/ en Sun, 27 Apr 2025 10:59:55 -0500 Tue, 20 Jun 23 15:30:00 -0500 /resources/2016-04-12-verification-graduate-medical-education <p>Over time, hospitals and their medical staff services offices have developed unique forms to verify resident training for credentialing as required for hospital accreditation. To help streamline and standardize the residency verification process and meet hospital credentialing needs, the AHA, in partnership with other national organizations, has developed templates to provide the necessary information to meet credentialing needs while reducing the need for program directors to complete multiple requests for information.</p> Tue, 12 Apr 2016 00:00:00 -0500 Teaching /fact-sheets/2022-12-02-fact-sheet-increased-graduate-medical-education-needed-preserve-access-care <div class="container"> <div class="row"> <div class="col-md-8"> <h2>The Issue</h2> <p>A talented, qualified, engaged and diverse workforce is at the heart of America’s hospitals and health care systems. However, hospitals and health systems now face mounting and critical physician shortages — estimated to reach 124,000 physicians by 2033 — that will jeopardize access to care in communities across the nation.</p> <p>These shortages — combined with an aging population, a rise in chronic diseases and behavioral health conditions, physician burnout from the pandemic, and “state-of-the-art” care delivery advancements — all contribute to a need for robust graduate medical education (GME) funding to adequately prepare America’s health care workforce for the health system of the future and ensure continued access to care.</p> <p>Congress enacted the Medicare GME program to ensure a sufficient supply of well-trained physicians. However, the current cap on Medicare-supported residency positions, imposed by the Balanced Budget Act of 1997, restricts the number of positions for which teaching hospitals can receive direct GME funding (DGME) and the amount of indirect graduate medical education (IME) funding they receive.</p> <h2>AHA Take</h2> <p><strong>We urge Congress to increase the number of Medicare-supported GME residency positions.</strong></p> <p>The AHA supports the bipartisan Resident Physician Shortage Reduction Act of 2023 (H.R. 2389/S.1302) which would add14,000 Medicare-funded residency slots over the next seven years. The bill would also require the Government Accountability Office to study strategies for increasing the diversity of the health professional workforce and report its findings and recommendations to Congress within two years of enactment.</p> <h2>Background</h2> <p>Physician shortages are growing, exacerbated by caps on the number of Medicare-funded residency slots. The Association of American Medical Colleges projects a national shortage of up to 124,000 physicians by 2033, including shortages of primary care physicians and specialists, such as pathologists, neurologists, radiologists and psychiatrists.</p> <p>While the aging of the U.S. population and the physician workforce drive some of the projected shortage, much of it stems from the caps on Medicare-funded residency slots imposed by Congress nearly 25 years ago as a cost-saving measure, based on erroneous projections about the need for physicians. Although the number of medical school graduates has increased significantly over the past two decades, Medicare-funded training opportunities for these graduates has remained frozen at 1996 levels. As a result, more than 3,300 applicants lacked residency slots in 2022.<sup>1 </sup>Furthermore, the caps have created imbalances that favor allocation of slots toward lower-cost and higher-reimbursement specialties, rather than more urgently needed primary care and behavioral health. While some hospitals are filling in gaps by self- funding a portion of their own, this model is not sustainable over the long haul, as evidenced by the -17.3% Medicare margins (without COVID-19 relief funds) for teaching-only hospitals in 2020.<sup>2</sup></p> <p>Lifting the cap on Medicare-funded residency positions would enhance access to care and help America’s hospitals better meet the needs of the communities they serve. Increasing Medicare-funded residency slots would provide hospitals more flexibility to diversify and maintain training programs, including both primary care and specialty programs. In addition, an increase in slots would allow health systems to train residents in more diverse facility types, such as smaller rural hospitals which may not be able to operate their own training programs. This would benefit both the quality of physician education and the patients they would serve.</p> <hr> <ol> <li id="fn1">NRMP 2022 Main Residency Match, <a href="https://www.nrmp.org/wp-content/uploads/2022/11/2022-Main-Match-Results-and-Data-Final-Revised.pdf" target="_blank">https://www.nrmp.org/wp-content/uploads/2022/11/2022-Main-Match-Results-and-Data-Final-Revised.pdf</a>.</li> <li id="fn2">July 2022 MedPAC Databook Section 6 Acute Inpatient Services, <a href="https://www.medpac.gov/wp-content/uploads/2022/07/July2022_MedPAC_DataBook_Sec6_SEC.pdf" target="_blank">https://www.medpac.gov/wp-content/uploads/2022/07/July2022_MedPAC_DataBook_Sec6_SEC.pdf</a>.</li> </ol> </div> <div class="col-md-4"> <p><a href="/system/files/media/file/2022/12/Fact-Sheet-Increased-Graduate-Medical-Education-Needed-to-Preserve-Access-to-Care.pdf" target="_blank" title="Click here to download the Fact Sheet: Increased Graduate Medical Education Needed to Preserve Access to Care PDF."><img alt="Fact Sheet: Increased Graduate Medical Education Needed to Preserve Access to Care April 2023 page 1." data-entity-type="file" data-entity-uuid="e" src="/sites/default/files/2023-06/Page-1-Fact-Sheet-Increased-Graduate-Medical-Education-Needed-to-Preserve-Access-to-Care-r..png"></a></p> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/05/Fact-Sheet-Increased-Graduate-Medical-Education-Needed-to-Preserve-Access-to-Care.pdf" target="_blank" title="Click here to download the Fact Sheet: Increased Graduate Medical Education Needed to Preserve Access to Care PDF.">Download the PDF</a></div> </div> </div> </div> Tue, 20 Jun 2023 15:30:00 -0500 Teaching /education-events/2023-aha-annual-membership-meeting <p><span><span>Join your colleagues at the 2023 AHA Annual Membership Meeting, April 23-25, to ensure our message is united, powerful and able to break through the noise, making a positive impact for the patients and communities you serve. Meet face-to-face with your elected officials and key policymakers to discuss how you are caring for your community and making a difference. Hear from innovative health care leaders, legislators, journalists, and other thought leaders of our day on critical issues that will have an impact on our field and how we will continue to care for patients. And network with your peers as you tackle today’s toughest issues, together. We look forward to seeing you there!</span></span></p> <p>Please visit the <a href="https://annualmeeting.aha.org/registration">conference website</a> for additional information. Registration is now open.</p> Tue, 10 Jan 2023 13:57:21 -0600 Teaching /case-studies/2022-11-29-temple-university-hospital-pennsylvania <div class="container"><div class="row"><div class="col-md-8"><h2><span>Overview</span></h2><p><img src="/sites/default/files/inline-images/Temple-University-Hospital-Pennsylvania.jpg" data-entity-uuid="06e6d841-d122-49c6-a1c1-4488ba50e5e2" data-entity-type="file" alt="Temple University Hospital, Pennsylvania." width="518" height="295" class="align-right">Temple University Hospital (TUH) was founded in 1892 as "Samaritan Hospital," with the mission of caring for patients with limited incomes and ensuring access to medical care in its surrounding neighborhoods. As the chief academic teaching hospital of the Lewis Katz School of Medicine at Temple University, Temple University Hospital (TUH) provides medical education to the next generation of physicians and biomedical scientists, while also serving the broader Philadelphia community through over 600,000 outpatient visits, 151,000 emergency department visits, 10,000 psychiatric crisis response visits, and 17,000 inpatient and outpatient surgeries in 2021.</p><p>The North Philadelphia community is one of the lowest-income areas in Pennsylvania, so the population TUH serves is already dealing with challenges due to social or economic disadvantages. Approximately 62% of the local population has an education level of high school or less, 12% do not speak English as a primary language, and 45% live in households that earn less than the federal poverty level. Of Philadelphia’s 46 neighborhoods, Temple University Hospital’s immediate neighborhood has the lowest life expectancy. With respect to patients served, about 70% have one or more chronic conditions, 50% have a behavioral health diagnosis, and 25% have a substance use disorder.</p><blockquote><h3><span><em>“We face additional pressures on top of the traditional care model that others don’t have. We’re expected to play poker with two cards, but you can’t win very often doing that."</em></span></h3><p><span><strong>Michael A. Young</strong></span><br>President and Chief Executive Officer, TUH</p></blockquote><h2><span>Patient–Payer Mix</span></h2><p>As a metropolitan anchor hospital (MAH), TUH treats some of the most medically complex patients in the region who rely on public programs for health care coverage. Approximately 45% of patients are covered by Medicaid, 41% are covered by Medicare, and 12% are covered by commercial insurance. Medicaid and Medicare patients comprise about 87% of total discharges. Payments from these government payers comprise about 75% of TUH’s net patient revenue. TUH provides about $25 million in charity care each year.</p><p>Due to its patient-payer mix, TUH faces significant financial and workforce challenges. Hiring and retaining the staff necessary to treat this community are two of the biggest challenges facing TUH. Given the overall economics, it is difficult for TUH to offer competitive salaries <em>and</em> provide for the unique needs of the broader community.</p><h2><span>TUH's Unique Approach to Care</span></h2><p>Each year, TUH spends $1.6 billion to further its health care mission. With 50% of its employees living in the community, TUH is a vital part of the local economy. TUH’s contributions include:</p><h3><span>COVID-19 Community Outreach</span></h3><p>TUH administered more than 128,000 COVID-19 vaccine doses, and two-thirds of those recipients were Black or Hispanic. The hospital established a monoclonal antibody infusion clinic and post-COVID-19 recovery clinic. Although TUH’s population is at high risk for COVID-19, its COVID-19 patient mortality rate was 33% better than hospitals across the nation. It was the only Pennsylvania hospital honored by Healthgrades as a <em>Leading Hospital in COVID Care</em> for excellence in treating high volumes of coronavirus patients during the pandemic’s first wave.</p><h3><span>Supporting Moms and Newborns</span></h3><p>TUH’s pre- and post-natal care programs include perinatal care, breastfeeding support, and Sleep Awareness Family Education. TUH offers trauma-informed care for mothers with substance use disorder (SUD), including behavioral health services and medication-assisted treatment. To strengthen equity in care delivery, TUH is planning a dedicated hospital for women and infants. Medicaid covers 90% of infant deliveries.</p><h3><span>Workforce Development</span></h3><p>With more than 10,000 faculty members and employees, Temple University Health System is a major regional employer. More than 2,500 students of medicine, nursing, and other health professions received hands-on training at TUH last year. Trainees are enrolled not only in Temple’s affiliated School of Medicine, College of Public Health, and School of Pharmacy, but in numerous other colleges and community-based training programs.</p><h3><span>Housing Smart</span></h3><p>In collaboration with managed care plans and social service agencies, TUH launched a two-year program to help 25 homeless Medicaid patients who frequently use hospital emergency departments. Patients are provided free housing and caseworkers to connect them with healthcare, nutritious meals, and social services.</p><h3><span>Other Community and Social Support Programs</span></h3><p>Like many other metropolitan anchor hospitals, TUH offers food, housing, behavioral health, trauma, and SUD support programs. A multi-visit patient clinic has been established to specifically treat patients with a high frequency of emergency department use. This holistic treatment of high-use patients not only lowers treatment costs but also leads to better health outcomes.</p><h2><span>Metropolitan Anchor Hospitals Need Support</span></h2><p>Despite its financial challenges, TUH continues to support innovative programs to improve the health and well-being of its community. However, with higher care costs and less reimbursement, staff retention remains a challenge. With additional and more stable financial resources, MAHs like TUH could expand their successful programs, strengthen patient outcomes, and further improve overall health.</p></div><div class="col-md-4"><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2022-10-21-exploring-metropolitan-anchor-hospitals-and-communities-they-serve" target="_blank" title="Click here to read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report and download the PDF.">Read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report</a></div><p><a href="/system/files/media/file/2022/10/Temple-University-Hospital-MAH-Case-Study.pdf" target="_blank" title="Click here to download the Temple University Hospital, Pennsylvania: Metropolitan Anchor Hospitals (MAH)case study PDF."><img src="/sites/default/files/inline-images/Page-1-Temple-University-Hospital-MAH-Case-Study.png" data-entity-uuid="66d75501-debf-47ba-a4ed-734ef4b0c4fb" data-entity-type="file" alt="Temple University Hospital, Pennsylvania Metropolitan Anchor Hospital (MAH) Case Study page 1." width="695" height="900"></a></p><hr><p><div class="views-element-container"> <section class="top-level-view js-view-dom-id-5cb7828cee8b61fdd677b725b078776409b75e024004f066afbfc5750ac14cc0 resource-block"> <h2 id="mahcasestudies">Metropolitan Anchor Hospital Case Studies</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/2024-01-04-adventist-health-bakersfield-california" hreflang="en">Adventist Health Bakersfield | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-01-04T08:41:22-06:00">Jan 4, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-12-05-henry-ford-hospital-michigan" hreflang="en">Henry Ford Hospital | Michigan</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-12-05T10:22:49-06:00">Dec 5, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-10-25-denver-health-system-colorado" hreflang="en">Denver Health System | Colorado</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-10-25T06:00:00-05:00">Oct 25, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-12-broadlawns-medical-center-iowa" hreflang="en">Broadlawns Medical Center | Iowa</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-12T15:13:18-05:00">May 12, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-10-mlk-community-healthcare-california" hreflang="en">MLK Community Healthcare | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-10T08:48:40-05:00">May 10, 2023</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/mah-case-studies">More MAH Case Studies</a></div> </section> </div> </p></div></div></div> Tue, 29 Nov 2022 10:08:08 -0600 Teaching /case-studies/2022-11-02-uams-health-arkansas <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>Overview</span></h2> <p><img alt="UAMS Health, Arkansas." data-entity-type="file" data-entity-uuid="a8489588-7658-4297-b3bb-0cff3d376f5a" src="/sites/default/files/inline-images/UAMS-Health-Arkansas_0.jpg" width="513" height="380" class="align-right">Since 1879, the University of Arkansas for Medical Sciences (UAMS) has been a fixture in Little Rock, Arkansas. UAMS Health is on a mission to improve the health and well-being of Little Rock residents and patients across the entire state through its <a href="https://web.uams.edu/wp-content/uploads/2022/04/Fast-Facts-04_2022-1.pdf" target="_blank" title="UAMS Fast Facts">statewide health system</a>, which includes UAMS Health; a statewide network of campuses providing primary and specialty care; and, expertise in population health, digital health, health informatics, and research.</p> <p>UAMS maintains a 535-bed hospital on its main campus with the only adult Level 1 Trauma Center in Arkansas. UAMS’ centrality also makes it a region-wide magnet for high-quality care—some of which is offered nowhere else in Arkansas. The system operates the state’s only adult sickle cell clinic, adult spina bifida clinic, adult cystic fibrosis clinic, ALS treatment center, liver transplant program, kidney transplant program, high risk maternal-fetal medicine program, and cord blood bank.</p> <p>UAMS offers primary care at three off-campus locations in Little Rock and nearby Maumelle. Its eight family medical centers at regional campuses across the state recorded approximately 120,000 visits in 2020. As Arkansas’ only academic health system, UAMS has made significant investments in the future health care workforce, training nearly 2,900 students, including 900 medical residents in Fall 2020 alone.</p> <blockquote> <h3><span><em>“You can't be an anchor institution without substantively committing to being an equal parity member of the communities in which you reside.”</em></span></h3> <p><span><strong>Stephen Mette, MD</strong></span><br> Senior Vice Chancellor for UAMS Health and CEO of UAMS Medical Center</p> </blockquote> <h2><span>Patient–Payer Mix</span></h2> <p>As a metropolitan anchor hospital (MAH), UAMS faces a challenging patient-payer mix in its mission to serve all patients, regardless of insurance status. Located between one of the wealthiest communities and one of the lowest-income ZIP codes in the state, UAMS treats patients with varying and complex care needs.</p> <p>Approximately, 20% of patients treated at UAMS are Medicaid beneficiaries and 30% are covered by Medicare. Medicaid and Medicare patients make up more than 52% of total visits and nearly 50% of total discharges, yet make up only 44.4% of net patient revenue. More than 40% of patients have commercial health insurance. Only about 2.5% of patients were uninsured, down from 19% prior to the implementation of the Affordable Care Act. UAMS provides an average of more than $81 million in charity and uncompensated care annually.</p> <p>UAMS is proud to serve a diverse group of patients. Approximately 15% of admissions are patients transferring from other hospitals seeking high-quality, specialty care.</p> <h2><span>An Institution Anchored to Its Community</span></h2> <h3><span>Meeting the Unique Needs of All Local Communities</span></h3> <p>The main campus of UAMS services a variety of different communities with various needs, all of which UAMS is able to meet, demonstrating its role as a true anchor to the community. To the north lie several affluent neighborhoods whose residents receive primary care from other providers but depend on UAMS Health for specialty and emergency services. South of the campus, across the highway, are several neighborhoods that have no grocery stores, pharmacies, or banks. UAMS knows that these communities have different needs and face different social determinants of health (SDOH), which is why it collects SDOH information from every patient at the point of care. Understanding that a variety of factors such as household income, exposure to violence, and food security impact patient health helps UAMS’ medical providers address health inequities.</p> <p>Recognizing the need to be a trusted member of the community, UAMS partners with several community organizations to bring health care and social services to traditionally marginalized areas. For example, a partnership to establish a healthy grocery store is underway. This commitment to equity also extends to supporting the UAMS workforce, especially those who come from low-income communities. The health system recently committed to paying a living wage for all employees, and through a partnership with local banks, builders, and the City of Little Rock, UAMS is working to rehabilitate old homes and provide low-interest loans to employees to purchase them.</p> <h3><span>Training Future Health Care Professionals – and Educating About Health Equity</span></h3> <p>UAMS plays an enormous role in educating Arkansas’ health care workforce, producing nearly half of the state’s practicing physicians. This commitment extends far beyond the Little Rock area. In rural areas of the state, which often face a shortage of doctors, UAMS trains an even higher percentage of physicians—nearly 60%.</p> <p>A significant part of the curriculum includes mandatory training education around health equity and social determinants of health. UAMS staff are also required to attend educational seminars on intrinsic bias and health disparities, and they have the opportunity to volunteer with the health system’s clinics that provide free care in low-income communities.</p> <h2><span>Metropolitan Anchor Hospitals Need Greater Support</span></h2> <p>Like many other metropolitan anchor hospitals, UAMS faces serious financial pressures. Without stable financial support, the specialized programs and extensive community outreach activities that benefit the Little Rock community will be at risk. With a MAH designation and adequate funding, systems like UAMS would have the opportunity to ensure financial stability. Federal policymakers must do more to ensure systems like UAMS are able to obtain sustained, adequate support so their leadership can plan for the future and build upon their many successes.</p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2022-10-21-exploring-metropolitan-anchor-hospitals-and-communities-they-serve" target="_blank" title="Click here to read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report and download the PDF.">Read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report</a></div> <p><a href="/system/files/media/file/2022/10/UAMS-Health-MAH-Case-Study.pdf" target="_blank" title="Click here to download UAMS Health, Arkansas: Metropolitan Anchor Hospitals (MAH)case study PDF."><img alt="UAMS Health, Arkansas: Metropolitan Anchor Hospital (MAH) case study page 1." data-entity-type="file" data-entity-uuid="61e72911-d356-4d7e-9bea-0729b82717f3" src="/sites/default/files/inline-images/Page-1-UAMS-Health-MAH-Case-Study_0.png" width="695" height="900"></a></p> <hr><div class="views-element-container"> <section class="top-level-view js-view-dom-id-36bd4998dac48c13e6a5b6bdae665b31a24a1f07a237e6e839da2f761e01e00a resource-block"> <h2 id="mahcasestudies">Metropolitan Anchor Hospital Case Studies</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/2024-01-04-adventist-health-bakersfield-california" hreflang="en">Adventist Health Bakersfield | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-01-04T08:41:22-06:00">Jan 4, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-12-05-henry-ford-hospital-michigan" hreflang="en">Henry Ford Hospital | Michigan</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-12-05T10:22:49-06:00">Dec 5, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-10-25-denver-health-system-colorado" hreflang="en">Denver Health System | Colorado</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-10-25T06:00:00-05:00">Oct 25, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-12-broadlawns-medical-center-iowa" hreflang="en">Broadlawns Medical Center | Iowa</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-12T15:13:18-05:00">May 12, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-10-mlk-community-healthcare-california" hreflang="en">MLK Community Healthcare | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-10T08:48:40-05:00">May 10, 2023</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/mah-case-studies">More MAH Case Studies</a></div> </section> </div> </div> </div> </div> Wed, 02 Nov 2022 06:00:00 -0500 Teaching /case-studies/2022-11-04-metrohealth-system-ohio <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>Overview</span></h2> <p><img alt="The MetroHealth System, Ohio." data-entity-type="file" data-entity-uuid="9534ff9d-d1b7-4b12-b034-c4d8cc9edd62" src="/sites/default/files/inline-images/The-MetroHealth-System-Ohio.jpg" width="452" height="256" class="align-right">The MetroHealth System, founded in 1837 and located in the metro-Cleveland area, operates four hospitals, four emergency departments, and more than 20 health centers and 40 additional sites throughout Cuyahoga County, Ohio. MetroHealth is home to a Level 1 Adult Trauma Center and the state’s only adult and pediatric trauma and burn center. The system serves more than 300,000 patients annually, two-thirds of whom are uninsured or covered by Medicare or Medicaid.</p> <p>MetroHealth currently employs more than 1,000 doctors and advanced practice providers, 1,700 nurses, and 7,800 other health care professionals who are committed to caring for everyone in the community regardless of an individual’s ability to pay. Because of its dedication to providing health care to all, MetroHealth is seen as a true community partner focused on providing all levels of care – from primary care to the most complex services.</p> <p>MetroHealth is also an academic medical center that trains more than 400 residents and fellows. For more than 100 years, MetroHealth has been a major academic affiliate of the Case Western Reserve University School of Medicine. It also seeks to shape the future health care workforce earlier in their education by maintaining the only hospital-based high school in the United States, which is located on MetroHealth’s main campus.</p> <h2><span>Patient–Payer Mix</span></h2> <p>Like many metropolitan anchor hospitals (MAHs) across the country, MetroHealth patients mostly have public health care coverage. Nearly nine-in-ten visits (86%) are by Medicaid or Medicare beneficiaries, while about 41% of net patient revenue comes from Medicaid or Medicare. Approximately 25% of MetroHealth’s patients have commercial coverage. In 2020, MetroHealth’s Medicaid shortfall totaled $53.7 million—a major gap between what Medicaid paid for health care services and the cost of providing care.</p> <p>Further, in 2021 MetroHealth provided an estimated $238 million in community benefits, including $89 million in uncompensated care, demonstrating their commitment to serving all in need of care. This investment in the health and well-being of the Cleveland community represents a significant return (approximately $6 in benefit for every $1 spent) to the county, which contributes $32.4 million to MetroHealth annually.</p> <blockquote> <h3><span><em>“We see ourselves as a ‘super safety net hospital’ where no one is left behind.”</em></span></h3> <p><span><strong>Craig Richmond, CPA</strong></span><br> Executive Vice President & Chief Financial & System Services Officer of MetroHealth</p> </blockquote> <h2><span>Commitment to the Community</span></h2> <p>As a valued MAH, MetroHealth plays an essential role in the region. While Greater Cleveland is home to some of the best health care institutions in the world, historically, many area residents have experienced poor health outcomes. MetroHealth takes a comprehensive approach to improving poor health outcomes. MetroHealth provides quality clinical care and beyond, by addressing the societal factors that influence a person’s health status. To improve community health and wellbeing—especially among structurally marginalized populations—MetroHealth supports a variety of programs including affordable housing, convenient transportation, community partnerships, education, and much more.</p> <h3><span>Addressing Social Determinants of Health</span></h3> <p>Defined as a catalyst of change for health, neighborhoods, the economy, and the future, MetroHealth launched its Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment) in 2019 to implement a coordinated, collaborative and strategic approach to support patients with non-medical needs such as healthful food, stable housing, transportation, and job training. Located on MetroHealth’s main campus, the Institute supports an economic opportunity center where community residents can build workforce skills like computer literacy, résumé writing, and interviewing. The Institute also includes a grocery store, a food pantry, and a community kitchen to give local residents access to healthful and nutritious food. MetroHealth has begun executing on a $100 million investment in affordable housing, with the opening of a 72-unit affordable housing location in late Summer 2022 and a 200-unit affordable senior housing location slated to open in 2024.</p> <h3><span>Training the Future Healthcare Workforce</span></h3> <p>MetroHealth is home to Lincoln-West School of Science and Health, the only hospital-based high school campus in the United States. Combining a traditional curriculum with interactive learning in a health care setting, the school engages more than 170 students in grades 9-12 with plans to expand to accommodate more students in the future. Black and Hispanic students constitute 80% of the student body at Lincoln-West.</p> <blockquote> <h3><span><em>“Our Institute of H.O.P.E. is a model that can be replicated across the country as a whole because of its significant impact and improved outcomes in just two years.”</em></span></h3> <p><span><strong>Craig Richmond, CPA</strong></span><br> MetroHealth</p> </blockquote> <h2><span>Metropolitan Anchor Hospitals Need Support</span></h2> <p>Annual reimbursement cuts have put a real strain on a system that primarily serves Medicare, Medicaid, and uninsured patients. These cuts put the community programs that MetroHealth has established – and that have shown to improve the health and well-being of the Cleveland community – at risk. Despite MetroHealth’s desire to build upon the success of its community programs, additional resources are needed to support continued investment in these initiatives.</p> <p>Adequate, sustained federal support must be put in place so that MAHs can plan for the future, build upon the success of vital community programs, and continue to focus on realizing healthy, inclusive, and thriving communities.</p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2022-10-21-exploring-metropolitan-anchor-hospitals-and-communities-they-serve" target="_blank" title="Click here to read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report and download the PDF.">Read the Exploring Metropolitan Anchor Hospitals and the Communities They Serve report</a></div> <p><a href="/system/files/media/file/2022/10/The-MetroHealth-System-MAH-Case-Study.pdf" target="_blank" title="Click here to download The MetroHealth System, Ohio: Metropolitan Anchor Hospitals (MAH)case study PDF."><img alt="The MetroHealth System, Ohio: Metropolitan Anchor Hospital (MAH) case study page 1." data-entity-type="file" data-entity-uuid="d56b95b9-c05e-46e5-97c6-3c27b71b3303" src="/sites/default/files/inline-images/Page-1-The-MetroHealth-System-MAH-Case-Study.png" width="695" height="900"></a></p> <hr><div class="views-element-container"> <section class="top-level-view js-view-dom-id-5bd7905cf38a9485be46e5d9b8f4933114048f39057341f9ed1b1da53bac8ef9 resource-block"> <h2 id="mahcasestudies">Metropolitan Anchor Hospital Case Studies</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/2024-01-04-adventist-health-bakersfield-california" hreflang="en">Adventist Health Bakersfield | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-01-04T08:41:22-06:00">Jan 4, 2024</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-12-05-henry-ford-hospital-michigan" hreflang="en">Henry Ford Hospital | Michigan</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-12-05T10:22:49-06:00">Dec 5, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"> <div class="meta custom-lock-position"> <div class="views-field-access-level access-type-public" data-toggle="tooltip" data-placement="bottom" title="Members only"><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-10-25-denver-health-system-colorado" hreflang="en">Denver Health System | Colorado</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-10-25T06:00:00-05:00">Oct 25, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-12-broadlawns-medical-center-iowa" hreflang="en">Broadlawns Medical Center | Iowa</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-12T15:13:18-05:00">May 12, 2023</time> </span> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <span class="field-content"><a href="/case-studies/2023-05-10-mlk-community-healthcare-california" hreflang="en">MLK Community Healthcare | California</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2023-05-10T08:48:40-05:00">May 10, 2023</time> </span> </div></div> </div> </div> <div class="more-link"><a href="/mah-case-studies">More MAH Case Studies</a></div> </section> </div> </div> </div> </div> Wed, 02 Nov 2022 06:00:00 -0500 Teaching /node/681453 <p>This pamphlet is an example of an active DEI initiative at a health organization. They clearly define diversity and inclusion, why it's important, outlining their mission and explaining what they do, and identifying their leaders and members. Most importantly, they indicate how they should be percieved in the community and in the hospital so they may be held accountable.</p> Thu, 06 Jan 2022 15:02:13 -0600 Teaching /education-events/aha-annual-membership-meeting-2022 <p>Join your colleagues at the 2022 AHA Annual Membership Meeting, April 24-26, to ensure our message is united, powerful and able to break through the noise, making a positive impact for the patients and communities you serve. Meet face-to-face with your elected officials and key policymakers to discuss how you are caring for your community and making a difference. Hear from innovative health care leaders, legislators, journalists and other thought leaders of our day on critical issues that will have an impact on our field and how we will continue to care for patients. And network with your peers as you tackle today’s toughest issues, together. We look forward to seeing you there!</p> <p>Please visit the <a href="https://annualmeeting.aha.org/registration">conference website</a> for pricing information. </p> <h2><a href="https://annualmeeting.aha.org/">Register Now!</a> </h2> <hr /> <p><strong>Join our email list for updates!</strong></p> <p> </p>   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 1367); Mon, 09 Aug 2021 11:39:08 -0500 Teaching /special-bulletin/2021-05-28-special-bulletin-white-house-releases-fy-2022-budget-request <div class="container"> <div class="row"> <div class="col-md-8"> <p>President Biden today submitted to Congress his <a href="https://www.whitehouse.gov/omb/budget/" target="_blank">budget request</a> for fiscal year (FY) 2022. The budget primarily includes proposals from President Biden’s American Jobs Plan and American Families Plan.</p> <p>The budget request, which was released this afternoon, is not binding, but can act as a guide for Congress and the Administration as they debate health care issues this year. Highlights of some of the provisions affecting hospitals and health systems follow. More details about these and other proposals are included in the Department of Health and Human Services’ (HHS) <a href="https://www.hhs.gov/sites/default/files/fy-2022-budget-in-brief.pdf" target="_blank">Budget in Brief document</a>.</p> <p>The budget includes a discussion of certain health care policies, such as a public option, lowering the Medicare eligibility age to 60, reducing the costs of prescription drugs and expanding coverage in non-Medicaid expansion states through a Medicaid-like federal public option, but does not include details on these proposals or their fiscal impact in the budget.</p> <p>In addition, the budget says that “evidence shows that we can reform Medicare payments to insurers and certain providers to reduce overpayments and strengthen incentives to deliver value-based care, extending the life of the Medicare Trust Fund, lowering premiums for beneficiaries, and reducing Federal costs.”</p> <h2>Highlights of Proposals Affecting Hospitals and Health Systems</h2> <h3>Health Insurance Coverage</h3> <p>The budget calls for making permanent the marketplace subsidy expansions that were temporarily enacted as part of the American Rescue Plan that was signed into law and were proposed by the Administration to be extended in the American Families Plan. These provisions reduce the cost of Marketplace coverage for subsidy-eligible individuals and families by increasing the dollar value of premium tax credit subsidies and expand eligibility to individuals with incomes above 400% of the federal poverty level. The 10-year cost of this is estimated at $163 billion.</p> <h3>Provider Payments</h3> <p>The budget does not reflect any reductions in Medicare or Medicaid payments to health care providers.</p> <h3>Pandemic Preparedness</h3> <p>The budget proposes $6 billion in new mandatory funding for HHS in FY 2022, as part of a multi-department four-year program totaling $30 billion to prepare for future pandemics.</p> <h3>Infrastructure</h3> <p>As part of the community health and hospital resilience portion of the American Jobs Plan, the budget proposes $1 billion to increase support for hospital infrastructure, $250 million for health emergency preparedness, and $250 million to build resilience against climate effects.</p> <h3>Health Equity and Maternal Mortality</h3> <p>The budget includes several sources of new funding to address issues of health equity and racial disparities in health care. This includes $3 billion over five years to invest in maternal health and reduce the maternal mortality rate and end race-based disparities in maternal mortality.</p> <h3>Discretionary Spending</h3> <p>As previously released on April 9, the budget calls for $1.5 trillion for appropriated spending in FY 2022, including $769 billion for domestic programs, a 16% increase over last year’s level.</p> <p>The budget proposes nearly $134 billion for HHS, a 23% increase over last year’s enacted level. This includes the following policies and funding levels:</p> <ul> <li> <h4>Centers for Disease Control and Prevention</h4> <p>$8.7 billion in discretionary funding.</p> </li> <li> <h4>National Institutes of Health (NIH)</h4> <p>$51 billion, including $6.5 billion for a new Advanced Research Projects Agency-Health inside NIH.</p> </li> <li> <h4>Food and Drug Administration</h4> <p>$6.5 billion for the agency.</p> </li> <li> <h4>Behavioral Health and Substance Use</h4> <p>$9.5 billion for Substance Abuse and Mental Health Services Administration programs, including $1.6 billion for the Community Mental Health Services Block Grant program. The budget also includes $10.7 billion in discretionary funding to address the opioid epidemic and other substance use issues.</p> </li> <li> <h4>Hospital Preparedness Program (HPP)</h4> <p>$292 million for the HPP, the primary federal funding mechanism for health care emergency preparedness.</p> </li> <li> <h4>Maternal and Child Health Block Grant</h4> <p>$592 million to states to expand health care and public health services that currently benefit millions of women, infants and children.</p> </li> <li> <h4>Rural Health Care</h4> <p>$400 million for rural health programs under the Health Resources and Services Administration (HRSA), including for telehealth, the Rural Communities Opioid Response Program and the Rural Residency Program.</p> </li> <li> <h4>Children’s Hospital Graduate Medical Education</h4> <p>$350 million for the CHGME program.</p> </li> <li> <h4>Nursing Workforce Development</h4> <p>$268 million for programs to support nursing workforce development.</p> </li> <li> <h4>340B Drug Pricing Program</h4> <p>$17 million to support program integrity oversight and to establish a formal Administrative Dispute Resolution process to resolve claims disputes between 340B covered entities and drug manufacturers. In addition, HRSA requests general rulemaking authority over the operation of the 340B program as well as specifically proposing reporting requirements of covered entities to ensure net income is used for the covered entities low-income and uninsured patients.</p> </li> <li> <h4>Strategic National Stockpile</h4> <p>$905 million for the Strategic National Stockpile.</p> </li> </ul> <h2>Further Questions</h2> <p>If you have questions, please contact AHA at <a href="tel:1-800-424-4301">800-424-4301</a>.</p> </div> <div class="col-md-4"> <img alt="Special Bulletin: White House Releases FY 2022 Budget Request page 1." data-entity-type="file" data-entity-uuid="d6f7dd61-11ce-420f-ac53-5a80ad642afa" src="/sites/default/files/inline-images/Page-1-AHASBBidenFY22Budget-052821.jpg" width="1700" height="2189" class="align-center"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2021/05/AHASBBidenFY22Budget-052821.pdf" target="_blank">Download the Special Bulletin PDF</a></div> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/action-alert/2021-05-25-urge-your-senators-representatives-include-resources-support-hospitals-and" target="_blank">Action Alert: Urge Your Senators, Representatives to Include Resources to Support Hospitals and Health Systems in Upcoming Infrastructure Legislative Package</a></div> </div> </div> </div> Fri, 28 May 2021 18:04:23 -0500 Teaching /lettercomment/2021-05-14-aha-letter-senate-leaders-support-train-act <div class="container"> <div class="row"> <div class="col-md-8"> <p>May 13, 2021</p> <div class="row"> <div class="col-md-6"> <p>The Honorable Sherrod Brown<br /> United States Senate<br /> 503 Hart Senate Office Building<br /> Washington, DC 20510</p> <p>The Honorable Bob Menendez<br /> United States Senate<br /> 528 Hart Senate Office Building<br /> Washington, DC 20510</p> <p>The Honorable Tammy Duckworth<br /> United States Senate<br /> 524 Hart Senate Office Building<br /> Washington, DC 20510</p> </div> <div class="col-md-6"> <p>The Honorable Shelley Moore Capito<br /> United States Senate<br /> 172 Russell Senate Office Building<br /> Washington, DC 20510</p> <p>The Honorable Rob Portman<br /> United States Senate<br /> 448 Russell Senate Office Building<br /> Washington, DC 20510</p> </div> </div> <p>Dear Senators Brown, Capito, Menendez, Portman and Duckworth:</p> <p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) writes to express support for S.1568, the Technical Reset to Advance the Instruction of Nurses (TRAIN) Act.</p> <p>A talented, qualified, engaged and diverse workforce is at the heart of America’s health care infrastructure. Recent studies show that America will need to hire at least 200,000 nurses per year to meet increased demand and to replace retiring nurses. In 2017, more than half of all nurses were age 50 or older, and almost 30% were age 60 or over. Workforce pressures also exist across a variety of allied health professions. According to one recent survey, the annual turnover rate of hospital certified nursing assistants (CNAs) was 27.7% (nearly double the turnover rate of nurses and physician assistants). Meanwhile, the Bureau of Labor Statistics projects a need for 11% more CNAs by 2025. These projected shortages highlight the need for supportive policies that ensure America’s health care workforce can meet the demands of today and be adequately prepared for the delivery system of tomorrow.</p> <p>The Centers for Medicare & Medicaid Services (CMS) supports nursing and allied health education programs by funding approximately 120 hospital-based nursing schools operated by a sponsoring hospital. These schools play a key role in training our health care workforce and providing a pipeline of highly-trained nurses to their communities and the nation overall.</p> <p>Beginning in 1998, Medicare began making direct graduate medical education (DGME) payments based on Medicare Advantage utilization, as well as traditional fee-for-service utilization. Beginning in 2000, Medicare also began making reasonable cost-based payments for nursing and allied health education programs based on Medicare Advantage utilization. CMS last provided instructions for the calculation of these payments in 2003, and at that time the agency failed to factor in a statutorily-required cap on total payments. As a result, Medicare has made incorrect payments to both hospital-based nursing and allied health education programs and DGME.</p> <p>Last year CMS discovered it had miscalculated annual updates to these payments by failing to apply the cap, and that this mistake went back for more than a decade. On Aug. 21, 2020, CMS instructed Medicare Administrative Contractors (MACs) to recalculate Medicare Advantage payments to nursing and allied health and DGME, and to recoup payments previously made to nursing and allied health programs. This solution proposed by CMS will jeopardize the financial health of these essential hospital-based nursing programs and could cause many of them to close, amid a pandemic and a nationwide nursing shortage.</p> <p>Your bipartisan bill, the TRAIN Act, provides an important remedy to the current situation. The legislation would direct CMS not to seek repayment from nursing and allied health programs. In addition, importantly, DGME payments would not be affected and those who received inadequate DGME payments could continue to pursue remedies from CMS.</p> <p>Thank you for your leadership on behalf of the nation’s health care workforce. The AHA looks forward to working with you to enact this important legislation.</p> <p>Sincerely,</p> <p>/s/</p> <p>Stacey Hughes<br /> Executive Vice President</p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2021/05/web-TRAINAct-051321.pdf" target="_blank" title="Click here to download a PDF of this letter.">Download the Letter</a></div> </div> </div> </div> Fri, 14 May 2021 11:50:59 -0500 Teaching