Rendell’s health care proposal opposed
The president and chief executive officer of Gateway Health Plan testified Tuesday that a proposal by Gov. Ed Rendell to delay payments to managed-care organizations for a month would be “devastating.” “The new change would be devastating for us. The state has put forth a damaging proposal. I ask you to reject the proposal for delayed payments,” said Michael Blackwood during comments before a subcommittee hearing hosted by members of the state House Appropriations Committee, subcommittee on health and human services. The proposal calls for delaying the January 2008 payment until February, thus providing 11 payments next year. Blackwood said his managed-care plan has 243,000 members.
Blackwood was one of 15 people who included officials of managed-care organizations, hospitals and nursing homes who had an opportunity Tuesday to voice concerns about how Rendell’s proposed budget would impact the services they provide.
Sherry Knowlton, senior vice president of AmeriHealth Mercy Health Plan, said she also was concerned about a proposal to “carve out” the pharmacy component from the Health Choices program.
“The quality and continuity of care will be disrupted,” she said.
Knowlton also was critical of a study in which the Department of Public Welfare estimated certain savings by making changes to programs.
After the panel of managed care representatives testified, state Rep. Timothy S. Mahoney, D-South Union Twp., said he doesn’t like the idea of either delayed payments or “carve outs.” State Rep. Dave Reed, R-Indiana County, also expressed concerns about the proposed delayed payments.
State Rep. Kathy Manderino, D-Philadelphia, chairwoman of the subcommittee on health and human services, hosted the medical assistance-themed hearing at Penn State, The Eberly Campus. It is one of several subcommittee hearings on various topics being held throughout the state this week.
While the concerns varied among the panel members, the overwhelming theme throughout the afternoon was the reimbursement rate for Medicaid patients, as well as the increasing number of Medicaid patients visiting the facilities.
Manderino said she also shares concerns about carve outs and delayed payments, but urged those who testified to give concrete alternatives to saving money in contrast to the proposal made by the DPW.
“There are $400 million in savings if you believe the DPW. We need concrete alternatives,” Manderino said.
Hospital representatives testified that the number of Medicaid births is increasing statewide. And the reimbursement rate is only at 75 percent.
Carolyn Scanlon, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, said she disagrees with the proposed $144 million reduction to hospital and is asking for $62 million more for hospitals.
Michelle Cunningham, CEO of Highlands Hospital, said as the smallest independent hospital in the area, she has to come up with creative ways to fund the hospital, including accepting grants and donations for equipment.
“Any cuts to medical assistance would devastate us. The small community hospitals are the safety net for the poor,” Cunningham.
Katherine Levins, director of government affairs for Temple University Health System, said her five hospitals are the safety net provider for North Philadelphia, and the Medicaid volume has really spiked.
Reed said he sees two areas as the problem being cracking down on fraud via the DPW and the cost of health care in general.
Dr. Lawrence Glad, an obstetrician at Uniontown Hospital, said the tort system needs repaired. He said more than 15 physicians have been lost over the issue.
Nursing homes operators also lamented the high percentage of Medicaid patients and corresponding reimbursement rate.
Dr. Stuart Shapiro, president and CEO of Pennsylvania Health Care Association, called it “poppycock” that the budget includes a 2 percent increase for nursing homes. He said what is needed to more concrete data about the number of people in nursing homes.
Sister Beatrice Marie of St. Ann’s Nursing Home in Greensburg said there are too many regulations for nursing homes.
“People are allowed to fall and die in their own homes, but don’t let it happen in nursing homes,” she said.
Davis Smith, owner of South Fayette Nursing Center in Markleysburg, said the “unnecessary regulations and constant changes” could be cut.
The testimony will be used to finalize the health and humans services portion of the budget.