As hospitals focus on taking care of COVID-19 patients, the American Hospital Association is stepping up its advocacy for hospitals, fighting on their behalf for everything from PPE to reimbursement for uninsured patients. AHA’s Policy Director, Akin Demehin, dives into the top issues facing U.S. hospital administrators as they scramble to adjust their businesses to meet the unprecedented demands of the pandemic.
Besides the obvious concerns related to the direct delivery of care to a surge of very sick patients, hospitals are worried about cash flow, having enough personal protective equipment (PPE) for front-line clinicians, and the challenges of rolling out massive telehealth and remote monitoring programs to care for non-COVID patients at-home.
As the pandemic wears on, and the evolution of hospitals continues, the way these institutions function as part of the U.S. healthcare system will likely be forever changed. We learn what’s important to the AHA — and its 5,000 hospitals and healthcare system members — as they redefine their role in the healthcare system of the future in real-time.
The deadline for comments to Stage 2 is upon us and a clear fork has emerged for federal regulators. The cats and dogs here are institutional vs. patient engagement. The institutional fork has been taken by the American Hospital Association. The patient fork is exemplified by the National Partnership for Women and Families. The primary argument is over patient access to their own information. The draft regulation suggests a 36 hour (or 4 days in other circumstances) delay. The AHA wants 30 days. Some patient advocates are seeking immediate and highly convenient access.
The fork in the road for federal regulators, with some $30 Billion dollars of incentives in hand, is whether to micromanage the institutions or to encourage patient-centered innovation. This choice is deeply entangled in the $Trillion realities of payment reform.
The micromanagement of institutions through increasingly complex regulations on EHR vendors, clerical and clinical staff seems like slow torture. We have institutions begging for relief. Large vendors are consolidating their lock-in business model as the barriers to entry into the health information market get higher and higher. Quality transparency is controversial and price transparency is almost unimaginable.
The Sunlight Foundation today gave us a fascinating first peak at the hospital safety data from the Centers for Medicare and Medicaid Services, which was finally convinced to release the information after years of stonewalling by the American Hospital Association. For the first time, the public can compare less-than-stellar performance at competing local hospitals on key indicators like catheter or urinary tract infections or bed sores.
As their story points out, the data only cover about 60 percent of hospitals since many states, like Maryland, failed to cooperate with the voluntary CMS program. They also caution that any comparison of the raw numbers must take into account the numerous confounding variables that can make one hospital look more slipshod in its practices than another. Some hospitals take in many more older and poorer patients, who are more likely to have multiple chronic conditions that make them prone to complications during their hospital stays.
Yet as Arthur Levin of the Center for Medical Consumers, a New York-based advocacy group, pointed out, “”I think it’s fair (to release the data) as long as everybody agrees on what the limitations are, and what the caveats are. There are those who say this data isn’t ready for prime time and public review. If we waited for perfection, we wouldn’t have anything out there.”Continue reading…