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Archive for June 2017

PHC4 Looks at “Super-Utilizers”

The Pennsylvania Health Care Cost Containment Council has released a new research brief on so-called super-utilizers:  a small portion of the population that consumes an inordinate amount of health care.  Super-utilizers are defined as individuals with five or more hospital admissions a year. According to the PHC4 report, Three percent of hospitalized patients accounted for 10 percent of hospital payments, or $1.25 billion, in 2016. Super-utilizers accounted for three percent of hospitalized patients, 10 percent of hospital payments, 12 percent of hospital admissions, and 15 percent of hospital days. 46 percent of that care was paid for by Medicare, 19 percent by Medicaid, and 19 percent was for dually eligible patients. The top three reasons for admissions among super-utilizers were … Read More

Posted in Uncategorized

SNAP Joins Others in Letter to PA Senators

SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians. Among the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections. See the complete … Read More

Posted in American Health Care Act, Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May newsletter.  Included in this edition are articles on new criteria for Medicaid coverage of high-cost hepatitis C drugs and the release of a draft of the state’s proposed Medicaid quality strategy; an update on Community HealthChoices, Pennsylvania’s new program of Medicaid managed long-term services and supports; an overview of Medicaid-covered behavioral health services; a summary of recent federal proposals with implications for the state’s Medicaid program; and a report on the nomination of Teresa Miller to lead the new Department of Health and Human Services that Governor Wolf has proposed establishing.  Find the newsletter here.

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

The Prospect of a Medicaid Work Requirement

Over the past three years a dozen states have proposed establishing a work requirement for eligibility for their Medicaid programs and in its proposed FY 2018, the Trump administration has called for extending the ability to impose such a requirement to all states. But how would a Medicaid work requirement work?  To whom would it apply and what kinds of work might satisfy such a requirement for the approximately 22 million Medicaid recipients (out of 76 million total recipients) to whom it might apply? Work requirements would have significant implications for the patients and communities that Pennsylvania safety-net hospitals serve, and possibly for the hospitals as well. A new Commonwealth Fund report looks at these and other issues.  Go here … Read More

Posted in Federal Medicaid issues
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2012 Safety-Net Association of Pennsylvania