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Archive for Pennsylvania safety-net hospitals

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

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation came just a month after CMS proposed reducing Medicare reimbursement for 340B drugs from its current level, average sales price … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, Uncategorized

SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

The federal government should give states the option of monitoring Medicaid disproportionate share payments (Medicaid DSH) to hospitals through prospective DSH limit calculations rather than through retroactive DSH audits. SNAP recently shared this view with the House Ways and Means Committee’s Health Subcommittee in response to that subcommittee’s request for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.  According to SNAP, retroactive DSH audits are cumbersome, burdensome, and expensive, give rise to many disputes and appeals, and in the end yield results very similar to much simpler prospective DSH limit calculations performed by the very state governments that distribute Medicaid DSH funds.  See SNAP’s comments … Read More

Posted in Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized

Serving High-Risk Patients Leads to VPB Penalties

Practices that served more socially high-risk patients had lower quality and lower costs, and practices that served more medically high-risk patients had lower quality and higher costs. These patterns were associated with fewer bonuses and more penalties for high-risk practices. So concludes a new study that looked at the results of the first year of the Medicare Physician Value-Based Payment Modifier Program. The study looked at 899 physician practices serving more than five million Medicare beneficiaries, and it points to the continuing challenge of how best to serve patients who pose greater socio-economic risks than the average patient. Pennsylvania safety-net hospitals serve far more high-risk patients than the typical hospital. Learn more these findings and how they were reached in … Read More

Posted in Medicare, Pennsylvania safety-net hospitals

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

Congress Looks at 340B Program

Last week the House Energy and Commerce Committee took a look at the 340B prescription drug discount program, which requires pharmaceutical companies to sell discounted drugs for outpatient use to hospitals that care for especially large numbers of low-income patients. The previous week, the Centers for Medicare & Medicaid Services issued a proposed Medicare regulation calling for significant reductions in Medicare payments for such drugs. The hearing touched on the CMS proposal to reduce Medicare payments for 340B drugs, the high prices of prescription drugs, the 340B program’s growth over the years, the possibility that the program is being abused by hospitals and clinics, and more. The 340B program is an essential tool in the efforts of Pennsylvania safety-net hospitals … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, Uncategorized

Medicaid Enrollees: Access and Quality Are Good

Medicaid beneficiaries are generally satisfied with their access to care and the quality of care they receive. Or so reports a new study based on results of the federal Medicaid Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for December of 2014 to July of 2015. According to the survey, nearly half of Medicaid patients rated their overall care 7.9 or greater on a scale of 10; 84 percent reported that they had been able to receive all of the care they needed over the past six months; and most were generally satisfied with the coverage.  Relatively few reported problems finding providers willing to accept their Medicaid coverage. Survey results generally were slightly more positive in Medicaid expansion states … Read More

Posted in Pennsylvania safety-net hospitals

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

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

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
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2012 Safety-Net Association of Pennsylvania