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PA Seeks to Connect Medicaid Beneficiaries With Job

Pennsylvania has launched a new program that seeks to help Medicaid beneficiaries who would like to find jobs. The program, called Medicaid Work Supports, is a joint project of the state’s Department of Human Services and Department of Labor & Industry. As described in The Impact, DHS’s weekly newsletter: The Medicaid Work Supports initiative will create a more direct and systematic introduction to employment and training resources available to Pennsylvanians. When people are deemed eligible and enroll in a new Medicaid health plan, they will be asked if they are interested in help finding a job, training programs, and opportunities to get a high school diploma or GED. The referral system will help identify this population for the first time … Read More

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A Look at Surprise Medical Bill Legislation

While Congress’s decision this week to put off addressing the surprise medical bill challenge until next year has disappointed many, that decision did not reflect any lack of ideas for what to do. At last count, various parts of Congress were considering four major surprise medical bill proposals:  one from the Senate Health, Education, Labor and Pensions Committee, one from the House Energy and Commerce Committee, one from the House Ways and Means Committee, and a compromise proposal from the Senate HELP and House Energy and Commerce committees.  Some have been around for some time while one emerged only in the past week. The Commonwealth Fund has prepared a summary of the four proposals that includes a chart that compares … Read More

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PA Rural Hospitals to Get Boost From State

A new law seeks to stabilize the financial condition of Pennsylvania’s rural hospitals. Senate Bill 314, passed by the legislature and signed by Governor Wolf, establishes a new Rural Health Redesign Center Authority and Pennsylvania Rural Health Redesign Center fund that will seek to support the delivery of health care by rural hospitals in the state by, as a legislative co-sponsorship memo explained, creating an annual, prospective budget with regular, predictable payments; improving the ability to develop and carry out expanded and innovative community health services; and providing the capacity to pursue programs addressing key needs such as behavioral health and substance abuse and cooperative EMS. The new approach will shift participating hospitals from fee-for-service to global payments.  Eligible hospitals … Read More

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Progress Continues Toward Launch of PA Health Insurance Exchange

Pennsylvania remains on target to launch its own health insurance exchange in time for the 2021 open enrollment season. The shift away from using the federal exchange and developing a state-based exchange was approved by the state legislature earlier this year.  That shift took a major step forward recently when the state hired a contractor to create the site’s platform. State officials estimate that once the state’s site is up and running it will costs $25 million a year to operate; currently, Pennsylvania pays $95 million a year to participate in the federal exchange.  In addition, the state will be able to collect the three percent of premiums that insurers pay to appear on the federal site.  Those seeking insurance … Read More

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PHC4 Reports on Hospital Mortality, Admission Rates, and Performance

Mortality rates, admission rates, and other aspects of hospital performance are the subject of a new report by the Pennsylvania Health Care Cost Containment Commission. The report presents information on hospital volume and outcomes for 17 different medical conditions and surgical procedures from October 2017 through September 2018.  It also compares hospital performance over the five-year period from 2013 through 2018 on an aggregate state-wide basis and for individual hospitals. Overall, the report found decreases in hospital mortality for most of the 17 conditions, with respiratory failure, sepsis, colorectal procedures, and intestinal obstructions experiencing the biggest decreases (by percentage).  Hospital admissions for chest pain, chronic obstructive pulmonary disease, and pneumonia experienced the biggest declines while admissions for respiratory failure and … Read More

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PA Insurance Exchange Rates to Rise in 2020

Insurance premiums will rise on Pennsylvania’s new health insurance exchange in 2020, the Wolf administration has announced. 2020 will mark the first year Pennsylvania operates its own health insurance exchange under the Affordable Care Act.  Previously, Pennsylvanians shopped for health insurance on the federal health insurance exchange. Pennsylvania rates will rise an average of four percent for individual plans and 9.7 percent for small groups, the state Insurance Department has announced.  All insurers that offered plans in 2019 will do so again in 2020 and the exchange will include a new insurer and increased choice in some of the state’s 67 counties.  Beginning in 2020, residents of only six counties will have only a single insurer offering individual plans. Learn … Read More

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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

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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.

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Study Finds Surprise in Sources of Medicaid, CHIP Growth

While enrollment in Medicaid and CHIP has been greatest among low-income families working full-time for small businesses, growth in Medicaid and CHIP enrollment among low-income families employed full-time by big businesses has been rising faster in recent years. According to a new study published in the journal Health Affairs, Medicaid and CHIP enrollment among low-income families employed full-time by large companies rose from 45 percent to 69 percent between 2008 and 2016.  The driving force behind this growing reliance on public insurance appears to be the shift of health insurance costs from companies to employees:  employee share of health insurance premiums rose 57 percent during that same period, leaving many families unable to afford even employer-subsidized health insurance. Learn more … Read More

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Opioid Prescriptions Down in PA

Pennsylvania doctors are writing fewer prescriptions for opioids, according to a new analysis by the American Medical Association. According to the AMA, prescriptions for opioids declined 40 percent in the state between 2013 and 2018 – one of the largest declines in the country. In a news release, the Pennsylvania Medical Society attributed the decline in part to physician education and in part to the state’s prescription drug monitoring programs. Learn more from the Central Pennsylvania Business Journal article “Pa. physicians writing fewer opioid prescriptions” and from a news release from the Pennsylvania Medical Society.

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