Archive for May 2019

Medicaid DSH Delay Wins Bipartisan Support

More than 300 members of the U.S. House have joined a letter to House leadership urging a delay in Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH). The bipartisan letter notes that hospitals that receive Medicaid DSH funds cannot absorb the loss of revenue such a cut would bring.  That cut, scheduled to begin in FY 2020, would amount to a $4 billion reduction in nation-wide Medicaid DSH spending in FY 2020 and an $8 billion reduction in each of FY 2021, FY 2022, FY 2023, FY 2024, and FY 2025. SNAP was actively involved in urging Pennsylvania House members to join the letter.  If implemented, the Medicaid DSH cuts would be especially harmful to SNAP members … Read More

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

PHC4 Reports on PA Hospital Financial Performance

Pennsylvania hospitals’ financial performance in 2018 was mixed, according to a new analysis by the Pennsylvania Health Care Cost Containment Council. According to PHC4, uncompensated care declined two percent total margins fell 0.05 percentage points operating margins declined 0.39 percentage points net patient revenue rose 3.9 percent discharges fell 1.2 percent inpatient days fell 0.3 percent Learn more about the 2018 financial performance of acute-care hospitals in Pennsylvania, including data for every such hospital in the state and measures such as payer mix, in the PHC4 report Financial Analysis 2018:  General Acute Care Hospitals

Posted in Uncategorized

SNAP Joins Letter Urging Preservation of Tobacco Funding

The Safety-Net Association of Pennsylvania has joined 10 other organizations in urging Pennsylvania’s General Assembly to use 100 percent of Tobacco Settlement Fund monies for health-related services and programs in the coming fiscal year. For FY 2018-2019, Pennsylvania borrowed against future proceeds from the Tobacco Settlement Fund to help balance the state budget.  Debt service payments will soon be due and the Wolf administration has proposed paying that debt service with proceeds from the state’s sales and use taxes.  In a letter to state legislators, SNAP and the others endorse this aspect of the administration’s proposed budget FY 2019-2020 budget. Tobacco fund proceeds are vital to Pennsylvania’s safety-net hospitals, helping to compensate them for some of the care they provide … Read More

Posted in Medicaid supplemental payments, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals

Tackling Social Determinants of Health

Two states are working to address social determinants of health through their Medicaid programs. In California and Oregon, the state Medicaid programs are using care coordination and funding from multiple sources, including traditional Medicaid funding, alternative payment approaches, and savings from care coordination to provide services such as housing, food, and legal assistance while also building the capacity of health care and community groups to support such efforts.  Both states obtained federal Medicaid waivers to enable them to expend Medicaid resources on non-Medicaid-covered services. Learn more about how California and Oregon are using their Medicaid programs to address social determinants of health in the Health Affairs report “Medicaid Investments To Address Social Needs In Oregon And California.”

Posted in Federal Medicaid issues, social determinants of health

CMS Speeds Up Medicaid Review Process

The federal government has greatly increased the speed with which it is reviewing and approving state applications to modify their Medicaid programs. Most often, such applications involve Medicaid state plan amendments and section 1915 waiver requests. According to a recent post on the CMS blog (in CMS’s own words), Between calendar years 2016 and 2018, there was a 16 percent decrease in the median approval time for Medicaid SPAs [note:  state plan amendments]. Seventy-eight percent of SPAs were approved within the first 90 day review period during calendar year 2018, a 14 percent increase over 2016. Between calendar year 2016 and 2018, median approval times for 1915(b) waivers decreased by 11 percent, 1915(c) renewal approval times decreased by 38 percent, … Read More

Posted in Federal Medicaid issues

New Poverty Level Standards to Jeopardize Medicaid Eligibility?

The Trump administration is considering changing how the federal government measures inflation for the purpose of calculating the federal poverty level. Such a change, if implemented, could potentially reduce inflation-related increases in the federal poverty level, which in turn could limit the ability of some individuals and families to qualify, or continue to qualify, for a variety of public safety-net services – including, potentially, Medicaid. Among the possible alternatives to the current methodology for calculating inflation is the Chained Consumer Price Index for All Urban Consumers.  The Obama administration also explored substituting this index for the current inflation factor. Any change that makes it more difficult for people to qualify for Medicaid could be particularly damaging to Pennsylvania safety-net hospitals, … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

Senate Finance Committee Reports on Supplemental Medicaid Payments

The majority members of the Senate Finance Committee have published a report on supplemental Medicaid payments. According to the new document, This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for these payments to ensure adequate stewardship of taxpayer dollars.  The report consists of descriptions of the different types of supplemental Medicaid payments that states make to some providers, including: Medicaid disproportionate share payments (Medicaid DSH) non-DSH payments upper-payment limit payments (UPL payments) demonstration supplemental payments medical education payments It also describes the magnitude of these payments, noting that supplemental Medicaid payments accounted for $50 billion of the $600 billion spent on Medicaid by the federal and state governments in 2016, … Read More

Posted in DSH hospitals, Medicaid supplemental payments, Pennsylvania safety-net hospitals

Uninsured ED and Inpatient Visits Down Since ACA

Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act. And Medicaid-covered admissions and ER visits are up, according to a new analysis. The report, published on the JAMA Network Open, found that ER visits by uninsured patients fell from 16 percent to eight percent between 2006 and 2016, with most of this decline after 2014, while uninsured discharges fell from six percent to four percent. The rate of uninsured ER visits declined, moreover, at a time when overall ER visits continued to rise. While the Affordable Care Act is likely the cause of most of these changes, other contributing factors include the emergence of urgent care facilities, telemedicine, and free-standing ERs as well … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid, Pennsylvania safety-net hospitals

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its March-April 2019 newsletter. Included in this month’s edition are articles about: The launch of a new tool to determine applicants’ eligibility for Medicaid-covered long-term services and supports. An update on Medicare Part D payment problems that affect some dually eligible Medicare/Medicaid patients. Highlights of the state’s Department of Human Services budget (including Medicaid). An update on the status of the Affordable Care Act. Go here for articles about these and other subjects.

Posted in Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2020 budget
P:(717)234-6970; F:(717)234-6971
2012 Safety-Net Association of Pennsylvania