Archive for December 2012
Slightly more than half of all U.S. hospitals will receive enhanced payments from Medicare and slightly fewer than half will see their payments reduced slightly as a result of the first reporting period for Medicare’s new value-based purchasing program. The largest bonus will be awarded to Treasure Valley Hospital, in Utah. Each of its Medicare payments will rise 0.83 percent. The largest penalty will be assessed to Auburn Community Hospital, in Syracuse, which will see its Medicare payments reduced 0.9 percent. Two-thirds of all hospitals will see their payments rise or fall less than 0.25 percent. Medicare’s value-based purchasing program, created by the Affordable Care Act, seeks to enhance provider accountability for the care they deliver. Seventy percent of a … Read More
The U.S. Government Accountability Office (GAO) is now reviewing audits of states’ Medicaid disproportionate share payments (Medicaid DSH) to hospitals and is raising questions about states’ compliance with federal requirements for those payments. Based on its analysis of state Medicaid DSH audits, GAO found that states are making Medicaid DSH payments to hospitals that exceed those hospitals’ uncompensated care costs and are inaccurately calculating those hospital uncompensated care costs. The GAO also found that states are not always targeting their Medicaid DSH payments to the hospitals that provide the most uncompensated care. States are required to submit audits and data as a condition of receiving Medicaid DSH funds from the federal government. Currently, the Centers for Medicare & Medicaid Services … Read More
In a message to members of Pennsylvania’s congressional delegation, the Safety-Net Association of Pennsylvania (SNAP) has asked elected officials in Washington, D.C. to protect the state’s ability to levy assessments on providers to help fund the commonwealth’s Medicaid program. The proceeds from the state’s current provider assessments, SNAP notes, have made a major difference in ensuring the ability of Pennsylvania’s safety-net hospitals to continue serving their many Medicaid patients. Read SNAP’s message to the Pennsylvania congressional delegation here.
In an op-ed piece in Sunday’s Philadelphia Inquirer, Pennsylvania Governor Tom Corbett presented the reasons he decided to let the federal government develop the state’s health insurance exchange – a key part of the Affordable Care Act – instead of having his own administration develop the exchange. Read Governor Corbett’s op-ed piece here.
Medicaid enrollment in southeastern Pennsylvania fell 10,000 people between June and September of this year, with most of that loss occurring in Philadelphia. Read more about this change in Medical Assistance enrollment, and the HealthChoices plans in which active participants are enrolled, in this report from the Delaware Valley Healthcare Council.
The Pennsylvania Department of Public Welfare has issued a Medical Assistance Bulletin detailing changes in the fee-for-service fee schedule. The changes take effect immediately. Read the bulletin with the changes here.
Declaring that “We in the commonwealth have never witnessed a law so vast, with such demands on state resources, and lack of federal guidance,” Pennsylvania Department of Public Welfare Secretary Gary Alexander told the House Energy and Commerce Committee last week that while Pennsylvania has not ruled out expanding its Medicaid program in accordance with the Affordable Care Act, “Under the constraints of the health care reform law, I do not think we can afford the expansion.” Mr. Alexander made these remarks at a hearing of the committee’s Health Subcommittee, which was taking testimony on the Medicaid expansion component of the 2010 health care reform law. While the Kaiser Foundation on Medicaid and the Uninsured says that expansion would cost … Read More
If Medicaid is a health care program for at-risk low-income people, it appears that Medicaid itself is at risk during the current fiscal cliff talks in Washington, D.C. While Medicaid was left untouched by last year’s sequestration bill, it is now viewed by growing numbers of policy-makers as a potential source of savings to help stave off the fiscal cliff. Several aspects of Medicaid, in particular, appear to be vulnerable in the coming weeks. They include Medicaid provider taxes, which are incurring growing opposition in Washington and which, if ratcheted back, could save more than $25 billion; supplemental payments for Medicaid primary care providers, scheduled to take effect on January 1, which if eliminated would save $13 billion; better management … Read More
Safety-net hospitals are 30 percent more likely to have readmission rates that exceed the national average – always a problem, but a greater problem than ever now that Medicare is penalizing hospitals for readmissions through its new Hospital Readmissions Reduction Program. A recent Commonwealth Fund study quantified the degree to which safety-net hospitals’ readmissions exceed national averages, citing as the reason for those reasons that Safety-net hospitals care for a disproportionate share of vulnerable populations who are low-income, uninsured, underinsured, or on Medicaid. They have substantially higher rates of chronic health problems, disability, mental illness, and substance abuse, compared with the general population. Safety-net hospital patients also have disproportionate personal and social needs that adversely affect their health and act … Read More
Uncompensated care rose more than five percent for hospitals in western Pennsylvania while operating margins fell slightly during the fiscal year that ended on June 30. Hospitals reported more patients unable to pay their bills and lower reimbursements as more procedures move to an outpatient basis and more inpatient care is accorded “observation day” status. Read more about the results of a survey of 56 hospitals conducted by the Hospital Council of Western Pennsylvania in this Pittsburgh Post-Gazette article.