PA becomes 27th state to expand Medicaid

A half-million more low-income Pennsylvanians are in line to get federally funded health insurance after HHS on Thursday approved the state’s plan to accept Medicaid expansion money under the landmark 2010 federal healthcare law.

Republican Gov. Tom Corbett’s administration and the federal agency agreed to a plan that lets private insurers administer Medicaid-funded coverage that adheres to Medicaid’s existing rules. The plan vastly expands a Medicaid program that already covers 2.2 million adults and children in Pennsylvania.

Enrollment in the plan, named Healthy Pennsylvania, is expected to begin Dec. 1 with coverage to start the following Jan. 1. With the agreement, Pennsylvania joins 26 other states and Washington, D.C., in opting for the Medicaid-funded expanded coverage.

Corbett was under pressure from hospitals, labor unions, the AARP and advocates for the poor to accept the Medicaid expansion money, which became available Jan. 1 of this year. They argued it would cover hundreds of thousands of low-income working adults.

The governor, a critic of President Barack Obama’s signature healthcare law, initially refused to accept the federal money without changes to the Medicaid expansion as it was envisioned by the law. He proposed ways to make the Medicaid coverage more like private insurance, including waiving some […]

By |August 31st, 2014|Health Reform, Medicare/Medicaid|Comments Off

CMS finalizes EHR meaningful-use rule, adds some flexibility

The CMS late Friday finalized a rule allowing hospitals and eligible professionals more flexibility in how they meet requirements for the electronic health-record incentive program. The agency had first proposed the idea in a May draft rule. Friday’s final rule left the May proposal unchanged.

The rule would grant providers a longer timeline and more flexibility in meeting the incentive goals laid out by the stimulus program first created in the 2009 HITECH Act. The incentive program provides doctors and hospitals stimulus funding to implement electronic health records.

The rule pushes back the beginning of the third stage of meaningful use for the first cohort of adopters until Jan. 1, 2017, as opposed to the old standard of Jan. 1, 2016.

Also, some providers struggling with adoption of 2014 certified EHRs will be granted more flexibility. Providers essentially now have an extra year to use 2011 Edition software. The final rule notes that availability of technology was constrained because of late certification and high demand.

Stakeholders had a mixed response to the rule.

The American Hospital Association’s Chantal Worzala, director of policy, said in a statement: “The American Hospital Association appreciates the flexibility offered by CMS today. Unfortunately, this rule offers little relief because […]

By |August 30th, 2014|Health Reform|Comments Off

Ratings Agency: Not-for-Profit Hospital Earnings Tumble

Revenue growth at not-for-profit hospitals slowed to its lowest level on record last year, according to a new report by Moody’s Investors Service.

Revenue at 383 hospitals tracked by the ratings agency grew 3.9 percent—far below the usual 7 percent annual growth.

Hospital admissions fell for the first time, according to the report, and growth in hospital expenses outpaced revenue growth for the second year in a row.

Among the culprits of the income slowdown, according to Moody’s, was the increased use of high-deductible health plans that led patients to postpone care or to use lower-cost retail clinics. Additionally, Medicare increased reimbursement cuts required by the 2012 Budget Control Act and the Affordable Care Act (ACA). Also cited were Medicare’s two-midnight rule and lower payment rates by many commercial payers.

Demand for inpatient care also declined as a growing share of patients sought outpatient care instead.

Hospitals also reported growing levels of bad debt from people who could not or would not pay their share of the costs of their care.

“As hospitals feel the squeeze of payment reductions they are trying to cut costs to keep up with the lower revenues, which is becoming increasingly difficult,” said Todd Nelson, director of healthcare finance policy, […]

By |August 30th, 2014|Industry News|Comments Off


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