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Archive for April 2018

Behavioral Risk Factor Surveillance System

A new study found that the increase in the number of insured Americans as a result of the Affordable Care Act has resulted in increased utilization of primary health care services. According to a study by the National Bureau of Economic Research, primary care utilization rose 3.8 percent, mammograms 1.5 percent, HIV tests 2.1 percent, and flu shots 1.9 percent over a three-year period.  The study suggests that preventive care increased between 17 and 50 percent. The study attributes all of the gains to improved access to private insurance and none to Medicaid expansion. These results are based on self-reported information gathered from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System. Learn more about these and … Read More

Posted in Affordable Care Act

Medicaid is Toughest Insurer for Providers

Medicaid is the hardest insurer for providers when it comes to billing. Or so reports a new study published in the journal Health Affairs. According to this analysis, Medicaid claims take longer to file, are more likely to be rejected, more likely to be challenged, and take longer to be paid than Medicare and private insurance claims.  While the biggest problem is Medicaid fee-for-service claims, even Medicaid managed care claims pose more problems than Medicare and private insurance claims. This can pose a special challenge to Pennsylvania safety-net hospitals because they care for so many more Medicaid patients than the typical hospital. Learn more about the challenges providers face when working with Medicaid in the Health Affairs report “The Complexity … Read More

Posted in Uncategorized

Eat! You’ll Feel Better

And maybe need to spend less on health care. That is the lesson learned from a program in Massachusetts that provided home delivery of food to dually eligible Medicare/Medicaid recipients who were struggling with their meals. In a limited experiment, selected individuals received home delivery of food:  some received general meal deliveries while others received food tailored to their individual medical conditions.  The purpose:  address a major social determinant of health in this difficult-to-serve population. The result, according to a report published in the journal Health Affairs, was that Participants in the medically tailored meal program also had fewer inpatient admissions and lower medical spending. Participation in the nontailored food program was not associated with fewer inpatient admissions but was … Read More

Posted in Pennsylvania safety-net hospitals

Safety-Net Hospitals Improve More on Readmissions But Still More Likely to be Penalized

Hospitals that serve large numbers of minority patients are reducing their Medicare readmissions rates more than other hospitals but are still more likely to be penalized under Medicare readmissions reduction program. This is one of the findings in a new study published in the journal Health Affairs. According to the study, hospitals that serve larger numbers of minority patients – typically, safety-net hospitals – are more likely to be penalized for readmissions than other hospitals because even though they are reducing their readmissions rates faster than other hospitals, their performance is compared, unfavorably, to hospitals that had fewer Medicare readmissions prior to the launch of the readmissions reduction program. This situation may change beginning in FY 2019 when a new … Read More

Posted in Medicare

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has just published the March 2018 edition of its monthly newsletter. Included in this edition are articles about: new procedures that will make it easier for Medicaid recipients to be treated for opioid abuse the continued implementation of the Community HealthChoices program of managed long-term services and supports for nursing home-eligible seniors, including its introduction in southeastern Pennsylvania beginning next year the work of special needs units in the HealthChoices managed care plans the confirmation of Teresa Miller as Secretary of the Pennsylvania Department of Human Services Find these stories and others here, in the latest edition of the Pennsylvania Health Law Project’s newsletter.  

Posted in HealthChoices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy
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2012 Safety-Net Association of Pennsylvania