PA health information goes cloud-based

Pennsylvania Patient and Provider Network (P3N), the statewide federated health information exchange (HIE), has been modernized to a cloud-based solution to improve health care delivery across the state, the Department of Human Services (DHS) announced Monday. 

The transition ensured providers can deliver whole-person care to patients. 

P3N connects independent health information organizations (HIOs) to share information with health care providers with the goal of improving care for patients. The P3N-certified HIO allows connected health care providers to find patient medical records on the P3N network and by notified when patients receive medical services from other Pennsylvania health care providers, including visits to an emergency room. While P3N does not store health records, providers can use it to find current health information. 

“As technology and innovation advance, we must continue to leverage this progress to improve our work and deliver services across the health care system,” DHS Acting Secretary Meg Snead said. “The P3N’s new platform gives us the opportunity to continue strengthening connections and information across health care providers with the goal of improving the patient experience whenever possible and helping Pennsylvanians to live healthy, fulfilling lives.” 

Using technology to transform into a more efficient health information exchange, the new P3N platform has improved document query and retrieval, enhanced patient matching, and enabled single sign-on for an improved user experience that is also more secure. The coming months are expected see the platform enhanced to a greater degree to support new services, including improved reporting, enhanced portal experience, and integration of the Public Health Gateway. 

“P3N’s new platform provides the foundation for additional services that will integrate care coordination and advance health data exchange in Pennsylvania,” Martin Ciccocioppo, director of the Pennsylvania eHealth Partnership Program said. “Pennsylvanians will greatly benefit from increased system capabilities, making health records securely available to providers and patients in streamlining public health reporting, which will ultimately improve patient health.” 

The Pennsylvania eHealth Partnership Program has worked with P3N participants, regional HIOs, and Cognosante since February 2022 on the modernization project. Cognosante is the technology company contracted for the project. Securely connecting P3N participants and regional HIOs to the new technology platform was the focus of the collaborative effort, along with transitioning P3N services and capabilities with minimal disruption to users. 

For more information on the statewide HIE, visit eHealthPartnership. 

New agreement proposes to cap MCO profits to ensure taxpayer dollars benefit Pennsylvanians

A new profit-sharing agreement between Pennsylvania and its Medical Assistance physical health (PH) managed care organizations (MCOs) has been proposed to ensure taxpayer dollars benefit vulnerable citizens, Governor Tom Wolf announced. 

Under the proposed agreement, which would take effect in 2023, PH-MCOs will be capped at annual profits of 3 % and be required to invest additional profits in approved initiatives and projects aimed at benefiting individual health and well-being. 

“At a time when managed care organizations are seeing incredible returns, it is only right that excess dollars be funneled back into helping the very people those organizations serve,” Wolf said. “This agreement is a responsible use of public money and will put a cap on annual profits to allow the wealth to be shared among those who need it most.” 

MCOs will be able to maintain 3 % profit annually under the proposed profit-sharing agreement. Each MCO will have an opportunity to submit proposals to retain these profits to be used to support initiatives in line with the goals of the Department of Human Services (DHS).  

These goals include achieving health equity, employment supports, food security, housing, and programs focused on community development. The DHS’ Office of Medical Assistance Programs will approve and track each proposal’s measurable goals. All or a portion of the profits may be recouped by DHS should approved programs fail to meet their goals. 

“Managed care organizations are important partners in our work to help Medical Assistance recipients access the care and services necessary to achieve the health and quality of life they deserve,” Acting Secretary Meg Snead said. “This profit-sharing agreement will allow us to ensure that taxpayer resources for this program can be used to further invest in the program’s mission or be returned to offset program costs.” 

MCOs work with the DHS to negotiate and establish rates paid on a monthly basis based on how many members they have. To ensure the program remains financially solvent while allowing for profit of 2-3 %, capitation rates are developed. 

Over the last three years, an overall increase in the physical health program’s profits have exceeded 3 %. As this trend is expected to continue, an opportunity exists to require investments by the PH-MCOs in the Medical Assistance population. The excess profit would be spent on people the funding is intended to benefit. 

More than three million Pennsylvanians are covered by the Medical Assistance program. This profit-sharing agreement is intended to leverage Medical Assistance to ensure taxpayer money aids lower income and vulnerable Pennsylvanians.