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PHC4 Reports on Hospital Performance

The Pennsylvania Health Care Cost Containment Council has released its annual report on hospital performance for discharges between October of 2015 and September of 2016. The report, which details the performance of all of the state’s acute-care hospitals and some children’s and specialty hospitals, looks at hospital-specific outcomes for 16 individual medical conditions and surgical procedures. Among the measures reported by PHC4 are number of cases, risk-adjusted mortality, risk-adjusted 30-day readmissions, and case-mix-adjusted average hospital charges. Among its findings, PHC4 reported that mortality and readmission rates decreased in most categories and did not increase significantly in any. The PHC4 report comes in different volumes for different parts of the state.  Find a description of the reports, a summary of their … Read More

Posted in Uncategorized

Survey Says: More Than One in Four Underinsured

28 percent of insured adults under the age of 64 were uninsured in 2016, according to a Commonwealth Fund survey. The survey also found that: More than half of the uninsured are insured through their employer. Nearly one in four insured through their employer are underinsured. More than one in four Medicaid recipients were underinsured. Half of the underinsured report problems paying their medical bills. Individuals with higher deductibles are more likely to report problems paying their medical bills. More than 45 percent of the underinsured report skipping care they need because of cost. Low-income people and those with chronic health problems are more likely to be underinsured. Learn more about the survey’s findings, its implications, and possible means of … Read More

Posted in Uncategorized

Wolf Vetoes Medicaid Work Requirement

Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work.  Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.

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

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 … Read More

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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.

Posted in 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 … Read More

Posted in 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.

Posted in 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 … Read More

Posted in 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 … Read More

Posted in 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 … Read More

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