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Things You Need to Know about Community HealthChoices

Community HealthChoices (CHC) is Pennsylvania’s mandatory managed care program for individuals who are dually eligible for both Medical Assistance and Medicare–older adults and individuals with physical disabilities.  This program was implemented in southwestern Pennsylvania in January 2018, southeastern Pennsylvania in January 2019, and will be implemented in the remainder of the state on Jan. 1, 2020.  CHC information for providers or participants can be found at www.healthchoices.pa.gov.  Fact sheets and online trainings can be found here.   Access a list of frequently asked questions (FAQs) about CHC by clicking here.  To become part of the provider network contact:

Pennsylvania Senate Advances Telemedicine Bill

During the week of October 28, 2019, the Pennsylvania Senate quickly fast-tracked a telemedicine bill that nearly made it to Governor Wolf’s desk last December. Senate Bill 857 expands the use of telemedicine for providers, including Community Health Centers , to provide care and receive reimbursement from both managed care organizations (MCOs) and commercial insurance. One new caveat to the bill is a requirement for any affected licensure boards overseeing specialties to promulgate regulations within 24 months of passage. As of October 30, the legislation is before the House for consideration.

Pennsylvania Partnerships for Children’s Annual State of Children’s Health Care Report Released

The opportunity to prosper begins with preventive health care when children are young. A healthy start includes immunizations, screenings, regular dental care, well-child visits and access to nutritious food.  However, 124,000 Pennsylvania children do not have health insurance, and children under six are the most likely to be without coverage according to our newest report, “State of Children’s Health Care in Pennsylvania: Powering Up Healthy Kids.”

While Pennsylvania’s uninsured rate falls below the national average, it remains stagnant at 4.4 percent, with Pennsylvania ranking in the middle of the pack at 24th for the percentage of uninsured children.

According to a new report released by the Georgetown University Center for Children and Families, the number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend.

No child should be without health care insurance and our report sets a clear agenda to strengthen both access and coverage benefits in health care for the Commonwealth’s children.

Research: Policy Change and Implementation of a Needle Exchange Program Averts More than 10,000 Potential Diagnoses of HIV

Syringe exchange programs (SEP) reduce HIV incidence associated with injection drug use (IDU), but legislation often prohibits implementation. We examined the policy change impact allowing for SEP implementation on HIV diagnoses among people who inject drugs in 2 US cities.

Using surveillance data from Philadelphia (1984–2015) and Baltimore (1985–2013) for IDU-associated HIV diagnoses, we used autoregressive integrated moving averages modeling to conduct 2 tests to measure policy change impact. We forecast the number of expected HIV diagnoses per city had policy not changed in the 10 years after implementation and compared it with the number of observed diagnoses postpolicy change, obtaining an estimate for averted HIV diagnoses. We then used interrupted time series analysis to assess the immediate step and trajectory impact of policy change implementation on IDU-attributable HIV diagnoses.

The Philadelphia (1993–2002) model predicted 15,248 new IDU-associated HIV diagnoses versus 4656 observed diagnoses, yielding 10,592 averted HIV diagnoses over 10 years. The Baltimore model (1995–2004) predicted 7263 IDU-associated HIV diagnoses versus 5372 observed diagnoses, yielding 1891 averted HIV diagnoses over 10 years. Considering program expenses and conservative estimates of public sector savings, the 1-year return on investment in SEPs remains high: $243.4 M (Philadelphia) and $62.4 M (Baltimore).

The authors conclude that pPolicy change is an effective structural intervention with substantial public health and societal benefits, including reduced HIV diagnoses among people who inject drugs and significant cost savings to publicly funded HIV care.

Access the full report here.