

With Medicaid expansion about to begin in many states and managed care expected to be a major tool in that expansion, advocates are suggesting that states need to do a better job of monitoring the performance of the managed care plans that serve their Medicaid population.
Currently, according to advocates, different states monitor their Medicaid managed care plans for different aspects of their performance and some states do a better job than others. With relatively few federal standards, state-to-state comparisons either are difficult or impossible.
Thirty-six states and the District of Columbia have at least some Medicaid patients enrolled in managed care plans, and together, those plans receive about one out of every four dollars that the states and the federal government spend on Medicaid.
With nearly all of the state’s Medicaid recipients now in managed care plans, this issue is of special interest to Pennsylvania’s safety-net hospitals.
Read more about the issue, the challenges, and why this issue is now receiving attention in this Kaiser Health News report .

PA Safety Net Admin2013-07-10T06:00:18+00:00July 10th, 2013|Pennsylvania Medicaid policy|Comments Off

Will Medicaid Coverage Mean Access?

With many states preparing to expand their Medicaid programs and enroll unprecedented numbers of new people, it is not clear whether Medicaid coverage will lead to access to care.
That concern arises in the wake of a survey that found that only 43 percent of physicians accept Medicaid patients. Other providers, moreover, may not be up to filling the gap: the same survey found that only 20 percent of physician assistants and nurse practitioners serve Medicaid patients.
Thus, while more people than ever will have health insurance once the Medicaid expansion component of the Affordable Care Act takes effect, it is not clear whether those who find themselves newly insured will have reasonable access to medical services.
While the Affordable Care Act attempts to anticipate this challenge by raising the traditionally low fees that Medicare pays primary care physicians to the same level as those paid by Medicare for the next two years, it is not clear whether this new policy is working and if will have a lasting impact after the two-year experiment ends.
This could become a major challenge for Pennsylvania’s safety-net hospitals if the state eventually chooses to expand its Medicaid program. To date, the state has chosen not to expand the program but has been discussing the possibility of doing so with federal officials. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state.
Read more about the survey and its implications in this Healthcare Finance News report .

PA Safety Net Admin2013-05-08T06:00:00+00:00May 8th, 2013|Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

ER Overuse May be Overstated

The common perception that many hospital emergency rooms are significantly overused by people not suffering genuine medical emergencies may not be accurate according to a new report published in the Journal of the American Medical Association.
According to the study “Comparison of Presenting Complaint vs. Discharge Diagnosis for Identifying ‘Nonemergency’ Emergency Department Visits,” many ER patients who turn out not to be suffering genuine medical emergencies present with virtually the same symptoms as patients who are suffering true emergencies. This suggests that it may be unreasonable in at least some cases for patients to determine whether their medical problems genuinely require emergency assistancePennsylvania’s safety-net hospitals typically experience very high emergency room utilization.
Overuse of hospital emergency rooms is frequently cited as a major cause of rising health care costs.
Read more about these latest findings in this New York Times blog entry and find the JAMA study here.

PA Safety Net Admin2013-04-03T06:00:54+00:00April 3rd, 2013|Uncategorized|Comments Off

Feds Offer New Carrot to Promote Medicaid Expansion

In their desire to persuade states to expand their Medicaid programs as called for in the Affordable Care Act, federal officials are now suggesting that states could use new federal Medicaid funds to enable Medicaid-eligible people to purchase private insurance.
Even though this was not envisioned in the health reform law, the prospect of making greater use of the private sector appears to be appealing to many Republican governors who have otherwise been reluctant to commit their states to expanding their Medicaid programs.
Pennsylvania has no current plans to expand Medicaid eligibility, although there appears to be growing interest in doing so throughout the state. Expansion would add approximately 500,000 people to the state’s Medicaid rolls, many of whom would be served by safety-net hospitals. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the commonwealth.
Read more about how this idea came about, why many states find it appealing, how it would work, and what the potential challenges are in this New York Times article .

PA Safety Net Admin2013-03-27T06:00:31+00:00March 27th, 2013|Health care reform, Safety-Net Association of Pennsylvania|Comments Off

Immigrants Muddy Reform Calculus for Safety-Net Hospitals

Immigrants to the U.S. – legal and not – pose a special challenge in the health care environment of the future.
Legal immigrants will not be able to benefit from many of the Affordable Care Act’s provisions until they have resided in the U.S. for five years while undocumented residents will not benefit from the reform law’s Medicaid expansion at all. Meanwhile, many of these individuals will continue to turn to health care providers, and especially to hospitals, when they are sick or injured.
But is this is a problem? And if it is, how great a problem is it? How many such individuals are there?
The Robert Wood Johnson Foundation has attempted to answer that question in a new report titled “State Estimates of the Low-Income Uninsured Not Eligible for the ACA Medicaid Expansion.” Among the report’s findings, it notes that

Safety-net health care providers are likely to continue to be key providers for this population after health reform, and the need for safety-net care will not be spread evenly across states. The capacity of safety-net providers to fill this gap will need to be assessed. While all states will need to develop strategies for meeting the health care needs of these adults, the challenges will be particularly difficult for safety-net providers in states with large numbers of immigrants who will not be eligible for Medicaid.

According to the report, about two percent of Pennsylvania’s non-elderly adults are unauthorized or recent legal immigrants; three percent of the state’s low-income, non-elderly adults are unauthorized or recent legal immigrants; and six percent of the state’s low-income, uninsured, non-elderly adults are unauthorized or recent legal immigrants.
Many of these individuals will undoubtedly turn to Pennsylvania’s safety-net hospitals for medical services.
Find the report here .

PA Safety Net Admin2013-03-26T06:00:04+00:00March 26th, 2013|Health care reform|Comments Off

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress.
The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report.
First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid.
And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than the program’s limit to retain their Medicaid eligibility for several additional months.
The MACPAC report also includes analyses of several issues involving services for dually eligible (Medicare and Medicaid) individuals.
Because Pennsylvania’s safety-net hospitals serve so many Medicaid, CHIP, and dually eligible patients, MACPAC’s recommendations and analyses can be especially important to them.
Find the MACPAC March 2013 report here .

PA Safety Net Admin2013-03-25T06:00:01+00:00March 25th, 2013|Uncategorized|Comments Off

DSH Losses Will Hurt Safety-Net Hospitals

Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014.
So concludes Moody’s, the bond-rating agency.
The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes.
Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act.
Hospitals face other specific challenges as well as a result of these cuts.
Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this report in Becker’s Hospital Review.

PA Safety Net Admin2013-03-20T06:00:57+00:00March 20th, 2013|Health care reform|Comments Off

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