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 ultrasoundPennsylvania 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.


Filed under: Uncategorized

Wolf Nominates Four for Health-Related Posts

Pennsylvania Governor Tom Wolf has nominated four acting department secretaries to assume those positions permanently.

His nominees are:

  • Rachel Levine, to be Secretary of the Department of Health
  • Teresa Miller, to be Secretary of the Department of Human Services
  • Jennifer Smith, to be Secretary of Drug and Alcohol Programs
  • Jessica Altman, to be state Insurance Commissioner

Learn more about the nominations and the nominees in this Central Penn Business Journal article.

Filed under: Uncategorized

340B Changes Would Hurt Hospital Margins

Proposed changes in the federal section 340B prescription drug discount program would hurt hospital margins.

So says Moody’s Investors Service, the credit rating agency.

According to Moody’s, the margins of non-profit hospitals are already under pressure because revenue increases are not keeping pace with prescription drug costs.  Reductions of payments under the 340B program recently proposed by the Centers for Medicare & Medicaid Services would make a challenging situation worse, Moody’s speculates.

Under the 340B program, eligible hospitals purchase prescription drugs at a discount, supply them to eligible outpatients, and use the savings they gain to provide additional services and outreach to the low-income residents of their communities.

Skeptics maintain that hospitals simply pocket the savings.

Under the regulation proposed by CMS, federal payments to 340B-eligible hospitals would be greatly reduced.

All Pennsylvania safety-net hospitals participate in the 340B program and benefit considerably for it.

Learn more about the issue and Moody’s report on the potential impact of changes in the program in this Healthcare Finance News article.

Filed under: Medicare, Pennsylvania safety-net hospitals

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.

Filed under: Uncategorized

Suit Claims Low Medicaid Rates are Discriminatory

A lawsuit filed in state courts in California argues that the state’s low Medicaid payments amount to discrimination against the state’s large Hispanic Medicaid population.

California pays among the lowest rates in the country to physicians, making health care inaccessible for some, and the suit maintains that this is a civil rights issue in which low rates amount to discrimination.

The suit is based on state anti-discrimination and equal protection laws, and many other states have similar laws on the books.  Observers question whether the low rates constitute discrimination against the suit’s Hispanic plaintiffs because the low rates affect the state’s entire Medicaid population, but health advocates around the country will be watching the suit’s progress closely as they consider whether it offers a model for how they, too, might seek redress over the low Medicaid payments that are common in so many states – payments typically much lower than those paid by Medicare.

Pennsylvania safety-net hospitals will be following this lawsuit closely.

For a closer look at the lawsuit, the situation in California, the suit’s legal implications, and how others view it, see this Stateline article.

Filed under: Uncategorized

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.

Filed under: Federal Medicaid issues

PA Drug Monitoring Program Showing Results

Pennsylvanians are having a harder time inappropriately obtaining prescriptions for opioids and other dangerous prescription drugs because of continued implementation of the state’s prescription drug monitoring program.

Under the program, introduced last year, anyone who can prescribe Schedule II-V class drugs must query a state database before doing so and report any prescriptions they write by the end of the next business day.

The idea is to prevent people from going from doctor and doctor and pharmacy to pharmacy seeking prescriptions for dangerous drugs, and it appears to be working.  The state’s Department of Health reports that the number of people who visited five or more doctors to obtain prosecutions for drugs covered by the program fell 86 percent in a year and the practice of visiting ten or more doctors in search of such drugs disappeared entirely.

Learn more about Pennsylvania’s prescription drug monitoring program, how it works, and whether it is working in this Erie Times-News article.

Filed under: Uncategorized

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.


Filed under: Uncategorized


The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C.

Among the issues MACPAC commissioners discussed during their two-day meeting were:

  • delivery system reform incentive payment programs
  • Medicaid enrollment and renewal processes
  • managed care oversight
  • monitoring and evaluating section 11115 demonstration waivers
  • Medicaid coverage of telemedicine services

MACPAC advises the administration, Congress, and the states on Medicaid and CHIP issues.  It is a non-partisan agency of the legislative branch of government.

Go here to find background information on these and other subjects as well as links to the presentations that MACPAC staff made to the commissioners during the meetings.

Filed under: Federal Medicaid issues

PA Medicaid Director Honored

Leesa Allen, deputy secretary of the Pennsylvania Department of Human Services’ Office of Medical Assistance Programs and state Medicaid director, has been appointed to the board of directors of the National Association of Medicaid Directors.

See the Wolf administration’s news release about Ms. Allen’s appointment here.

Filed under: Pennsylvania Medical Assistance

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2012 Safety-Net Association of Pennsylvania