Pennslyvania State Flex Program
What is one Core Competency your state Flex Program is working on developing through Flex activities?
Core Competency: Improving Financial Sustainability
A significant activity conducted through the Pennsylvania Flex Program is the effort focused on the Medicaid supplemental funds provided by the Commonwealth of Pennsylvania and the Centers for Medicaid and Medicare Services. The Flex Coordinator collaborates with a contracted specialist to calculate the shortfall amount for Medicaid services provided by the CAHs using the Medicaid Cost Report. This calculation is provided to the Pennsylvania Department of Human Services, the state’s Medicaid Agency, which audits the report. After the total is validated, advocacy efforts begin with the Pennsylvania Office of Rural Health staff and the Hospital and Healthsystem Association of Pennsylvania to maintain reimbursement in the Commonwealth budget at 101 percent of the CAHs Medicaid costs to be paid in April-June of the following year.
What is one activity your state is funding through SHIP?
The Pennsylvania Office of Rural Health (PORH) SHIP funds will be used to prioritize ICD-11 coding readiness by providing a webinar to all SHIP hospitals, resources to the hospitals including allowable expenses for ICD-11 readiness, and technical assistance. Many Pennsylvania hospitals within larger health systems do not have independent control over their health system’s ICD-11 implementation plans or timelines. PORH staff will address this complication by encouraging participation in ICD-11 readiness activities that fall in other allowable investment categories.
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