Archive for April, 2014


PA Recoups Tobacco Money in Court Ruling

A Philadelphia court has restored $120 million of Pennsylvania’s share of the annual proceeds from the master settlement that tobacco manufacturers entered into with state governments in 1998.

Last year, an arbitration panel ruled that Pennsylvania had failed to enforce selected tax collection requirements properly and reduced the state’s share of the settlement proceeds by $180 million.  The state appealed the ruling, and last week the court restored $120 million of the $180 million reduction mandated by the arbitration panel.

Pennsylvania uses the proceeds of the tobacco settlement for a number of purposes, including to make Tobacco Uncompensated Care Fund payments to hospitals that serve especially large numbers of uninsured patients and to underwrite clinical, health services, and biomedical research under the state’s Commonwealth Universal Research Enhancement Program (CURE).

Learn more about the tobacco funding issue, the court’s ruling, and the implications of that ruling in this Allentown Morning Call article.

Community Factors Influence Readmissions, Study Says

A new study reports that a variety of factors, including several linked to socio-economic status, account for 58 percent of the variation in the rate of Medicare hospital readmissions at the county level.

Among those factors are low employment, living alone, inability to afford care, the supply of primary care providers and specialists, access to post-discharge nursing home care, and more.

The study found that

The evidence shows that after accounting for patient-risk factors (done by the risk- standardization of the publicly reported rates) and community socioeconomic factors (such as income and employment levels), as well as accounting for hospital characteristics and location, a substantial amount of the variation in readmission rates is explained by local health-system characteristics related to primary care access and the quality of nursing homes. These findings have significant implications on how health care leaders, payers, and policy makers should conceptualize the level of accountability for excess readmissions. The current readmission reduction program that aims to penalize hospitals whose readmissions are above a certain threshold may not be appropriate (Centers 2012). Instead, other payment methods such as those being tested in the Community-based Care Transitions Program (Community 2012), where community-based organizations receive a bundle payment to

Medicaid Growth Doesn’t Mean Increased ER Use

A new study has found that increased enrollment in Medicaid does not necessarily result in increased use of hospital emergency rooms.

Nor does it necessarily contribute to difficulty obtaining care.

According to a study of ten states that eased their Medicaid eligibility requirements between 2000 and 2009, emergency room use among Medicaid patients decreased, as it did in those states that did not ease their eligibility requirements, and the proportion of Medicaid patients reporting difficulty getting access to care declined in expansion states while remaining unchanged in states that did not expand.

The study, led by researchers at the Yale School of Public Health and the Brown University School of Public Health, was published in JAMA Internal Medicine and can be found here.…

Better Integration of Medical, Behavioral Care Could Save Billions

Better integration of medical and behavioral care could save $26-48 billion a year, according to a new report from the American Psychiatric Association.

That would be a savings of between five and ten percent to serve patients with behavioral health problems.

Currently, according to the report, the cost of medical care for patients with behavioral health problems is two to three times greater than care for those without behavioral problems.

The complete study, Economic Impact of Integrated Medical-Behavioral Healthcare Implications for Psychiatry, can be found here, on the web site of the American Psychiatric Association.

Pennsylvania Medicaid Expansion in Jeopardy?

Pennsylvania Governor Tom Corbett has publicly expressed concern over whether the federal government will approve the state’s attempt to expand its Medicaid program under terms made possible by the federal health care reform law.

Both Corbett and Department of Public Welfare Secretary Beverly Mackereth have suggested that negotiations between the state and federal officials have not been going well.

The state submitted an application for a waiver from selected federal Medicaid requirements in February and has modified its proposal once since then, withdrawing a controversial mandatory job-search requirement.  The application is currently undergoing a period of open public comment while state and federal officials negotiate its terms.

Under the Corbett administration’s Healthy Pennsylvania proposal, the state would expand Medicaid eligibility as envisioned under the federal Affordable Care Act but instead of simply opening up its current Medicaid program to the newly eligible, it would underwrite their enrollment in private health insurance plans chosen by those individuals.

Learn more about the latest developments in the state’s attempt to take Medicaid expansion in a decidedly different direction in this Philadelphia Inquirer article.…