BLOG: Increasing Access to High-Quality Health Care in Pennsylvania
By: Ted Dallas, Secretary of Human Services
January 12, 2016
When I joined Governor Tom Wolf’s team, he asked me to work with him to develop better health care options for Pennsylvania’s most vulnerable.
In 2015, the Department of Human Services made significant improvements to ensure Pennsylvanians have access to high-quality health care. We are committed to delivering health care options that fit people’s needs, while working towards a shift in health care provider thinking about value over volume.
Watch Secretary Ted Dallas talk about the Department of Human Services’ year in review:
First: We Expanded Medicaid
For individuals and families, access to health care coverage improves health outcomes and offers financial protection against costly health care expenses that some cannot afford. The governor asked that I smoothly transition people into HealthChoices (Pennsylvania’s Medical Assistance program), while enrolling hundreds of thousands more into the program.
Throughout his campaign, Governor Wolf promised to simplify a complicated health care system. Once he was in office, DHS transitioned to a traditional Medicaid expansion through our HealthChoices program. Pennsylvania’s uninsured population has decreased from 14 percent in 2013 to eight percent today. A majority of the decrease can be attributed to Governor Wolf’s expansion plan.
DHS now serves more than 2.6 million individuals through HealthChoices. Most importantly, more than 511,000 Pennsylvanians have access to health care coverage who did not have this access before.
That means people who previously fell in “the gap” — the working class who previously made too much for Medicaid, but not enough to qualify for subsidies on the federal exchange — have access to dental, behavioral, and physical health care. As a result, hundreds of thousands of people have a brighter future and the potential for better health outcomes, which provides the added bonus of enhancing the fiscal well-being of our state.
Then: We Began the Shift from ‘Volume’ to ‘Value’
My department believes it’s time for the health care system to shift their thinking from volume to value. We are working hard to make sure those involved in your medical needs are focused on the outcomes of your health, not how quickly services are provided.
In September, DHS issued a request for proposals (RFP) for physical health services provided through HealthChoices. When awarded, the contracts will require the managed care organizations (MCOs) to increase the amount of money they spend on contracts that reward value, care coordination, and better health outcomes rather than simply paying for services.
I believe that if you pay for services, you will get services. If you pay for outcomes, you will get outcomes. The result will be a system that focuses more on the patient as a whole and provides higher quality care to those in the Medicaid system.
Next: We Will Continue to Work Towards Highest Quality Care
We must continue to innovate and move forward if we are going to provide the high-quality health care that all Pennsylvanians deserve. As the biggest insurance payor in the commonwealth, our hope is that these changes will encourage innovation in the private sector as well.
I believe the efforts made this year have laid the groundwork to achieve the goals that Governor Wolf has laid out for me, as well as the goals that the DHS team has established. I remain grateful and excited for the opportunity to work with the Wolf Administration to make Pennsylvania a better place.
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