Coalition Formed to Address Transition to Statewide Medicaid Managed Care
For Immediate Release
September 5, 2019
Harrisburg, PA - The Pennsylvania Coalition for Quality Post-Acute Care (PCQPAC), a not-for-profit 501(c)6, has formed to advance the interest of its high-quality, Medicaid-certified, long-term care nursing facility providers as the Commonwealth transitions from the traditional Medicaid fee-for-service reimbursement program to the new Community Health Choices (CHC) Medicaid program.
CHC is Pennsylvania’s mandatory managed care program for individuals who are eligible for both Medicaid and Medicare, older adults and individuals with physical disabilities. CHC was implemented in the southwest region of the Commonwealth beginning January 1, 2018, in the southeast region January 1, 2019 and will be implemented statewide beginning January 1, 2020.
Among the stated goals of Community HealthChoices is to enhance quality care and create accountability for advancing that goal by measuring and publishing quality metrics so Medicaid patients can make informed choices.
PCQPAC was founded to advance the goal of quality care by:
Facilitating the ongoing contracting between high-quality member facilities and the CHC MCOs;
Ensuring that PCQPAC member facilities will be reimbursed sustainable rates so they can continue their mission of providing quality care;
Ensuring that Pennsylvania’s Medicaid consumers will continue to have an adequate network of high-quality skilled nursing facilities to choose from in their communities; and
Working with our partners, the Department of Human Services (DHS) and the CHC MCOs to enhance program quality by incentivizing quality care through enhanced payment for that quality care. PCQPAC intends to work with DHS and the MCOs to assist in establishing quality parameters for contracting and payment.
High-quality, 3-5-star Medicaid certified nursing facilities interested in joining PCQPAC can reach out to Capozzi Adler, general counsel, for additional information.
PCQPAC is comprised of multiple for-profit, not-for-profit, hospital-based and general skilled nursing facilities that are enrolled in the Commonwealth’s Medical Assistance Program and all have been rated 3-5-star overall quality facilities by the Federal Government’s Center for Medicare and Medicaid Services (CMS). Currently PCQPAC has 18 skilled nursing facility members located throughout the Commonwealth and that number continues to grow as members join to advance the goal of maintaining the Commonwealth’s network of high-quality skilled nursing care providers in the challenging new environment of Medicaid Managed Care.
Dan Natirboff, Esquire