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Archive for August 2019

ACA Has Reduced Insurance Disparities

The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities. According to a new Commonwealth Fund analysis, All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates…  However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points. Learn more about specific differences among racial and ethnic groups, differences based on residence in Medicaid expansion states and non-expansion states, and differences in … Read More

Posted in Affordable Care Act

New Public Charge Rule Could Affect Immigrants, Providers

Legal immigrants may become reluctant to seek government-sponsored health care and providers may find themselves delivering more uncompensated care in the wake of the adoption of a new federal “public charge” regulation that seeks to define more narrowly the kinds of individuals who should be granted entry to the U.S. in the future. The new Department of Homeland Security regulation, while focused on applicants for entry into the U.S., could have the unintended effect of discouraging legal immigrants from enrolling in Medicaid, CHIP, and other government programs and even lead them to disenroll from such programs out of a mistaken concern that participating in such programs could jeopardize their status as legal immigrants.  The Kaiser Family Foundation, in fact, estimates … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

Overdose Deaths Down in PA

Overdose deaths in Pennsylvania fell 18 percent from 2017 to 2018, according to a news release issued by Governor Wolf’s office. The decline results, according to the news release, from a combination of prevention, rescue, and treatment.  These and efforts, including the distribution of free naloxone, a drug that helps rescue those who have overdosed on some drugs, have been funded in part by a grant from the U.S. Substance Abuse and Mental Health Services Administration and Pennsylvania’s own Substance Use Disorder Loan Repayment Program, which assists health care professionals who work in the behavioral health field with the cost of their education. At the same time, however, overdose deaths in Pennsylvania from stimulants such as cocaine and methamphetamines continue … Read More

Posted in Uncategorized

PHC4 Reports on Common Procedures

The Pennsylvania Health Care Cost Containment Council has published a new report detailing hospital performance on four common surgical procedures:  knee replacement, hip replacement, spinal fusion, and coronary artery bypass graft. The report details individual hospital performance on these procedures, including in-hospital mortality, complications, and extended post-operative length of stay.  In addition, it breaks down hospital performance for all of these measures and all of these procedures based on patient age, income, gender, geographic location, and race and ethnicity. The PHC4 report also reveals how many of these procedures individual hospitals performed and how much they charged for their services. Learn more in the new PHC4 publication Common Procedures Report.

Posted in Uncategorized

CMS Introduces New Medicaid Opioid Management Guidelines

States must do more to monitor the prescription and use of opioids within their Medicaid programs, the Centers for Medicare & Medicaid Services told them this week. In a formal guidance letter to state Medicaid programs issued as part of implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act of 2018, CMS called on states to update their drug utilization programs, revise relevant portions of their state Medicaid plan, and introduce stronger practices for setting limits on the prescription of opioids and monitoring the use of opioids among patients for whom such drugs are prescribed.  These changes must include both prospective and retrospective drug utilization review. The new requirements apply both to … Read More

Posted in Federal Medicaid issues

PA Slams Brakes on Medicaid Transportation Program Overhaul

The plan to introduce major changes in Pennsylvania’s free medical transportation program for the Medicaid population has temporarily been halted. As envisioned by the state, the current program, in which individual counties contract independently with transportation providers to serve their residents on Medicaid, was to be replaced by a regional approach in which the state contracts with three vendors to serve all of Pennsylvania.  Objections by members of the state legislature and county officials, however, led to legislation that requires the Department of Human Services, Department of Transportation, and Department of Aging to study the implications of such a change for patients and taxpayers and to report their preliminary findings to the legislature in September. Learn more about Pennsylvania’s Medical … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance
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