Pennsylvania safety-net hospitals Archives - Page 17 of 21 - Safety-Net Association of Pennsylvania

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.
While 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.

PA Safety Net Admin2013-11-26T06:00:25+00:00November 26th, 2013|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Millions to Fall Into Coverage Gap

More than five million adult Americans will fall into the Affordable Care Act’s Supreme Court-created coverage gap in states that have chosen not to expand their Medicaid programs.
In those 26 states, adults whom the reform law intended to be covered by Medicaid will still earn too much money to qualify for Medicaid yet also will fall below the income level needed to qualify for Affordable Care Act health insurance subsidies.
This gap was created when the Supreme Court made the reform law-mandated Medicaid expansion optional for individual states, and so far, 26 states have chosen not to expand their Medicaid programs. The result, according to a new issue brief from the Kaiser Commission on Medicaid and the Uninsured, is that 5.2 million low-income adults whom the law intended to enroll in Medicaid will remain uninsured.
More than 280,000 of these people reside in Pennsylvania, which has not yet expanded its Medicaid program. Many will continue to be served by the state’s private safety-net hospitals, which will not be paid for the care they provide.
To learn more about these people and why they will remain uninsured, read the study “The Coverage Gap: Uninsured Poor Adults in States That Do Not Expand Medicaid.” Find the study here, on the web site of the Kaiser Family Foundation.

PA Safety Net Admin2013-10-16T10:08:33+00:00October 16th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

DPW Reaches Out to Stakeholders Over Tobacco $ Loss

Pennsylvania Department of Public Welfare Secretary Beverly Mackereth has sent the following message to health care providers and other stakeholders that will be affected by the state’s loss of $180 million in national tobacco settlement money as a result of a recent arbitrary decision.

October 2, 2013

I am reaching out to you, our valued stakeholder, to provide you with information about the potential impact of the recent tobacco master settlement agreement (MSA) decision. Please understand this legal action and the potential next steps are in no way a reflection of the quality of your work or actions as a partner with the Department of Public Welfare (DPW). This decision stems back to circumstances that occurred in 2003.

As you may be aware, the Pennsylvania Attorney General’s office recently notified the Governor’s Budget Office that the state’s annual share of the tobacco MSA will be reduced by an estimated $180 million, or 60 percent of the state’s base tobacco payment, as a result of a decision by an arbitration panel to address claims from 2003.

While this decision has immediate impacts to Pennsylvania’s health and human services programs, the Corbett Administration is committed to maintaining direct services and mandatory healthcare programs. I would like to reassure you that we are working diligently to ensure services will continue without interruption for all Pennsylvanians.

The reduction will occur in the state’s April 2014 MSA payment, which supports spending in the current fiscal year. This has forced the state to freeze discretionary funding from the MSA. As of now the only DPW program affected will be uncompensated care payments to hospitals.

Please be assured, this course of action was not arrived at lightly. Immediate action is necessary in the face of such a dramatic decrease in revenues due to the MSA decision. Moving forward, the Attorney General’s Office is preparing an appeal of the decision.

The attached press release provides additional information regarding this issue. I appreciate your time and understanding as we work together on this issue.

Sincerely,
Beverly Mackereth, Secretary
Department of Public Welfare

The loss of uncompensated care payments will pose a major challenge to the state’s safety-net hospitals, which are the primary providers of care to the uninsured in Pennsylvania and the primary recipients of these funds.
Go here for the press release cited above.

PA Safety Net Admin2013-10-04T06:00:00+00:00October 4th, 2013|Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

CMS Proposes Basic Health Program

The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposal to establish what it is calling a “Basic Health Program” that gives states “the option to establish a health benefits coverage program for low-income individuals who would otherwise be eligible to purchase coverage through the Health Insurance Marketplace.”
The program, established in the Affordable Care Act, is designed for people who do not qualify for Medicaid or CHIP and whose incomes are between 133 percent and 200 percent of the federal poverty level. Legal residents who are non-citizens whose incomes are below 133 percent of the federal poverty level also qualify. The federal government is picking up 95 percent of the cost of this program.
A new proposed regulation addresses who is eligible, how enrollment works, enrollee financial responsibilities, the program’s basic benefits, and more.
Such a program could prove beneficial to many low-income residents of communities served by Pennsylvania’s safety-net hospitals.
Read about the new Basic Health Program in this CMS fact sheet, which also includes a link to the entire proposed regulation.

PA Safety Net Admin2013-09-27T06:00:53+00:00September 27th, 2013|Affordable Care Act|Comments Off

CMS Finalizes Medicaid DSH Cuts

The Centers for Medicare & Medicaid Services (CMS) has issued a final Medicaid disproportionate share (Medicaid DSH) regulation that cuts federal spending on Medicaid DSH $500 million in FY 2014 and $600 million in FY 2015.
The Medicaid DSH cuts were mandated by the Affordable Care Act in anticipation of every state expanding its Medicaid program. The reform law’s Medicaid expansion mandate was later made optional by a Supreme Court ruling.
Medicaid DSH cuts will hurt all Pennsylvania safety-net hospitals, and the Safety-Net Association of Pennsylvania (SNAP) has conveyed its opposition to the cuts to CMS and also has asked members of Pennsylvania’s congressional delegation to support current legislation to delay the implementation of both Medicaid DSH and Medicare DSH cuts for two years.
While the Affordable Care Act calls for Medicaid DSH cuts through 2020, the new regulation covers only two years. CMS has indicated that it will review its reduction methodology for future years.
Read more about the Medicaid DSH cut, why it was made, the objections to it, and future Medicaid DSH cuts in this CQ Healthbeat article presented by the Commonwealth Fund.

PA Safety Net Admin2013-09-20T06:00:29+00:00September 20th, 2013|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Gap in Reform Law Could Leave Many Low-Income People Uninsured

When the Supreme Court gave states discretion over whether to expand their Medicaid programs under the Affordable Care Act, it unintentionally created a gap in potential coverage options for many low-income people that may leave many of those people without affordable health insurance.
According to a new report from the Commonwealth Fund, the 2010 reform law anticipated that everyone with incomes below 133 percent of the federal poverty level would be covered by Medicaid. Individuals and families with incomes between 133 percent and 399 percent of the federal poverty level could use new federal subsidies to help purchase private health insurance.
In states that are not expanding their Medicaid programs, people with incomes between 133 percent and 399 percent of the federal poverty level will still be able to take advantage of federal premium subsidies. People with incomes less than 133 percent of the federal poverty level but who do not qualify for their state’s Medicaid program – qualification criteria vary from state to state – will not be eligible for the same subsidies as many who earn more than them because the reform law assumed that all such individuals would be covered by Medicaid.
According to the Commonwealth Fund, this unanticipated gap in the reform law means that as many as 42 percent of people who suffer from periodic or chronic lack of insurance and who live in states that are not expanding their Medicaid programs will not benefit in any way from Affordable Care Act insurance reforms.
Pennsylvania is one of the states in which this problem will occur because the state is not expanding its Medicaid program. It almost certainly will require Pennsylvania’s safety-net hospitals to provide more uncompensated care than originally expected when the reform law was enacted.
Read more about the unintended consequences of the Supreme Court’s decision and the choice by some states not to expand their Medicaid programs in In States’ Hands: How the Decision to Expand Medicaid Will Affect the Most Financially Vulnerable Americans, a new report from the Commonwealth Fund.

PA Safety Net Admin2013-09-09T06:00:22+00:00September 9th, 2013|Affordable Care Act, Health care reform, Pennsylvania Medicaid policy|Comments Off

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

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