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Archive for May 2017

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 … Read More

Posted in Pennsylvania safety-net hospitals

PA Medicaid to Expand Access to Hep C Drugs

Pennsylvania’s Medicaid program will make treatment for hepatitis C more readily available to Medicaid beneficiaries beginning on July 1, state officials have announced. In recent years, new drugs have become available that effectively cure hepatitis C but their exceptionally high costs led many insurers, including most state Medicaid programs, to limit access to those drugs until patients show more advanced signs of the disease.  A year ago the Pennsylvania Department of Human Services’ pharmacy and therapeutics committee recommended expanding access to these drugs for Pennsylvania Medicaid beneficiaries and now, that recommendation has been adopted and that expansion will begin with the new state fiscal year on July 1. Under the new criteria, patients with lower scores of severity of hepatitis … Read More

Posted in Pennsylvania Medicaid policy

Hospital Uncompensated Care Down

As was surely expected, reforms introduced through implementation of the Affordable Care Act have driven down uncompensated care costs for many hospitals. How much? A new study published by the Commonwealth Fund offers the following findings: uncompensated care declines in expansion states are substantial relative to profit margins; for every dollar of uncompensated care costs hospitals in expansion states had in 2013, the Affordable Care Act erased 41 cents by 2015; and Medicaid expansion reduced uncompensated care burdens for safety-net hospitals that are not made whole by Medicaid disproportionate share payments (Medicaid DSH). Learn more, including how the decline in uncompensated care costs affected different kinds of hospitals in different kinds of states, in the report “The Impact of the … Read More

Posted in Affordable Care Act, Pennsylvania safety-net hospitals

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2017 newsletter. Included in this edition are articles about: the budget bill passed by the state House and its potential impact on Medicaid in Pennsylvania; the potential impact on Medicaid of the American Health Care Act under consideration by Congress; an update on Community HealthChoices, the state’s new program of managed long-term services and supports for seniors struggling to continue living in the community; information on the income verification process for those seeking to apply for or renew Medicaid eligibility; and the process of shifting prescriptions from Medicaid to Medicare. Find the latest edition of PA Health Law News here.

Posted in Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget

Department Consolidation in PA?

Is it a good idea to consolidate Pennsylvania’s Human Services, Aging, Health, and Drug and Alcohol Programs departments into a single new Department of Health and Human Services? Governor Tom Wolf offered such a proposal in his FY 2018 budget message and the Pennsylvania General Assembly is now weighing the merits of this proposal. To explain more about its intentions and plans, the Wolf administration has established a web page that explains the proposed consolidation, which it refers to as “unification.”  Included on the web page are a general description of the proposal, explanations of the benefits the administration believes it offers, a proposed organizational table for the new Department of Health and Human Services, and a link to proposed … Read More

Posted in Pennsylvania proposed FY 2018 budget

New Report on PA Hospital Financial Performance

The Pennsylvania Health Care Cost Containment Council has published its annual report detailing the financial health of acute-care hospitals in the state. According to the report, hospital net patient revenue increased in FY 2016, accounts receivable are being paid faster, operating and total margins rose, and uncompensated care declined. The report describes hospital financial performance and utilization state-wide and by region and also presents FY 2016 margin, uncompensated care, and Medicare and Medicaid share data for every acute-care hospital in the state. Go here to find the PHC4 report Financial Analysis 2016:  General Acute Care Hospitals.

Posted in Uncategorized

MACPAC Meets

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C.  The agency performs policy and data analysis and offers recommendations to Congress, the Department of Health and Human Services, and the states. During two days of meetings, MACPAC commissioners received the following presentations: Federal CHIP Funding Update: When Will States Exhaust Their Allotments? Review of June Report Chapter: Program Integrity in Medicaid Managed Care Review of June Report Chapter: Medicaid and the Opioid Epidemic Medicare Savings Program: Eligible But Not Enrolled Medicaid Reform: Implications of Proposed Legislation Preliminary Findings From Evaluations of Medicaid Expansions Under Section 1115 Waivers Potential Effects of Medicaid Financing Reforms on Other Health and Social Programs Review of June Report Chapter: Analysis … Read More

Posted in Federal Medicaid issues

SNAP, Other Groups Caution PA Delegation About Health Reform Bill

The Safety-Net Association of Pennsylvania has joined 13 other groups in writing to members of the state’s congressional delegation to warn about shortcomings in the American Health Care Act, health care reform legislation currently being considered by the U.S. House of Representatives. The letter warns that the American Health Care Act would “…dramatically reduce Medicaid coverage and strain resources for this critical program.” Read that letter here, on SNAP’s web site.

Posted in American Health Care Act, Safety-Net Association of Pennsylvania
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2012 Safety-Net Association of Pennsylvania