Pennsylvania per-inmate cost of prison medical services drops 8 percent
Pennsylvania's work to rein in spending on health care for prisoners led to an 8 percent drop in the per-inmate cost of medical services over five years, according to a report Tuesday from two nonprofit organizations.
But the state's overall bill for prisoner health care ballooned 20 percent over that period as the inmate population swelled by 30 percent, data in the report by Pew Charitable Trusts and the John D. and Catherine T. MacArthur Foundation show.
The findings buck a national trend of higher per-inmate medical costs, driven by a growing cohort of older prisoners who require care. The state was one of nine to show a decline from 2007 to 2011.
“Health care and prisons have been two of the fastest-growing areas in state budgets,” said Maria Schiff, director of the State Health Care Spending Project, a joint initiative of Pew and MacArthur.
“We did see a trend that states with older inmates tended to spend more on health care on a per-inmate basis,” Schiff said.
That didn't hold true in Pennsylvania, where 8.9 percent of inmates are 55 or older — putting Pennsylvania in the top 10 among states for the age of its prisoners.
The per-inmate cost dropped from $5,088 in 2007 to $4,705 in 2011. The state spent $262 million on prisoner health care in 2011, up from $219 million in 2007. The average daily inmate population grew from 42,998 to 55,696 over the period.
Susan Bensinger, a spokeswoman for the Department of Corrections, said several initiatives to lower costs paid off, including greater use of telemedicine services, close monitoring of pain-management drugs, and $5 co-payments for medical department visits.
Corrections consolidates sick prisoners in need of consistent treatment for cancer, liver disease and hepatitis C at SCI Pittsburgh, providing those services in-house, Bensinger said. Older inmates are housed in a geriatric unit at SCI Laurel Highlands in Somerset. These specialized units reduce travel expenses and the cost of duplicative services at multiple prisons, she said.
The biggest impact came from a 2011 state law that allows Corrections to pay Medicare rates for inmates treated at outpatient facilities and Medicaid rates for inpatient care at hospitals, she said.
The federal Medicare and Medicaid programs typically reimburse hospitals and other medical providers at lower rates.
The department received $2 billion from the state's $28.6 billion budget in the fiscal year that ended June 30.
“Every day is a challenge to make efficient use of taxpayer dollars,” Bensinger said. “With that being said, we are also tasked with the care of the inmate population, and we do that to the standards of community care. It's a fine balancing act.”
Brian Wyant, an assistant professor of sociology and criminal justice at La Salle University in Philadelphia, disagreed. Based on research he conducted at Pennsylvania prisons and from interviews with prisoners, Wyant said many inmates feel they don't get the medical care they would if they weren't incarcerated.
“Inmates on average do not feel they're getting the necessary adequate care,” he said. “(Prison administrators) want to keep costs down, so they are going to do the minimal amount required by law.”
Yet improving care for prisoners at a time of budget deficits is a tough sell, he said. “People are not going to get up in arms when it comes to cutting medical care for inmates.”
Alex Nixon is a Trib Total Media staff writer. Reach him at 412-320-7928 or firstname.lastname@example.org.
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