Pennsylvania

Hospitals, Insurers, City Government Launch Health Equity Effort

The pursuit of health equity is the subject of a new collaboration between health systems, health insurers, and a big city government. The new effort, dubbed “Accelerate Health Equity,” will seek to bring “…together organizations across the region to produce tangible improvement in health inequities, and ultimately achieve measurable, positive changes in health outcomes in Philadelphia.” Among the participants in the endeavor are AmeriHealth Caritas, Children’s Hospital of Philadelphia, the City of Philadelphia, Drexel University, Independence Blue Cross, Jefferson Health, Main Line Health, Penn Medicine, Philadelphia College of Osteopathic Medicine, Temple Health, and Trinity Health Mid-Atlantic. The group envisions its [...]

admin2022-03-24T06:00:51+00:00March 24, 2022|health equity, Pennsylvania|

Pennsylvania to Introduce Medicaid PDL on January 1

Starting on January 1, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients. And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs. The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services, which administers the state's Medicaid program. While physicians may submit requests to the state for exemptions for specific patients for specific purposes, those exemptions may be relatively uncommon: [...]

admin2019-12-26T11:42:42+00:00December 26, 2019|Medicaid, Pennsylvania, Pennsylvania Medicaid, Pennsylvania Medical Assistance|

State to Experiment with Global Budgets for Rural Areas

The Commonwealth of Pennsylvania plans to launch an experiment in which participating health insurers will fund global budgets to care for residents served by selected rural hospitals. The program seeks to preserve access to care in rural parts of the state by stabilizing the financial health of struggling rural hospitals. According to a Pennsylvania Department of Health news release, The Rural Health Model is an alternative payment model, transitioning hospitals from a fee-for-service model to a global budget payment. Instead of hospitals getting paid when someone visits the hospital, they will receive a predictable amount of money. Payment for the [...]

admin2019-03-07T13:00:31+00:00March 7, 2019|Alternative payment models, hospitals, Pennsylvania|