Pennsylvania safety-net hospitals Archives - Page 7 of 22 - Safety-Net Association of Pennsylvania

High-Deductible Plans Driving Rise in Hospital Bad Debt

Hospital bad debt rose in 2018 after several years of decline, and according to Moody’s, high-deductible health insurance is one of the major drivers of that increase.

According to the bond rating agency, non-profit hospitals are seeing growing amounts of bad debt as they struggle, often unsuccessfully, to collect from patients whose high deductibles leave them on the hook for meaningful amounts of care.

Kaiser Health News reports that 28 percent of covered workers, nearly half of them working for companies with fewer than 200 employees, now have health plan deductibles of at least $2000. That proportion of individuals with such high deductibles has nearly quadrupled in the last decade.

Bad debt can be an especially challenging problem for Pennsylvania safety-net hospitals because they care for so many low-income patients who, even when they have health insurance, often struggle to find the money to pay their share of the costs their plans do not cover.

Learn more about the bad debt challenge facing hospitals in the Healthcare Dive article “Nonprofit bad debt climbs again amid steeper deductibles, Moody’s says.”

PA Safety Net Admin2019-12-03T06:00:46+00:00December 3rd, 2019|Pennsylvania safety-net hospitals|Comments Off

Medicaid DSH Cut Delayed

Cuts in Medicaid DSH payments to hospitals will be delayed for another month after Congress passed, and the president signed, a continuing resolution to fund the federal government through December 20.

A cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states is mandated by the Affordable Care Act and has been delayed several times by Congress. If implemented, Medicaid DSH allotments to the states would be slashed $4 billion in FY 2020 and then $8 billion a year through FY 2025.

Cuts in allotments to the states would result in reductions of Medicaid DSH payments to DSH-eligible hospitals.

Medicaid DSH payments are a vital tool for helping safety-net hospitals care for the low-income residents of their communities. All Pennsylvania safety-net hospitals receive such payments.

The current cut is only temporary and expires when the continuing resolution expires after December 20.

PA Safety Net Admin2019-11-25T06:00:13+00:00November 25th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues|Comments Off

PA Safety-Net Hospitals Step Up When One of Their Own Closes

A core group of safety-net hospitals, led by SNAP members, has filled the gap left by the closure of Hahnemann University Hospital, another safety-net hospital, in Philadelphia.

Safety-Net Association of Pennsylvania logo The Philadelphia Business Journal reports that since Hahnemann’s closing was announced during the summer, ER volume has risen 15 percent, admissions have risen 12 percent, and births have risen more than 50 percent at Thomas Jefferson University Hospital, a SNAP member. Meanwhile, SNAP member Pennsylvania Hospital has seen its ER visits rise nine percent, SNAP member Penn Presbyterian Medical Center has seen its ER volume increase five percent, and SNAP member the Hospital of the University of Pennsylvania has seen its ER volume rise five percent.

Patient volume also has risen significantly at Temple University Hospital.

Learn more about how Pennsylvania safety-net hospitals, including SNAP members, have filled the void left by the closing of another safety-net hospital in the Philadelphia Business Journal article “Hahnemann fallout: Nearby hospitals see uptick in ER visits, admissions.”

PA Safety Net Admin2019-10-25T06:00:53+00:00October 25th, 2019|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

PA to Invest in Philadelphia Community Served by Safety-Net Hospitals

Pennsylvania will spend more than $4 million on health-related services in the North Philadelphia Enterprise Zone, an area in which nearly 13 percent of the state’s Medicaid population resides.

Hospital building This area is served almost exclusively by Pennsylvania safety-net hospitals and recently suffered a major loss when one of those providers, Hahnemann University Hospital, closed its doors. According to a SNAP analysis, more than 50 percent of the patients previously served by Hahnemann will now turn for care to SNAP members Thomas Jefferson University Hospital (18.3 percent), Pennsylvania Hospital (11.3 percent), the Hospital of the University of Pennsylvania (nine percent), Penn Presbyterian Medical Center (4.7 percent), Jefferson Health Northeast (4.1 percent), and Mercy Hospital Philadelphia (3.2 percent).

The $4 million will be spent on expanded home visiting services for families with children, eviction prevention assistance for low-income families, and programs that help residents move from public assistance to jobs.

Learn more in the Philadelphia Business Journal article “State Invests in North Philadelphia’s Health Enterprise Zone.”

PA Safety Net Admin2019-10-22T06:00:28+00:00October 22nd, 2019|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Safety-Net Hospitals Rally to Fill Void When Safety-Net Hospital Closes

When a safety-net hospital in Philadelphia closed recently, many predicted a crisis.

But there was no crisis.

Instead, patients previously served by Hahnemann University Hospital, a Pennsylvania safety-net hospital that served especially large numbers of Medicaid and uninsured patients, are now being served by other safety-net hospitals in Philadelphia: mostly, Jefferson Health, the University of Pennsylvania Health System, Einstein Healthcare Network, and Temple University Hospital. All report increased volume in their emergency rooms, more ambulance arrivals, and more inpatient admissions, but at least so far, they also report that they are comfortably handling the increased patient volume created when Hahnemann closed its emergency room and discharged its last patients in July.

Learn more in the Philadelphia Inquirer article “Hahnemann’s end was expected to be a crisis. But that’s not what happened, Philly health officials say.”

PA Safety Net Admin2019-10-07T06:00:40+00:00October 7th, 2019|Pennsylvania safety-net hospitals|Comments Off

CMS Proposes Easing Medicaid Access Protections

States would have to do less to ensure access to Medicaid-covered services for their Medicaid population under a new regulation proposed by the Centers for Medicare & Medicaid Services.

In 2015, CMS required states to track their Medicaid fee-for-service payments and submit them to the federal government as part of a process to ensure that Medicaid payments were sufficient to ensure access to care for eligible individuals. Now, CMS proposes rescinding this requirement, writing in a news release that

This proposed rule is designed to help streamline federal oversight of access to care requirements that protect Medicaid beneficiaries. CMS anticipates that the proposed rule would, if finalized, result in overall cost savings for State partners that could be redirected to better serve the needs of their beneficiaries.

The proposed regulation itself explains that

While we believe the process described in the current regulatory text is a valuable tool for states to use to demonstrate the sufficiency of provider payment rates, we believe mandating states to collect the specific information as described excessively constrains state freedom to administer the program in the manner that is best for the state and Medicaid beneficiaries in the state.

CMS also notes that the current requirement applies only to Medicaid fee-for-service payments even though most Medicaid beneficiaries now receive care through managed care plans, the payments for which are not subject to the same process.

The agency adds that it intends to

…replace the ongoing access reviews required by current regulations with a more comprehensive and outcomes-driven approach to monitoring access across delivery systems, developed through workgroups and technical expert panels that include key State and federal stakeholders.

Because they care for so many Medicaid patients, the adequacy of the rates states pay for Medicaid services is especially important to Pennsylvania safety-net hospitals.

Learn more about CMS’s proposal in its news release on the subject or see the proposed regulation itself. Learn about the process CMS intends to employ to replace its current approach to monitoring access to Medicaid services in this CMS informational bulletin.

PA Safety Net Admin2019-07-18T06:00:42+00:00July 18th, 2019|Federal Medicaid issues|Comments Off

Medicaid DSH Delay Advances in Energy and Commerce Committee

Medicaid disproportionate share cuts would be delayed for two years under a proposal advanced last week by the Health Subcommittee of the House Energy and Commerce Committee.

The Medicaid DSH cuts, mandated by the Affordable Care Act, have already been delayed three times by Congress and could be on their way to a fourth delay if the proposal advanced by the Health Subcommittee is endorsed by the Energy and Commerce Committee and works its way to the full House of Representatives, where such a proposal is thought to enjoy wide support.

The Safety-Net Association of Pennsylvania supports this delay of Medicaid DSH cuts. Earlier this year, SNAP asked members of the state’s congressional delegation to join a campaign in the House of Representatives to delay this cut.

Learn more about the possibility of another delay of Medicaid DSH cuts in the HealthLeaders article “House Panel Advances Surprise Bill Package.”

PA Safety Net Admin2019-07-16T06:00:31+00:00July 16th, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

The Role of Medicaid in Addressing Social Determinants of Health

Medicaid can play a major role in addressing the social determinants of health.

Or so argues a recent post on the Health Affairs Blog.

According to the post, social determinants of health – income, education, decent housing, access to food, and more – significantly influence the health and well-being of individuals – including low-income individuals who have adequate access to quality health care. Medicaid, the post maintains, can play a major role in addressing social determinants of health.

The post outlines the role state Medicaid programs can play in addressing social determinants of health; describes tools for such action such as section 1115 Medicaid demonstration waivers; offers examples of efforts currently under way in some states; and presents suggestions for steps the federal government can take to facilitate such efforts.

Addressing social determinants of health is an especially important issue for Pennsylvania safety-net hospitals because they care for so many more Medicaid-covered low-income patients than the typical hospital in the state.

Learn more from the Health Affairs Blog post “For An Option To Address Social Determinants Of Health, Look To Medicaid.”

PA Safety Net Admin2019-07-12T09:43:03+00:00July 12th, 2019|Federal Medicaid issues, Pennsylvania safety-net hospitals, social determinants of health|Comments Off

DHS Secretary Says No to Medicaid Work Requirements

Pennsylvania will not seek federal permission to create a Medicaid work requirement, Department of Human Services Secretary Teresa Miller told a joint hearing of the State Senate Republican Policy Committee and Health and Human Services Committee this week.

Miller conveyed what a news release described as

…the Wolf Administration’s firm opposition to work requirements for Medicaid recipients and the administration’s work to expand access to education and training programs and services to support employment for people served by DHS’ programs.

In her testimony, Miller explained that

Our goal is always to set policy and implement programs that empower Pennsylvanians to live fulfilling lives, support themselves and their families, contribute to our local economies, and build stronger communities. This is not about opposition to work. We want all people to achieve a better quality of life and not be caught in an intergenerational cycle of poverty. The Wolf Administration is not simply opposed to a work requirement; we are committed to increasing opportunities for meaningful work and providing the whole-person supports we contend are needed.

A Medicaid work requirement could affect the Medicaid eligibility of patients served by Pennsylvania’s safety-net hospitals.

Learn more about Secretary Miller’s testimony in this Department of Human Services news release.

PA Safety Net Admin2019-06-14T06:00:07+00:00June 14th, 2019|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Administration Ramps Up Scrutiny of Immigrants’ Use of Public Benefits

Immigrants’ sponsors could be more likely to be held financially responsible for the cost of public benefits those immigrants receive under a new memorandum issued by the White House.

The requirement itself is not new; the purpose of the memorandum is to encourage federal agencies to enforce existing laws that state that, according to the memorandum,

…when an alien applies for certain means-tested public benefits, the financial resources of the alien’s sponsor must be counted as part of the alien’s financial resources in determining both eligibility for the benefits and the amount of benefits that may be awarded. Financial sponsors who pledge to financially support the sponsored alien in the event the alien applies for or receives public benefits will be expected to fulfill their commitment under law.

Among the means-tested public benefits programs at which this new directive is aimed are Medicaid, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps), and Temporary Assistance for Needy Families (TANF).

While the law already requires agencies to enforce immigrants sponsors’ legal financial responsibilities, the White House memorandum notes that it is not being enforced and directs the federal agencies involved to review and update their enforcement procedures.

Enforcement of this directive could result in fewer people applying for and being found eligible to receive Medicaid. If this occurs, it could be especially harmful to Pennsylvania safety-net hospitals that serve large immigrant communities, potentially leaving them unpaid for care they provide to such patients.

Learn more from the administration’s “Memorandum on Enforcing the Legal Responsibilities of Sponsors of Aliens.”

PA Safety Net Admin2019-06-06T06:00:12+00:00June 6th, 2019|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

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