Archive for February 2017

Controversy Continues Over HealthChoices Awards

Pennsylvania appears to be no closer to awarding new contracts to serve its HealthChoices Medicaid physical health program than it was when it first launched the process of soliciting bids for such contracts in September of 2015. When losing bidders protested the contracts awarded based on the state’s original request for proposals and took the state to court, the state threw out all the bids and cast aside its decision and started the process all over again, issuing a new request for proposals last year.  When the state announced new awards in January the losing bidders again protested, this time alleging “irregularities” in the decision-making process.  With the renewed threat of litigation, the planned implementation of the new contracts on … Read More

Posted in HealthChoices

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

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing:  what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts. Pennsylvania is in the process of introducing more value-based purchasing into its Medicaid program, doing so through new contracts currently being negotiated with the managed care organizations recently … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy

Changing Medicaid

With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider. Among them are: giving states greater flexibility in the design and implementation of their own Medicaid programs requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments limiting benefits employing incentives to encourage healthy behaviors The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years. Because Pennsylvania’s safety-net hospitals care for so many low-income and Medicaid patients, they could be affected by any major federal Medicaid policy changes far more than the typical Pennsylvania … Read More

Posted in Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals

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

Serving High-Need, High-Cost Medicare Patients

With Medicare beneficiaries who have four or more chronic conditions accounting for 90 percent of Medicare hospital readmissions and 74 percent of Medicare costs (both 2010 figures), policy-makers are constantly looking for better ways to serve such individuals. Academic research suggests that these beneficiaries need a variety of non-medical social interventions and supports, most of which are not covered by Medicare. With this in mind, the Bipartisan Policy Center has prepared a review of current regulatory, payment, and other barriers that prevent providers and insurers from meeting some of the non-medical needs of high-need, high-cost patients that result in such high health care costs and hospital readmissions rates. Many of these high-need, high-cost patients live in low-income communities served by … Read More

Posted in Medicare, Pennsylvania safety-net hospitals

Governor Proposes FY 2018 Budget

On Tuesday Pennsylvania Governor Tom Wolf unveiled his proposed FY 2018 budget to the state’s General Assembly. This budget proposal includes a number of provisions with potential implications for Pennsylvania’s safety-net hospitals. The Safety-Net Association of Pennsylvania has prepared a detailed review of those provisions. Officials of safety-net hospitals who would like to receive a copy of this memo may request one by using the “contact us” link on the upper right-hand corner of this screen. Find a news release from the governor’s office that outlines the proposed budget here and go here (scroll to the bottom of the screen) for links to budget overviews, the entire budget itself, the Wolf administration’s presentation on its plan to consolidate Pennsylvania’s Department of … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2018 budget

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2017 newsletter. Included in this edition are stories about: impending changes in the lineup of managed care providers that serve Medicaid participants in the state’s HealthChoices program for physical health services; the status of the state’s implementation of its Community HealthChoices program of managed long-term services and supports for low-income, elderly Pennsylvanians who seek to continue living independently in the community; the potential impact of a repeal of the Affordable Care Act on Pennsylvanians; and Pennsylvania’s receipt of a Certified Community Behavioral Health Clinic demonstration grant from the federal government to improve services and care coordination for individuals on Medicaid or CHIP. Go here for the latest edition of PA Health … Read More

Posted in Affordable Care Act, HealthChoices PA, Pennsylvania Medicaid, Pennsylvania Medicaid policy
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2012 Safety-Net Association of Pennsylvania