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

Medicaid Expansion to Ease Hospitals’ Uncompensated Care But Not in PA

Hospitals in states that expand their Medicaid programs under provisions of the Affordable Care Act should see a reduction in their uncompensated care once people begin applying for Medicaid benefits.
That will not be happening in Pennsylvania, however, because the state is not expanding eligibility for its Medicaid program.
In states that do expand their programs, hospitals will continue to lose money serving Medicaid patients because Medicaid payments seldom cover the cost of the services hospitals provide. Demand for Medicaid services will grow in these states, moreover, as more people become eligible for benefits and some who have not had regular access to care for years begin to use their new benefits to address long-standing medical problems.
Recent published reports suggest that the Corbett administration is working on an expansion plan, to be negotiated with the federal government, and that this plan may be revealed to the public this fall.
Michigan became the most recent state to decide to take advantage of the Affordable Care Act and expand its Medicaid program. For a look at how Medicaid expansion will affect hospitals in that state, see this Detroit Free Press article .

PA Safety Net Admin2013-09-04T13:40:02+00:00September 4th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

Insurance Subsidies Will Be Common

Nearly half of all individuals and families expected to turn to health insurance exchanges for insurance policies under the Affordable Care Act will be entitled to federal subsidies to help pay their premiums.
Those subsidies will average more than $5500 per family and cover two-thirds of a premium’s overall cost.
These subsidies will be critical for Pennsylvania’s safety-net hospitals, which currently find themselves providing significant amounts of uncompensated care to low-income but working individuals and families that cannot afford health insurance today.
These were among the findings of a recent Kaiser Family Foundation analysis. Read more about the analysis and the future that awaits individuals and families in the new individual health insurance market in this CQ HealthBeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-08-22T06:00:31+00:00August 22nd, 2013|Affordable Care Act|Comments Off

Tackling Medicaid “Super-Users”

All Pennsylvania safety-net hospitals have them: a relatively small number of Medicaid patients who are constantly in need of care.
Five percent of all Medicaid beneficiaries account for more than half of all Medicaid expenditures. The challenges such patients pose are legitimate: many have multiple chronic conditions.
How best to serve these patients? The Center for Medicaid and CHIP Services has been looking into this problem and the Center for Medicare and Medicaid Innovation and the Robert Wood Johnson Foundation have been underwriting demonstration programs designed to find better ways to care for these patients.
Read more about the problem and these models, and find a direct link to a Center for Medicaid and CHIP Services advisory bulletin on the subject, here on the Fierce Healthcare web site.

PA Safety Net Admin2013-08-01T06:00:23+00:00August 1st, 2013|Uncategorized|Comments Off

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

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