safety-net hospitals Archives - Page 3 of 5 - Safety-Net Association of Pennsylvania

Underinsurance Remains a Problem

Twenty-three percent of American adults are uninsured, according to a new survey by the Commonwealth Fund.
Among them, 14 million had deductibles that exceeded five percent of their income while another 24 million had deductibles that fell below that threshold but had out-of-pocket health care costs – deductibles, co-insurance, co-payments, and out-of-network payments – that exceeded ten percent of their income.
The figures are for 2012 and reflected no change since 2010 but were nearly twice those found in 2003.
In addition, the survey found that the proportion of the insured with high-deductible plans has more than tripled, from three percent to 11 percent, since 2003. This is believed to reflect the proliferation of high-deductible plans in recent years – a proliferation that has increased with implementation of the Affordable Care Act and the many high-deductible plans offered through the federal exchange and state exchanges. This survey, however, did not distinguish between pre- and post-Affordable Care Act insurance policies.
Another category of the uninsured is those with income less than 200 percent of the federal poverty level whose out-of-pocket health care costs are greater than five percent of their income. Such individuals can pose a special challenge to safety-net hospitals because they often are unable to pay their co-pays, deductibles, and some of their medical costs.
For a closer look at the numbers, who is underinsured, the role of high-deductible plans in being underinsured, the effect of being underinsured on gaining access to care and addressing health problems, and more, see The Problem of Underinsurance and How Rising Deductibles Will Make it Worse, an issue brief summarizing the Commonwealth Fund survey.

PA Safety Net Admin2015-05-26T06:00:35+00:00May 26th, 2015|Affordable Care Act|Comments Off

Congressman Calls for Helping Safety-Net Hospitals by Improving Medicare Readmissions Program

Congressman James Renacci (R-OH) is again asking his House colleagues to support his proposal to adjust Medicare’s hospital readmissions reduction program – a program he maintains is especially harmful to safety-net hospitals.
Noting that in its current form the program penalizes hospitals that care for larger numbers of poorer, sicker patients and that this “jeopardizes the viability of hospitals that service this vulnerable population,” the congressman urges his colleagues to support his bill, H.R. 4188, the Establishing Beneficiary Equity in the Hospital Readmissions Program Act.
This bill calls for adjusting the program’s approach “to account for certain disparities in patient population…”
See Representative Renacci’s letter to House colleagues here.

PA Safety Net Admin2014-10-22T11:44:02+00:00October 22nd, 2014|Uncategorized|Comments Off

Medicare Announces Readmissions Penalties

Medicare will impose financial penalties in FY 2015 on the majority of U.S. hospitals for excessive patient readmissions.
In all, 2610 hospitals face penalties that range from one one-hundredth of one percent to three percent of all Medicare payments. Last year, the maximum penalty was two percent.
The majority of hospitals in 29 states will be penalized and 39 hospitals face the maximum penalty of three percent. Overall, the penalties will amount to $428 million. Many hospitals will be penalized even though they reduced their readmissions in the past year.
Medicare’s hospital readmissions reduction program was mandated by the Affordable Care Act in the belief that penalizing hospitals for what were considered avoidable readmissions would spur them to take steps to prevent such readmissions. Readmissions cost Medicare $26 billion a year, of which $17 billion is considered unavoidable.
Concerns have been raised that the readmissions penalties are unfair to safety-net hospitals because they serve more low-income patients with more complex medical problems and who, after discharge, face financial and logistical challenges during their recovery that make them more likely to require readmission. Some studies have verified this view and some groups – including the Medicare Payment Advisory Commission (MedPAC) – have called on Congress to revise the program with this consideration in mind.
For a closer look at FY 2015’s readmissions penalties, including links to a file that lists individual hospital penalties nation-wide, see this Kaiser Health News report.

PA Safety Net Admin2014-10-06T06:00:33+00:00October 6th, 2014|Affordable Care Act|Comments Off

Readmissions and Quality: Are They Related?

A new study casts doubt on a major principle underlying a good deal of recent federal health care policy.
That principle holds that hospitals that have lower rates of 30-day readmissions of Medicare patients provide better, more economical care than those with higher readmission rates.
But that may not be true.
According to an examination of the performance of safety-net hospitals in California published in the journal Health Affairs, those safety-net hospitals are more likely than others to be penalized by Medicare’s hospital readmissions reduction and value-based purchasing programs.
At the same time, however, these same hospitals had lower 30-day, risk-adjusted mortality rates for patients treated for myocardial infarction, heart failure, and pneumonia. The safety-net hospitals also had marginally lower adjusted Medicare costs.
Find out more about the findings of the study “California Safety-Net Hospitals Likely to be Penalized by ACA Value, Readmission, and Meaningful-Use Programs,” which can be found here, on the web site of the journal Health Affairs.

PA Safety Net Admin2014-08-21T06:00:31+00:00August 21st, 2014|Affordable Care Act, Health care reform|Comments Off

Safety-Net Hospital Finances Falling Behind Other Hospitals

While most hospitals have recovered from the worst of the recession, safety-net hospitals that were already weak before the recession now find a growing financial gap between themselves and other hospitals.
So reports the new study “Hospital Financial Performance in the Recent Recession and Implications for Institutions That Remain Financially Weak,” which was published in the May edition of Health Affairs.
According to a news release about the study,

About 28 percent of the safety-net hospitals were financially weak in 2006. While their financial performance dipped in 2008, these institutions rebounded by 2011. However, the financial gap between the safety-net hospitals and the non-safety-net hospitals continues to widen in terms of their total profit.

The release also notes the implications of this financial struggle:

On the one hand, financially weak and safety-net hospitals continue to keep their doors open. On the other hand, these institutions remain in precarious financial positions that could compromise their ability to invest in innovations or quality improvement activities that may provide value for patients.

Learn more about the study in this news release or find the study itself here, on the web site of the publication Health Affairs.

PA Safety Net Admin2014-05-14T06:00:04+00:00May 14th, 2014|Uncategorized|Comments Off

Increase Use of Value-Based Purchasing, HHS Told

A study performed for the U.S. Department of Health and Human Services calls for greater use of value-based purchasing in federal health care reimbursement policy.
The study, performed by the RAND Corporation, recommends developing a national value-based purchasing strategy; developing a more deliberate approach to evaluating the effectiveness of value-based purchasing efforts; and developing performance measures that support value-based purchasing approaches.
Such an approach could be a major challenge for Pennsylvania’s safety-net hospitals, according to a Harvard School of Public Health analysis that found that in the first year of Medicare’s value-based purchasing program, hospitals that served the largest numbers of low-income patients suffered the largest financial penalties from that program.
Read more about the RAND study in this Fierce Healthcare story and find the RAND study itself here. Read another Fierce Healthcare article about the impact of value-based purchasing on safety-net hospitals here.

PA Safety Net Admin2014-03-11T06:00:25+00:00March 11th, 2014|Uncategorized|Comments Off

SNAP Testifies About Healthy Pennsylvania

The Safety-Net Association of Pennsylvania (SNAP) has weighed in on Governor Corbett’s Healthy Pennsylvania health care reform and insurance expansion proposal.
Testifying at a January 9 public hearing in Harrisburg, SNAP president Michael Chirieleison expressed general support for the Healthy Pennsylvania proposal and addressed four aspects of it that safety-net hospitals would like to see improved:

extension of retroactive eligibility to the Medicaid expansion population;
including inpatient services provided to that same population as “Medicaid days” for the purpose of determining eligibility for supplemental Medicaid payments and other government programs;
reconsideration of proposed benefit limits and suspension of eligibility for non-payment of premiums; and
the addition of a Delivery System Reform Incentive Program or a similar program to support the development of health care infrastructure in communities with large numbers of low-income Pennsylvanians.

Read SNAP’s testimony here.

PA Safety Net Admin2014-01-09T14:14:05+00:00January 9th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

Safety-Net Hospitals Bear Brunt of Medicare Penalties

Hospitals that serve the largest proportion of low-income patients are suffering the greatest financial penalties under Medicare’s value-based purchasing program.
Collectively, hospitals that serve the most low-income patients are seeing their Medicare payments reduced 0.09 percent during year two of the Medicare program while hospitals that serve the fewest low-income patients have seen their Medicare payments rise 0.06 percent, according to a new study by a Harvard School of Public Health professor.
Medicare’s value-based purchasing program, mandated by the Affordable Care Act, bases penalties and bonuses on 24 quality measures.
In Pennsylvania, 45 percent of the state’s hospitals received bonuses while 53 percent were penalized; both figures are the same as the national averages. The average bonus for Pennsylvania hospitals was 0.24 percent – the national average – while the average penalty was 0.20 percent, slightly lower than the national average of 0.26 percent.
The author of the study suspects that the performance of safety-net hospitals may be suffering from the manner in which their patients are responding to the patient satisfaction survey that is one of the determining factors in evaluating hospital performance.
For a closer look at the study and its findings, see this Kaiser Health News report.

PA Safety Net Admin2013-11-22T06:00:26+00:00November 22nd, 2013|Affordable Care Act, Health care reform|Comments Off

Medicare Penalties Hurt Safety-Net Hospitals More, Some Argue

Penalties imposed on hospitals deemed to have excessive readmissions of Medicare patients may disproportionately target safety-net hospitals, some health care experts maintain.
Such penalties are part of Medicare’s hospital readmissions reduction program.
According to the recent New York Times article “Hospitals Question Medicare Rules on Readmissions,” “…health policy experts and hospital executives say the penalties, which went into effect in October, unfairly target hospitals that treat the sickest patients or the patients facing the greatest socioeconomic challenges.” The article goes on to cite a recent report in the New England Journal of Medicine, noting that “Large academic medical centers and so-called safety-net hospitals are bearing the brunt of the new policy, and the authors warn that the penalties could make it even harder for hospitals struggling to care for those patients with the highest needs.”
Read the Times article here.

PA Safety Net Admin2013-04-05T06:00:29+00:00April 5th, 2013|Uncategorized|Comments Off

DSH Losses Will Hurt Safety-Net Hospitals

Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014.
So concludes Moody’s, the bond-rating agency.
The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes.
Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act.
Hospitals face other specific challenges as well as a result of these cuts.
Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this report in Becker’s Hospital Review.

PA Safety Net Admin2013-03-20T06:00:57+00:00March 20th, 2013|Health care reform|Comments Off

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