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Helping Safety-Net Hospitals Help Their Patients

A new report published on the Health Affairs Blog describes the continuing challenges safety-net hospitals face and offers suggestions for helping them meet those challenges. The challenges, according to the report, are the virtual elimination of the Affordable Care Act’s individual health insurance mandate; the continued decline in the amount of Medicare disproportionate share hospital money (Medicare DSH) provided to safety-net hospitals; and hospital closures that shift more of the burden for caring for uninsured patients onto a smaller pool of safety-net hospitals.  The result is under-served patients and new financial risks for the hospitals that remain after some safety-net hospitals close because of the large amounts of uncompensated care those hospitals continue to provide. To address these challenges, the … Read More

Posted in Affordable Care Act, Medicare

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

ACA Improves Access to Surgical Services

The Affordable Care Act’s Medicaid expansion has improved access to surgical services for Medicaid patients. Or so says a new study published in JAMA Surgery, which reports that In this study of patients with 1 of 5 common surgical conditions, Medicaid expansion was associated with a 7.5–percentage point increase in insurance coverage at the time of hospital admission. The policy was also associated with patients obtaining care earlier in their disease course and with an increased probability of receiving optimal care for those conditions. As a result, the study found, The ACA’s Medicaid expansion was associated with increased insurance coverage and improved receipt of timely care for 5 common surgical conditions. This development is especially relevant to Pennsylvania safety-net hospitals … Read More

Posted in Affordable Care Act, Pennsylvania safety-net hospitals

The Continued Need for Medicaid DSH

While the Affordable Care Act has greatly increased the number of Americans with health insurance and reduced the demand for uncompensated care from hospitals, many hospitals still see significant numbers of uninsured patients. Some of those patients simply have not taken advantage of the health reform law’s creation of easier access to affordable insurance while others live in states that have not expanded their Medicaid programs. Hospitals that care for especially large numbers of such uninsured patients qualify for Medicaid disproportionate share hospital payments, commonly referred to as Medicaid DSH.  The purpose of these payments is to help these hospitals with the unreimbursed costs they incur caring for such patients. The Affordable Care Act calls for reducing Medicaid DSH payments … Read More

Posted in Affordable Care Act, Federal Medicaid issues, Medicaid supplemental payments

ACA Reduced Disparities in Access to Care

The Affordable Care Act has reduced socioeconomic disparities in access to health care in the U.S. According to a new study published in the journal Health Affairs, Health care access for people in lower socioeconomic strata improved in both states that did expand eligibility for Medicaid under the ACA and states that did not. However, gains were larger in expansion states. The absolute gap in insurance coverage between people in households with annual incomes below $25,000 and those in households with incomes above $75,000 fell from 31 percent to 17 percent (a relative reduction of 46 percent) in expansion states and from 36 percent to 28 percent in nonexpansion states (a 23 percent reduction). This serves as evidence that socioeconomic disparities in health care access narrowed … Read More

Posted in Affordable Care Act, Pennsylvania safety-net hospitals

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

Health Law Center Comments on Proposed Health Law

The Pennsylvania Health Law Project has issued a statement detailing its perspective on the recently proposed American Health Care Act, which would both repeal and replace the Affordable Care Act of 2010. See that statement here.

Posted in Affordable Care Act, American Health Care Act

Comparing “Repeal and Replace” Proposals

How can you keep score while Congress considers multiple proposals to repeal and replace the Affordable Care Act? The Kaiser Family Foundation has just created a new tool that enables users to compare and contrast all of the current repeal and replace proposals:  you pick the proposals you want to compare and you select the aspects of those proposals that interest you. Find this new interactive tool here, on the web site of the Kaiser Family Foundation.

Posted in Affordable Care Act

Impact of ACA Repeal on Pennsylvania

How might Pennsylvania be affected by a repeal of the Affordable Care Act? In a new report, the Pennsylvania Health Funders Collaborative attempts to answer that question, offering projections on the impact of the 2010 health reform’s repeal on jobs, prescription drug coverage for seniors, insurance status for low-income Pennsylvanians, hospitals, and the state’s economy as a whole. The study looks at this impact on a state-wide level as well as on a congressional district-by-district basis while also examining anticipated impact on some individual counties and even some individual hospitals. Learn more about how repeal of the Affordable Care Act might affect Pennsylvania and Pennsylvanians by going here to see the Pennsylvania Health Funders Collaborative report The Pennsylvania Health Funders … Read More

Posted in Affordable Care Act

Wolf Asks Ryan to Preserve Medicaid Expansion

In a letter to House Speaker Paul Ryan, Pennsylvania Governor Tom Wolf urged Congress, no matter how it addresses the Affordable Care Act, to preserve that law’s expansion of access to Medicaid-covered health care services. The governor specifically pointed to the many people who receive substance abuse treatment through those services. If the Affordable Care Act, or Obamacare, is repealed and not replaced, over a million Pennsylvanians could lose access to health care and tens of thousands of people – people who are our friends, our neighbors, and our family members that are currently receiving treatment for a substance use disorder – would lose insurance coverage and no longer be able to afford their treatment. See Governor Wolf’s complete letter … Read More

Posted in Affordable Care Act, Uncategorized
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2012 Safety-Net Association of Pennsylvania