Pennsylvania safety-net hospitals Archives - Page 9 of 22 - Safety-Net Association of Pennsylvania

CMS Shares Vision for Medicaid

Medicaid is about to undergo major changes, CMS administrator Seema Verma outlined in a news release yesterday and in a speech to state Medicaid directors.
According to the news release, those changes include:

re-establishing a state-federal partnership that Verma believes has become too much federal and not enough state
giving states greater freedom to innovate
offering new guidelines for how states can align their individual programs with federal Medicaid objectives
new guidance on section 1115 waivers
longer section 1115 waivers with simpler review processes
CMS willingness to consider proposals to impose work requirements on Medicaid beneficiaries
Medicaid and CHIP “scorecards” that track and publish state and federal Medicaid and CHIP outcomes

Pennsylvania safety-net hospitals serve more Medicaid patients than the typical hospital and would therefore be affected more by any major changes in how Medicaid operates.
Go here to see CMS administrator Verma’s full new release and to find links to relevant documents, web sites, and Ms. Verma’s speech about the changes. Go here to read a Washington Post report on Ms. Verma’s speech and here to see a Kaiser Health News report.

PA Safety Net Admin2017-11-08T06:00:43+00:00November 8th, 2017|Federal Medicaid issues|Comments Off

A New Twist on Telehealth

Residents of urban areas often have the same access-to-care problems as rural residents, although the latter receive far more attention.
So concludes a new report published on the Health Affairs Blog.
According to the analysis, urban and rural residents have similar access problems – and among urban residents, the problems in some instances are even greater. One distinction:

…while rural America has access problems because there are not enough doctors, urban America has access problems because there are not enough appointments.

One potential solution to this problem, the report suggests, is focusing on access instead of geography and making telehealth services more available to rural and urban residents alike. To date, most telehealth efforts have focused on serving residents of rural areas only.
Doctor giving patient an ultrasound Pennsylvania has safety-net hospitals in both urban and rural areas and many of the communities they serve have access-to-care problems that might benefit from greater access to telehealth services.
Learn more about the issue and this new perspective in the article “Giving Urban Health Care Access Issues The Attention They Deserve in Telemedicine Reimbursement Policies,” which can be found here, on the Health Affairs Blog.

PA Safety Net Admin2017-10-18T06:00:12+00:00October 18th, 2017|Uncategorized|Comments Off

House Committee to Hold 340B Hearing

The House Energy and Commerce Committee’s oversight subcommittee will hold a hearing on Wednesday about the 340B Drug Pricing Program.
At the hearing, titled “Examining How Covered Entities Utilize the 340B Drug Pricing Program,” the subcommittee hopes

…to hear directly from entities participating in the program to get a better understanding of how the program is used, including how much money is saved, the types of drugs purchased and prescribed within the program, how entities track their savings, and how those savings are used to improve patient care.

All Pennsylvania safety-net hospitals participate in the 340B program.
Learn more about the hearing and the witness list from the subcommittee’s news release on the subject.

PA Safety Net Admin2017-10-09T06:00:52+00:00October 9th, 2017|Uncategorized|Comments Off

House Members Seek Delay of DSH Cuts

221 members of the House of Representatives have written to House leaders asking them to delay cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to begin on October 1.
The cuts, mandated by the Affordable Care Act, have already twice been delayed by Congress, both times for two years, and now, a majority of House members have written to House speaker Paul Ryan and minority leader Nancy Pelosi asking them to advance legislation to delay Medicaid DSH cuts once again.
The purpose of Medicaid DSH payments is to help hospitals that serve especially large numbers of low-income patients to absorb some of the losses they incur serving uninsured and underinsured people. Pennsylvania safety-net hospitals receive, and greatly benefit from, Medicaid DSH payments.
See the letter to House leaders here and see NAUH’s letter to House members here.

PA Safety Net Admin2017-10-04T14:33:14+00:00October 4th, 2017|Federal Medicaid issues|Comments Off

U.S. House Committee Looks at 340B

Are hospitals using the savings generated by their participation in the section 340B prescription drug discount program to help their low-income and uninsured patients?
That’s what the U.S. House Energy and Commerce Committee’s Health Subcommittee is asking.
Earlier this year the committee requested such information from the Health Services and Resources Administration, which runs the 340B program, and now it’s asking hospitals as well.
Specifically, the subcommittee sent five-page letters to 19 providers that participate in the 340B program asking them about:

the quantity of 340B-purchased drugs they dispense to Medicare beneficiaries, Medicaid beneficiaries, and those with private insurance
the quantity of 340B-purchased drugs they dispense to uninsured patients
their savings from the 340B program and how they calculate those savings
how much charity care they provide
how they use 340B savings to serve vulnerable populations

The letters address many other 340B-related issues as well.
Most Pennsylvania safety-net hospitals participate in the 340B program and view it as a critical tool in their ability to meet the needs of their many low-income patients.
Learn more about the Health Subcommittee’s letter by reading this news release describing this initiative and go here to view the letters the subcommittee sent to selected 340B providers.

PA Safety Net Admin2017-09-22T06:00:05+00:00September 22nd, 2017|Uncategorized|Comments Off

New Book Addresses Social Risk Factors in Medicare

In the new book, the National Academies of Sciences, Engineering, and Medicine addresses the question of what social risk factors might be worth considering in Medicare value-based payment programs and how those risk factors might be reflected in value-based payments.
The book, the culmination of a five-part NASEM process, focuses on five social risk factors:

socio-economic position
race, ethnicity, and cultural context
gender
social relationships
residential and community context

Addressing such factors in Medicare value-based payments, the book finds, can help achieve four important goals:

reduce disparities in access, quality, and outcomes
improve the qualify and efficiency of care for all patients
foster fair and accurate reporting
compensate provides fairly

Doing so also can help prevent five types of unintended consequences from a failure to address social risk factors in Medicare payment policy:

providers avoiding patients with social risk factors
reducing incentives to improve the quality of care for patients with social risk factors
underpaying providers that serve disproportionately large numbers of patients with social risk factors
a perception of different medical standards for different populations
obscuring disparities in care and outcomes

The kinds of patients these social risk factors seek to identify are precisely those served by Pennsylvania safety-net hospitals in far greater numbers than other community hospitals throughout the state.
Learn more about social risk factors and their potential role in Medicare value-based payment policy in the new book Accounting for Social Risk Factors in Medicare Payment, which can be downloaded free of charge here, from the web site of the National Academies of Sciences, Engineering, and Medicine.

PA Safety Net Admin2017-05-24T13:10:08+00:00May 24th, 2017|Pennsylvania safety-net hospitals|Comments Off

Medical Homes and High-Need Patients

With five percent of patients accounting for 50 percent of health care costs, such high-need patients are the subject of increasing attention as health care providers search for better ways to serve them at less cost. Such patients are especially challenging when they lack the financial resources and personal support systems needed to address their considerable medical needs.
One of those ways is through the concept of the medical home: an approach to primary care, also often referred to as a patient-centered medical home, that is a team-based approach to delivering patient-specific, coordinated, accessible care that focuses on quality and safety and that features as one of its defining characteristics closer contact between patients and their caregivers.
Pennsylvania safety-net hospitals typically care for large numbers of such high-need patients.
In a new report, the Commonwealth Fund tells how one such program, Chicago’s Medical Home Network, is attempting to make a difference in the lives of its low-income, high-need patients. See that report here.

PA Safety Net Admin2017-04-12T16:16:27+00:00April 12th, 2017|Uncategorized|Comments Off

CMS Clarifies Medicaid DSH Rule

Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs. This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit.
According to CMS,

This rule clarifies federal requirements regarding the treatment of third party payers in determining the hospital-specific Medicaid DSH payment limit, which is set by statute as a hospital’s “uncompensated costs” incurred in providing hospital services to Medicaid and uninsured patients.

The final rule makes clearer our existing policy that uncompensated costs include only those costs for Medicaid eligible individuals that remain after accounting for all payments received by or on behalf of Medicaid eligible individuals, including Medicare and other third party payments. This is consistent with the statutory requirements governing Medicaid DSH and applicable limits.

All Pennsylvania safety-net hospitals receive Medicaid DSH payments.
See the full rule here.

PA Safety Net Admin2017-04-04T06:00:05+00:00April 4th, 2017|Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.”
How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are:

Pennsylvania’s private safety-net hospitals serve especially large numbers of dually eligible Medicare and Medicaid beneficiaries, so such programs are always of special interest to them.
In addition to viewing the reports, go here to learn more about the Medicare-Medicaid Financial Alignment Initiative.

PA Safety Net Admin2017-03-29T06:00:43+00:00March 29th, 2017|Federal Medicaid issues, Medicare, Uncategorized|Comments Off

MACPAC Meets, Discusses Medicaid Issues

Members of the non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program matters met in Washington recently to discuss a number of issues.
On the agenda of the Medicaid and CHIP Payment and Access Commission were the following issues:

state Medicaid flexibility
state Medicaid responses to fiscal pressures
a study requested by Congress on mandatory and optional benefits and populations
current Medicaid parallels to per capita financing options
illustrations of state-level effects of per capita cap design elements
high-cost hepatitis C drugs
the role of section 1915(b) waivers in Medicaid managed care

Because Pennsylvania safety-net hospitals serve so many Medicaid and CHIP participants, MACPAC’s deliberations are especially important and relevant to them.
Go here for a link to overviews of these issues and the presentations offered at the MACPAC meeting.

PA Safety Net Admin2017-03-23T06:00:24+00:00March 23rd, 2017|Federal Medicaid issues, Pennsylvania safety-net hospitals, Uncategorized|Comments Off

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