Pennsylvania safety-net hospitals Archives - Page 20 of 21 - Safety-Net Association of Pennsylvania

Post-Election Diagnosis for Health Care

While President Obama’s re-election probably spells the end of talk of repealing the Affordable Care Act, many questions remain about how – and how completely – the health care reform law passed in 2010 will be implemented.
In the days following the election, observers are asking these and other questions.
In the article “Federal Deficit Talks Could Impact Obama’s Moves on Health Law,” Kaiser Health News speculates about the future of some of the more controversial and expensive aspects of the Affordable Care Act, including creation of the Independent Payment Advisory Board; the extensive insurance subsidies for which many Americans will be eligible; the future of the medical device tax; and the law’s provisions that limit the degree to which insurers can charge higher rates for older people.
The Stateline web site looks at the decisions ahead for state governments in the article “Obama Win Means Big Health Care Decisions for States.” Many governors still have not declared whether their state will expand their Medicaid programs – a move required by the Affordable Care Act but made optional by the Supreme Court in a June 2012 decision.
The first issue that will be addressed, though, is state decisions on whether to create their own health insurance exchanges, a key part of the reform law, or let the federal government create those exchanges for them. States are required to inform the federal government of their intentions by November 16, although it now appears they will be given more time. Pennsylvania is among the states that have not yet declared their intentions.
Meanwhile, looming over the health care industry is the prospect of sequestration, part of last year’s deficit reduction compromise, that leaves Medicaid untouched but will require a cut of two percent in all Medicare payments beginning on January 1 unless Congress acts to prevent these cuts. Read more about this in an article from The Hill titled “Sequester Would Cut $11 Billion from Medicare.”
These and other issues are of particular importance to Pennsylvania’s safety-net hospitals because of the especially large numbers of low-income and publicly insured patients they serve.

PA Safety Net Admin2012-11-09T10:42:28+00:00November 9th, 2012|Health care reform|Comments Off

Shift to HealthChoices Hits Bumps in the Road

Pennsylvania’s switch to HealthChoices to serve nearly the entire state Medicaid population is running into short-term obstacles in parts of the state.
Some recipients, for example, failed to choose a participating managed care plan, were assigned to plans, and now are confused about where to go and how to obtain care. In other instances, physicians are still negotiating with those plans or waiting to be credentialed for participation.
Some Pennsylvania safety-net hospitals, because of where they are located and their especially large numbers of Medicaid patients, may experience these problems more than the average hospital.
Read more about the challenges Medicaid recipients are encountering during this transition in this Erie-Times News article .

PA Safety Net Admin2012-11-08T06:00:02+00:00November 8th, 2012|Pennsylvania Medicaid policy|Comments Off

Medicaid Primary Care Pay Raise Set; OB/GYNs, ER Docs Excluded

When the Affordable Care Act’s mandatory rate increase for primary care services provided to Medicaid patients takes effect on January 1, ob/gyns and emergency room physicians will not be among the beneficiaries of the temporary raise in pay.
Under a new regulation issued last week, only family doctors, internists, and pediatricians will receive the pay increase, which was established as a short-term (two years) incentive to attract more physicians to serve Medicaid patients in anticipation of the significant increase in enrollment expected when many states expand their Medicaid eligibility criteria in 2014.
When working under the supervision of eligible primary care physicians, nurse practitioners and physician assistants also will receive the enhanced Medicaid payments.
State Medicaid payments for primary medical care typically fall well below comparable Medicare rates. Under the reform law, Medicaid payments for such services will be raised to Medicare levels for two years, with the federal government footing the bill for the difference.
Because they serve so many Medicaid patients and the state’s outpatient fees are so much lower than those paid by Medicare, Pennsylvania’s safety-net hospitals and the primary care physicians they employ should benefit greatly from this new policy.
Read more about who will and won’t benefit from the primary care fee increase and how it will be implemented in this Kaiser Health News article .

PA Safety Net Admin2012-11-05T06:00:03+00:00November 5th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Implementation of Reform Act’s Medicaid Doc Pay Raise Uncertain

With the Affordable Care Act-mandated increase in Medicaid payments to primary care physicians now just a little more than two months away from taking effect, much remains unknown about how the increase will be implemented.
Under the 2010 reform law, payments to Medicaid primary care physicians will be increased to the same level as comparable Medicare payments, with the federal government picking up the entire $11 billion tab.
At this point, however, there are no regulations delineating how the increase will be achieved, leaving unanswered a number of questions, including what the new rates will be; how and when they will be paid; which physicians will receive them; and how physicians caring for Medicaid patients through managed care plans will receive their enhanced payments.
The purpose of the temporary, two-year increase is to attract more physicians to the care of Medicaid patients in time for the increased Medicaid eligibility that begins under the reform law in 2014.
Many physicians serving communities with large numbers of Medicaid patients, and those employed by Pennsylvania’s safety-net hospitals, are expected to benefit from this pay increase. Currently, Medicaid primary care physician payments in Pennsylvania are just 56 percent of comparable Medicare payments.
Learn more about the challenges of implementing this primary care physician Medicaid pay raise in this Kaiser Health News article.

PA Safety Net Admin2012-10-29T06:00:15+00:00October 29th, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Lawsuit Challenges Social Services Block Grants and the End of General Assistance Payments

A lawsuit has been filed in Pennsylvania’s Commonwealth Court challenging the state’s termination of General Assistance payments to low-income Pennsylvanians and the redirection of some state social services funding into block grants for selected counties.
General Assistance grants are small sums of money that were paid monthly to low-income Pennsylvanians. Many were thought to use this money for food, medicine, and other necessities.
Pennsylvania’s counties have long received social services funding from the state. Now, some counties have voluntarily agreed to accept less money in exchange for greater flexibility in how they spend it. Some of the services provided with this money are delivered by hospitals, including the state’s private safety-net hospitals.
The legal challenge is on procedural rather than policy grounds, with the plaintiffs alleging that the legislation that ended the General Assistance grants and created the social services block grant program violated a provision in the state constitution that requires legislation to address only a single issue.
Read more about the General Assistance and social services block grant lawsuit in this Philadelphia Inquirer article .

PA Safety Net Admin2012-10-26T06:00:16+00:00October 26th, 2012|Pennsylvania Medicaid policy, Pennsylvania state budget issues|Comments Off

Philadelphia Hospitals Hoping for Medicaid Expansion

Hospitals in the greater Philadelphia want the state to expand its Medicaid program as envisioned in the Affordable Care Act, the Philadelphia Business Journal reports.
According to a spokesman for the Delaware Valley Healthcare Council, Philadelphia-area hospitals are concerned that the state might not expand Medicaid eligibility. That expansion, mandated by the 2010 health care reform law, was made optional earlier this year by a Supreme Court decision.
Read more about why Philadelphia-area hospitals – many of which are safety-net hospitals – are eager for the state to embrace the reform law’s Medicaid eligibility expansion in this Philadelphia Business Journal article .

PA Safety Net Admin2012-10-22T06:00:32+00:00October 22nd, 2012|Health care reform, Pennsylvania Medicaid policy|Comments Off

Hospitals Worry About Lost DSH Money

Hospitals across the country are worried about what will happen come 2014, when the Affordable Care Act’s individual insurance mandate and Medicaid expansion take effect and they lose funds they currently receive from the federal government to help with the cost of caring for their low-income and uninsured patients.
Hospitals that care for large numbers of such patients receive what are known as disproportionate share hospital payments, commonly referred to as “DSH,” from both Medicare and Medicaid. Under the 2009 health care reform law, however, those payments will be reduced drastically in anticipation of a significant decline in the number of uninsured Americans.
The leaders of these hospitals, however, believe that even the individual insurance mandate and Medicaid expansion will still leave them with many uninsured patients to treat, including illegal residents and those who decline to buy insurance despite the insurance mandate.
Historically, DSH funds have been vital to the financial health of Pennsylvania’s safety-net hospitals.
Read more about this situation, and the challenges hospitals believe they will face as a result, in this New York Times article .

PA Safety Net Admin2012-08-01T06:00:12+00:00August 1st, 2012|Health care reform|Comments Off

Are Readmission Penalties Bad Medicine for Medicare Patients?

As the federal government prepares to penalize hospitals with high readmission rates, new research suggests that appropriate readmissions may actually result in better care for the nation’s seniors.

According to new research, some hospitals that have high readmissions rates for the medical conditions that Medicare tracks – heart attacks, heart failure, and pneumonia – also have higher survival rates among patients with those conditions.

Such findings, while preliminary, call into question the manner in which Medicare intends to adjust future payments to hospitals based on their readmission rates in the value-based purchasing program it will introduce in October of this year.

This issue is of particular concern to Pennsylvania’s safety-net hospitals, which care for many low-income and dually eligible seniors who have had sporadic contact with the health care system throughout their lives and often present multiple medical challenges that require more than one hospitalization to address.

Read more about these new findings and their implications in this Kaiser Health News report .

PA Safety Net Admin2012-07-27T06:00:16+00:00July 27th, 2012|Uncategorized|Comments Off

New Medicare Program Could Hurt PA’s Safety-Net Hospitals

A new federal initiative will use patient satisfaction to help determine Medicare payments to hospitals.

Under the new value-based purchasing program it will launch in October, Medicare will use the results of patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) as a factor in determining its payments to hospitals.

As reported in the Pittsburgh Post-Gazette, not everyone believes there is a tangible link between patient satisfaction and the quality of care a hospital provides – and not everyone believes the HCAHPS survey accurately measures either.

In addition, a recent article in the Archives of Internal Medicine reported that safety-net hospitals generally receive lower scores on the HCAHPS survey than other providers – a potentially major concern for Pennsylvania’s safety-net hospitals.

Read more about this controversial program in this Pittsburgh Post-Gazette report .

PA Safety Net Admin2012-07-24T06:00:56+00:00July 24th, 2012|Uncategorized|Comments Off

DSH and the Affordable Care Act

The National Health Law Program has prepared a useful Q&A about how the Affordable Care Act and its Medicaid expansion will affect Medicare disproportionate share (Medicare DSH) and Medicaid disproportionate share (Medicaid DSH) payments, both of which are so important to Pennsylvania’s safety-net hospitals.

Download that summary here .

PA Safety Net Admin2012-07-19T06:00:21+00:00July 19th, 2012|Health care reform, Medicaid supplemental payments|Comments Off

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