Pennsylvania

In response to Pennsylvania’s growing chronic disease burden and its impact on healthcare spending, the Governor issued Executive Order 2007-05 on May 21, 2007. This order created the Pennsylvania Chronic Care Management, Reimbursement and Cost Reduction Commission, also known as the Chronic Care Commission. The Commission proposed and then implemented the Pennsylvania Chronic Care Initiative (CCI) designed to achieve four strategic goals:

  • Widespread use of a new primary care reimbursement model that rewards PCMH care based on the Chronic Care Model.
  • Broad dissemination of the Chronic Care Model to primary care practices across Pennsylvania, through regional chronic care learning collaboratives. 
  • Achievement of tangible and measurable improvement in patiient satisfaction, access to care, health outcomes and quality of life.
  • Reduction in the cost of providing chronic care with the reduction of avoidable hospitalizations and emergency room visits and mechanisms to ensure that some of the savings are realized by all entities paying for health care. 

The first rollout (Southeast PA) started in May 2008 and six more learning collaboratives were launched through December 2009, involving a total of 152 mostly small and medium-size primary care practices and 640 providers (75% of the practices have 5 or fewer FTE providers). In four of PA’s seven regions, 17 payers, including Medicaid, provided $30 million in infrastructure payments to practices to support transformation. Since 2009, the state’s contracts with Medicaid managed care organizations (MCOs) have required MCOs to participate in the CCI. Phase II of the CCI began in January 2012 with funding from the Multi-payer Advanced Primary Care Practice demonstration.

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
12,759,200
Uninsured Population:
10%
Total Medicaid Spending FY 2013: 
$21.0 Billion 
Overweight/Obese Adults:
64.5%
Poor Mental Health among Adults: 
35.5%
Medicaid Expansion: 
Yes

Pennsylvania Introduces Legislation to Measure and Increase Investments in Primary Care

Primary care advocates in Pennsylvania are taking the first steps down the road to measuring and enhancing investment in primary care with a new state bill, Senate Bill 809, introduced on June 23, 2023.

News Author: 

SB 809 An Act Establishing the Primary Care Investment Task Force and Providing for Duties of the Primary Care Investment Task Force

Establishes the Primary Care Investment Task Force which will take a detailed and objective look at where Pennsylvania stands when it comes to primary care investments compared to other states. Building off their findings, the task force will also identify what can be done to bolster investment in primary care.

A Matter of Trust: Community Health Workers Build Bridges, Improve Health in West Philly

Community health workers like Norma Gerald, 63, perform a range of functions including social support, patient advocacy, and health system navigation, all with the goal of improving health.

News Author: 
Scott Harris

PCC Executive Member Spotlight: Geisinger

Geisinger has been a PCC Executive Member since June 2019. It was founded more than 100 years ago by Abigail Geisinger, widow of iron magnate George Geisinger, to provide care for her central Pennsylvania community. Since then, it has expanded and evolved to central, south-central and northeastern Pennsylvania and southern New Jersey and is now an integrated delivery system with an insurance company, a large network of physicians and other clinicians, 13 hospitals, a medical school and two research centers.

Health by zip code? Some Philly neighborhoods are ‘primary care deserts’

It was a busy morning at Health Center 10 on Cottman Avenue in Northeast Philadelphia. The seating area was full of families waiting to be called in by a doctor, and a line to see the receptionist snaked throughout the clinic.

News Author: 
Nina Feldman

Greater Philadelphia Comprehensive Primary Care Plus

The Greater Philadelphia Region was one of 14 locations selected to participate in round one of the Comprehensive Primary Care Plus (CPC+) initiative launched by CMS. The coverage areas include Bucks County, Chester County, Delaware County, Montgomery Country, and the Philadelphia County. CPC+ is an advanced five-year initiative designed to strengthen primary care delivery, promote better health outcomes, and control overall health care costs.

Are You And Your Primary Care Doc Ready To Talk About Your DNA?

If you have a genetic mutation that increases your risk for a treatable medical condition, would you want to know? For many people the answer is yes. But such information is not commonly part of routine primary care.

News Author: 
Michelle Andrews

Hoping To See Your Doctor Via Telemedicine? Here’s A Quick Guide.

Tucked into the federal budget law Congress passed in February was a provision that significantly expands the use of telemedicine — long a hyped health care reform, and now poised to go mainstream within five to 10 years.

“There’s much broader recognition of the benefits,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy, a research group that promotes telemedicine in Sacramento, Calif. “The law is the latest to make telemedicine more accessible. But we still have a ways to go before most consumers are aware of the option.”

News Author: 
Steven Findlay

Poll: Voters Say Health Care Top Issue in Election

Voters rank health care as the top issue heading into this year’s midterm elections, according to a HuffPost/YouGov poll released Friday.

More registered voters picked health care as the top issue than any other topic when asked to pick their top two issues, the poll found.

News Author: 
Peter Sullivan

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