Pennsylvania Launches Rural Hospital Global Budget Payment Model Pilot

On March 5, 2019, Pennsylvania Governor Tom Wolf announced the first insurer and hospital participants in the Pennsylvania Rural Health Model. The model transitions hospitals from a fee-for-service (FFS) model to a multi-payer global budget payment. The initial insurance payers for the model are Gateway, Geisinger, Highmark, and UPMC. Medicare is participating. Some of the state's physical HealthChoices Medicaid managed care plans are participating; the Behavioral HealthChoices managed care plans are not participating. The Pennsylvania Department of Health (DOH) said traditional FFS medical assistance is not included at this point due to low volume.

The first . . .