/ en Sat, 26 Apr 2025 05:07:33 -0500 Wed, 06 Mar 24 15:40:27 -0600 /news/headline/2024-03-06-aha-podcast-metropolitan-anchor-hospital-discusses-challenges-solutions <p>Deborah Brown, senior vice president of external and regulatory affairs at NYC Health + Hospitals, discusses common challenges for metropolitan anchor hospitals and why these hospitals need more federal recognition and support. <a href="/advancing-health-podcast/2024-03-06-metropolitan-anchor-hospitals-anchoring-community-health-nyc-health-hospitals?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today">LISTEN NOW</a> </p> Wed, 06 Mar 2024 15:40:27 -0600 Metropolitan Anchor Hospital (MAH) /advancing-health-podcast/2024-03-06-metropolitan-anchor-hospitals-anchoring-community-health-nyc-health-hospitals <p>For decades, Metropolitan Anchor Hospitals (MAHs) have provided critical health care and social services to diverse populations in the nation’s cities. MAHs and health systems, like NYC Health + Hospitals, are foundational to their community, providing comprehensive, equity-focused care. In this conversation, Deborah Brown, senior vice president of external and regulatory affairs at NYC Health + Hospitals, discusses innovative solutions to common MAH challenges, and the many ways in which the massive public health system meets its mission of taking care of every patient who walks in their doors.</p><hr><div></div><div class="raw-html-embed"><details class="transcript"><summary> <h2 title="Click here to open/close the transcript."><span>View Transcript</span><br>  </h2> </summary> <p> 00;00;00;21 - 00;00;24;25<br> Tom Haederle<br> The crowds, the skyscrapers, the excitement. Everything about New York City has always seemed magnified, bigger than life. That's equally true of New York City's Health + Hospitals, also known as H and H -the Big Apple's public health system that is the largest of its kind in the country. Extending comprehensive care to everyone, regardless of their ability to pay, with dignity and respect, is just part of its vast mission. </p> <p> 00;00;24;28 - 00;00;48;09<br> Tom Haederle<br> Systems like H and H serve as anchors within their community, providing care and being active community members. And while each metropolitan anchor hospital serves a unique role within its community, the challenges these hospitals face are common. </p> <p> 00;00;48;12 - 00;01;09;22<br> Tom Haederle<br> Welcome to Advancing Health, a podcast from the şÚÁĎŐýÄÜÁż Association. I'm Tom Haederle with AHA Communications. With the mission of taking care of every patient who walks in their doors, New York City Health + Hospitals deals every day with challenges that affect most care providers, but on a larger scale. The system has also come up with some innovative solutions to these challenges, </p> <p> 00;01;09;22 - 00;01;37;05<br> Tom Haederle<br> for example, an effective program to recruit and retain badly needed behavioral health professionals. In this podcast, Deborah Brown, senior vice president of External and Regulatory Affairs and Communications at New York City Health + Hospitals, is speaking with Ben Finder, vice president of Coverage Policy with the AHA, about the current trends and developments in the field and the many ways in which the massive public health system lives up to its responsibility to patients and the communities it serves. </p> <p> 00;01;37;07 - 00;01;45;22<br> Tom Haederle<br> They also discuss why metropolitan anchor hospitals like New York City Health + Hospitals need more federal recognition and support. </p> <p> 00;01;45;24 - 00;01;55;03<br> Ben Finder<br> Deborah, thank you for joining me this morning. I'm wondering if we can start our conversation by talking a little bit about your hospital and health system and NYC H + H and the patients and the communities that you serve. </p> <p> 00;01;55;05 - 00;02;15;03<br> Deborah Brown<br> Absolutely. First of all, thank you for having me. Thank you for having us. We always are proud to tell the story of H + H. So, New York City Health + Hospitals also known as H + H. We are New York City's public health care system. We are the largest municipal health care system in the country. We have 11 hospital sites, acutes. </p> <p> 00;02;15;08 - 00;02;45;16<br> Deborah Brown<br> We have five post-acutes, including one LPN. We have about 30 clinics in our FQHC, which is called Gotham. We provide all of the health care services on Rikers Island. We provide services through our homecare agency and we also have an insurance plan, Metroplus Health as a subsidiary. So our goal is to be a fully integrated system. We are a safety net system and proud to be one. </p> <p> 00;02;45;18 - 00;03;10;20<br> Deborah Brown<br> We are here to serve anyone who needs care, regardless of ability to pay, regardless of income, regardless of insurance status. What that means really is that we have 70% either Medicaid or uninsured patients, inverting the conventional wisdom of what a pyramid should be. We're actually relatively small on Medicare side, relatively small on commercial insurance. </p> <p> 00;03;10;22 - 00;03;22;10<br> Ben Finder<br> So you're in people's homes or in people's lives that are the cards that they carry. You're the places they go to. With all of that experience, I wonder if you could tell me a little bit about the trends that you've seen in recent years in terms of the patients and the community's needs? </p> <p> 00;03;22;13 - 00;03;44;01<br> Deborah Brown<br> Absolutely. I mean, I think it's no secret that we're all facing a behavioral health crisis, and I think that is potentially born of COVID, but it is also just the reality of where we are no matter how we got here. So one of the things that we are really focused on is ensuring that there is behavioral health and ensuring that there is behavioral health accessible to all. </p> <p> 00;03;44;04 - 00;04;15;13<br> Deborah Brown<br> We are the largest provider of behavioral health services in New York City. We're also the largest provider for people experiencing homelessness. And there is certainly an overlap in that population. We are looking at how we can continue to augment our excellent behavioral health care staff. That includes we've developed our own privately funded support program to support loan forgiveness for behavioral health workers who agreed to a three-year commitment in our system. </p> <p> 00;04;15;15 - 00;04;27;17<br> Deborah Brown<br> And we're very grateful to outside donations that help make that possible. We're working with the state on any number of ways to ensure that we have behavioral health beds open. It is an enormous priority for our system. </p> <p> 00;04;27;19 - 00;04;43;27<br> Ben Finder<br> The loan forgiveness program sounds really interesting. So you're trying to address the needs of your patients in the community in terms of behavioral health care needs, which are trying to help make the workforce more robust. And we've heard so much about workforce issues for the last couple of years. I wonder if you could tell me a little bit more about how that program works. </p> <p> 00;04;43;29 - 00;05;04;07<br> Deborah Brown<br> Absolutely. Again, first of all, you know, a lot of gratitude to private donors who supported us in this. And just to put in a little plug: though we are a public health care system and a public benefit corporation, we're also a tax exempt organization. Thus, we can accept donations in a way that I think conventionally people don't think that government agencies can. </p> <p> 00;05;04;13 - 00;05;38;16<br> Deborah Brown<br> And that's really helpful. And actually, philanthropy is one of the things in my portfolio. So what we did with this private donor is we set up a program whereby they donated a certain amount of money. We then can allocate that to behavioral health workers, either those we are recruiting or those we're either trying to retain. And we have a committee that sort of selects the people based on a series of criteria, and then we can provide support between $30,000 and $50,000 for each worker. </p> <p> 00;05;38;19 - 00;05;59;06<br> Deborah Brown<br> So it's not going to take care of their entire debt, but it might just be that little kind of tipping point that allows them to stay in our job. Because the reality is the work they do for us is very hard work. It is often physically taxing work, and we want to create the kind of stickiness that helps them help our communities, right? </p> <p> 00;05;59;07 - 00;06;15;11<br> Deborah Brown<br> They want to do this work. They've chosen to be here. We're incredibly grateful for that. And so and yet we need them. Without our workers, we can't provide services that our community needs. So we're doing lots of things to try to encourage our workers to stay. It's certainly a challenge. </p> <p> 00;06;15;14 - 00;06;33;07<br> Ben Finder<br> It's clear to me that the staff in the hospital itself are very mission driven, supporting the community and the patients. That's at the first priority of everyone's mind. I wonder if we can switch gears a little bit. You talked about the hospitals. About 70% of your patients are on Medicaid. With most of the patients you seen being covered by Medicaid or being uninsured, </p> <p> 00;06;33;10 - 00;06;41;28<br> Ben Finder<br> can you talk a little bit about how this program helps your patients or how it supports your patients? And how important these programs, Medicaid program is for H + H.? </p> <p> 00;06;42;00 - 00;07;09;05<br> Deborah Brown<br> We are happy to practice in a state where we do have a relatively generous Medicaid program. However, that program still pays hospitals 30% less than the cost of care. And we always say we give 100% to our patients, our Medicaid patients, all patients. We hope that our state program can cover that cost of care. So we are working with our associations, with hospitals across the state on an ongoing advocacy campaign to get to that 100% cost of care. </p> <p> 00;07;09;08 - 00;07;31;24<br> Deborah Brown<br> And that's, of course, a financial issue, but it's also an equity issue. We want to make sure that our patients who work through the Medicaid program get care through the Medicaid program, through providers like ours, that we have all the resources that we need to continue to care for them in a high quality and accessible way. Our Medicaid program is key to everything that we do. </p> <p> 00;07;32;01 - 00;08;02;03<br> Deborah Brown<br> We are very lucky to be in New York State where there is a robust Medicaid program, but even there, Medicaid only covers 70% of the cost of care. So we're always seeking Medicaid expansion to make it bigger, better, stronger, more rewarding. We are also heavily reliant and not ashamed to say it on DSH payments. Those federal this payments are enormously important, and that view has been - remains - our number one advocacy priority in D.C. and will be you know, we appreciate the ongoing postponements of those DSH cuts. </p> <p> 00;08;02;03 - 00;08;25;08<br> Deborah Brown<br> We would love to get rid of them altogether. The other thing that we do have, which I think is really exciting, as I said, it's a 70% that is both Medicaid and uninsured people who are unable to access insurance. One thing that we have is a direct access program called NYC Care, and we set that up with New York City probably about four years ago now. </p> <p> 00;08;25;11 - 00;08;51;09<br> Deborah Brown<br> And it allows people who don't have insurance to come into our system, as they always would. They get a card, they get assigned to a primary care physician. They're guaranteed a first appointment with Medicare within two weeks. And it really becomes a direct pathway to create that longitudinal primary and preventative care that is so important - and for some people that they have not had the opportunity to access. </p> <p> 00;08;51;11 - 00;09;06;25<br> Deborah Brown<br> We are at about the 120,000 mark in terms of patients. It's been incredibly exciting and rewarding. It really exemplifies how we try to serve our community with dignity, with compassion and with access. </p> <p> 00;09;06;27 - 00;09;32;03<br> Ben Finder<br> Wow. 120,000 patients is really something to be proud of. One of the things that we've all learned about is the Medicaid redeterminations, right? That's become a hot topic over the last year. So this was the support that Congress provided during the pandemic was to not require states to conduct these eligibility redeterminations. And now, as we unwind ourselves from the public health emergency, we're having to conduct redeterminations and our goal forms renewals for many of the Medicaid beneficiaries. </p> <p> 00;09;32;05 - 00;09;35;16<br> Ben Finder<br> Can you talk a little bit about how this has affected H + H? </p> <p> 00;09;35;19 - 00;09;55;23<br> Deborah Brown<br> Yeah, I mean, I think again, we're really we're really grateful to the federal government and we're really grateful to the state for their kind of operational support on this. You know, we've been doing kind of a long, a long ball program to make sure that people are aware and to make sure that we can get people recertified. We're at about 80%, which I think is really good. </p> <p> 00;09;55;23 - 00;10;04;01<br> Deborah Brown<br> And I think slightly above the national average. And, you know, it's something frankly, we're just grinding on. It is so important for our patients, so important for us. </p> <p> 00;10;04;04 - 00;10;22;02<br> Ben Finder<br> Great to hear about how you're engaging with the patients and trying to connect them or keep them connected with their coverage. You talked a little bit about Medicaid DSH. I think we know that historically Medicaid and Medicare have paid hospitals less than the cost of providing care for their beneficiaries. How does that shortfall affect H +H? </p> <p> 00;10;22;05 - 00;10;47;17<br> Deborah Brown<br> It's a great question. I mean, the reality is, as a public health care provider, which we are proud to be, we don't necessarily have all the bells and whistles. That doesn't mean it's not great care. It is. It doesn't mean it's not great staff. It is. But there are certain things, you know, we fill a different role in the ecosystem than some of the better resourced, more commercially reliant private hospitals. </p> <p> 00;10;47;17 - 00;11;05;28<br> Deborah Brown<br> And that's OK. We are proud of what we do. And so I think for us, it's always a matter of identifying what is the patient need, what is the community need, how do we best serve it? How do we do so in a way that is not just respectful and compassionate for our patients, but also for our staff? </p> <p> 00;11;06;00 - 00;11;25;11<br> Deborah Brown<br> And it's, you know, that's kind of the ballgame. We are never going to be in a position where we are anything but heavily Medicaid reliant. We love it, commercial insurance. We want more commercial insurance. We think that, you know, we have so much to offer. We welcome those patients. But we're also very mindful of the reality. </p> <p> 00;11;25;13 - 00;11;41;04<br> Ben Finder<br> The last few years have been incredibly challenging for the hospital field with record inflation, rising costs. You've talked a little bit about the workforce issues that you face and the COVID 19 pandemic. Can you share what specific workforce issues or staffing and financial challenges H + H is experiencing? </p> <p> 00;11;41;07 - 00;12;04;09<br> Deborah Brown<br> I mean, I think we're in many ways probably similar to a lot of AHA members, which is we are concerned about behavioral health workforce, we are concerned about nurses. Traveling nursing is a phenomenon that really took off during the pandemic and God bless them, everyone needed them. I think now what we really want to do is try to convert some of our temporary nurses or ideally all of them to permanent staff. </p> <p> 00;12;04;09 - 00;12;19;13<br> Deborah Brown<br> And we have a really kind of dedicated initiative on that. Our chief nursing officer is excellent and we're really having success there. Our nurses are in many ways the backbone of our system and we want them to be at home with us. </p> <p> 00;12;19;15 - 00;12;37;11<br> Ben Finder<br> We talked a little bit a minute ago just about commercial insurance rates and how they help support some hospitals. Your hospital relies mostly on Medicaid, which we knew historically pays less than the cost. I wonder if you could talk a little bit about the gaps that that causes and how you patch some of those gaps without having a commercially covered population to rely on? </p> <p> 00;12;37;13 - 00;13;02;09<br> Deborah Brown<br> Yeah, it's a great question. I think part of it is identifying what our priorities are and where we're going to put our resources. You know, we're not here or able to create a surplus. So when the dollars in our dollars out on patient care, on our staff, identifying, as I said, what communities need and trying to fill those holes. We are lucky enough to enjoy some support from private donors. </p> <p> 00;13;02;11 - 00;13;22;20<br> Deborah Brown<br> You know, it's it's a different model for us, right? A lot of private donations are based on a grateful patient model, which is wonderful. Our patients are largely not people who would have the means, even if they're delighted with the care. And I think many are. It's just sort of a different paradigm. So we are really creative. We try to we really creative in our fundraising. </p> <p> 00;13;22;20 - 00;13;43;07<br> Deborah Brown<br> We are really lucky that we have donors who understand that we are immodestly vital to New York City, vital to our our New York City functioning in a little "d" democratic way. Often That, I think, is what compels people to join in our mission and support us. And we're very grateful for that. </p> <p> 00;13;43;09 - 00;13;59;19<br> Ben Finder<br> You talked a lot about the population in the city and being vital to the city. I wonder if you could talk about some of the challenges of providing both clinical and non-clinical care to an urban population. You talked a little bit about housing instability. Are there other challenges that your population faces? </p> <p> 00;13;59;21 - 00;14;21;00<br> Deborah Brown<br> Yeah, and actually, I want to stay on housing for a second. One of the things that we are doing and this is really a priority project for Dr. Mitch Katz, our CEO, who is my boss, is we've created a Housing for Health program, which is we're taking unused lands on our campuses. As I said, we have 11 hospitals sites around the city. </p> <p> 00;14;21;06 - 00;14;48;07<br> Deborah Brown<br> Some of them are quite large and have areas that we can kind of leverage. We're using those areas to partner with nonprofit developers, nonprofits service providers and our city colleagues at HPD, which is the Housing Preservation and Development Agency, to work with us on financing the models. And we create supportive housing, supportive and affordable housing specifically to serve our patients. </p> <p> 00;14;48;10 - 00;15;07;25<br> Deborah Brown<br> I don't know what it's like nationwide, but at least in New York City, there is often a gap whereby a patient who has significant medical needs, they don't need to be in a hospital. They're not right for a SNF, nor are they right for a homeless shelter. Homeless shelter does many great things, but it doesn't necessarily provide the medical, the ongoing medical care that someone needs. </p> <p> 00;15;07;28 - 00;15;32;03<br> Deborah Brown<br> So we're trying to really fill that gap again that we've identified as a need for our patients. We're not going to be the city's largest real estate developer, but we have two major projects in the queue right now. We've done about three to this point, maybe more to this point. And it's really something that I think is a differentiating factor in a way in which we really try to engage in self-help for our patients. </p> <p> 00;15;32;05 - 00;15;42;18<br> Ben Finder<br> It's incredible to hear the different ways that hospitals and health systems have evolved beyond just providing care within the four walls. Are there any other programs that you want to talk about or would highlight for us? </p> <p> 00;15;42;21 - 00;16;10;24<br> Deborah Brown<br> Yeah, for sure. So we have a program called SHOW, which is street health outreach and wellness, and these are mobile vans that are developed to provide health care to people experiencing homelessness. They go to certain identified corners. There's sort of a route and they are there. They are meant to be reliable. It allowed us to access more people to provide COVID vaccinations during the beginning of the, I guess, the heavy points of the pandemic. </p> <p> 00;16;11;01 - 00;16;34;17<br> Deborah Brown<br> But it's also really blossomed into developing ongoing longitudinal primary care relationships, trying to get people in to see doctors because it becomes a trusted part of the community. And it does, you know, wound care. We've done A1C, there's a whole kind of suite of services that can be provided and that's something that didn't exist before. We're really, really proud of that. </p> <p> 00;16;34;19 - 00;16;54;12<br> Deborah Brown<br> We have one of the largest community health worker programs, or I should say, hospital based community health workers in the country. We have over 250 CHWs and they are really members of our communities. It's really important to us that we kind of retain that organic nature, not create too many barriers for CHWs to come in and work with us. </p> <p> 00;16;54;17 - 00;17;07;22<br> Deborah Brown<br> And that sort of lived experience can often help people as they're trying to find housing, as they're trying to find legal assistance, financial assistance. Those are the things that often our patients need in sort of a wraparound way. </p> <p> 00;17;07;25 - 00;17;35;26<br> Ben Finder<br> Your commitment to the mission and improving the health and well-being of your patients and community is really inspiring. You're doing all of this on on Medicaid, predominantly Medicaid reimbursements. I wonder if you could talk a little bit about the Metropolitan Anchor Hospital proposal, which AHA asking Congress for. This is a proposal that Congress would create a specific designation for hospitals like yours that are serving urban communities, that are serving patients that are predominately covered by Medicaid, Medicare, or are uninsured. </p> <p> 00;17;35;28 - 00;17;46;09<br> Ben Finder<br> Can you talk a little bit about as an integrated health system in New York City, supporting neighborhoods across all five boroughs and the diverse population? How would this designation be helpful to your organization and your community? </p> <p> 00;17;46;12 - 00;18;17;29<br> Deborah Brown<br> To be blunt, any additional funding is going to be helpful for us, particularly funding that doesn't disrupt our DSH allocation, doesn't kind of get in the way of existing existing funds. And that's something that's been really important, I know, to the AHA and all of us participating in developing this kind of model. So I think A) it's just the flat out funds is really important, but also really identifying who we are and what we do and that we are essential for health care delivery. </p> <p> 00;18;17;29 - 00;18;41;27<br> Deborah Brown<br> And we are lucky enough to to provide that essential role in New York City. But we've got peers all around the country doing this great work. And I think for not only the AHA, but, of course, Congress to recognize the importance of what we do and to codify that. I think that is really helpful financially. I think that is really helpful for sort of a reputational and almost emotional validation. </p> <p> 00;18;42;00 - 00;18;53;00<br> Deborah Brown<br> It's hard stuff. Not not what I do. It is hard stuff what our doctors and nurses and social workers and techs do. And having that recognized is really important. </p> <p> 00;18;53;03 - 00;18;56;29<br> Ben Finder<br> What should lawmakers in Congress know about metropolitan anchor hospitals? </p> <p> 00;18;57;01 - 00;19;27;24<br> Deborah Brown<br> It's a great question. We are really special places and we're lucky enough to have great relationships. An incredible New York City delegation or specifically the delegation that that represents H + H. They're just wonderful and supportive. I can't say enough good things about about our champions in D.C. But we always try to get them out to our facilities. We always try to get their staff out to the facilities because there is something incredibly sort of magical and humbling, I think, about being in our places. </p> <p> 00;19;27;24 - 00;19;52;19<br> Deborah Brown<br> Our staff is unbelievable. Our people, you know, the people care so much about patients, you know, sometimes in a lighthearted way. I know what we do is very serious. And there might be kind of a misperception that we're doom and gloom all the time, like we're human beings interacting with other human beings, and our facilities are really special places. </p> <p> 00;19;52;20 - 00;20;19;22<br> Deborah Brown<br> One of the things I love about our system is, as I said, we have 11 acute care sites and each of them is really organically representational of our community. It is really important for us to try to hire from the community. It's something that we are very successful in doing. We really serve as, as the designation says, as anchors for our community, not just as health care providers, but as employers, as sort of trusted agents as part of the culture. </p> <p> 00;20;19;25 - 00;20;25;18<br> Deborah Brown<br> Please come down. Well, we'll tour you through everything you want to see and just show you how special it is. </p> <p> 00;20;25;20 - 00;20;33;11<br> Ben Finder<br> An anchor is part of the culture and the community. I wonder if if we could end on a what are you most hopeful about in the in health care and in the future? </p> <p> 00;20;33;14 - 00;20;55;15<br> Deborah Brown<br> I'm really excited that there is kind of a growing understanding of the importance of social care needs. And I will shout out our state and CMS for the development of our new waiver, which is really about health equity and really about social care needs. This is work that again, sort of bubbles up organically in what we do. </p> <p> 00;20;55;15 - 00;21;25;18<br> Deborah Brown<br> And I'm using the royal we. The much more important people are the people doing the actual health care delivery in our facilities. But to understand that giving someone a prescription. It's wonderful. We want people to primary care. We want people to have preventative care. But there are a lot of aspects to health and to wellness even So, the fact that we're really seeing a commitment in funding and in action to those kind of services, that is super exciting. </p> <p> 00;21;25;18 - 00;21;45;01<br> Deborah Brown<br> We are big believers in value based care. Even as a safety net hospital, it is something that is very important to us. So that ongoing march is something that is exciting to us. I think there's a lot of opportunities for collaboration and innovation and just being able to continue to serve our patients is a privilege. </p> <p> 00;21;45;04 - 00;21;52;18<br> Ben Finder<br> Well, Deborah, it's been wonderful to learn more about H + H and the work that your hospital health systems are doing in your communities. Thank you again for joining me today. </p> <p> 00;21;52;20 - 00;21;55;06<br> Deborah Brown<br> Thank you so much for spotlighting us. </p> <p> 00;21;55;09 - 00;22;03;22<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </p> </details> </div> Wed, 06 Mar 2024 09:10:21 -0600 Metropolitan Anchor Hospital (MAH) /2024-01-04-adventist-health-bakersfield-california <div class="container"><div class="row"><div class="col-md-8"><h2><span>Overview</span></h2><p><img src="/sites/default/files/inline-images/Adventist-Health-Bakersfield-California.jpg" data-entity-uuid="4bb7f1a6-7162-4645-aa2e-2c0fd411f786" data-entity-type="file" alt="Adventist Health Bakersfield, California." width="514" height="275" class="align-right">Adventist Health Bakersfield (AHBD) has proudly served the Central Valley of California for over a century. Adventist Health Bakersfield is a 254-bed hospital committed to delivering exceptional health care for a service area population of almost 800,000 people. This includes a focus on serving lower-income residents and those who have been historically marginalized. The hospital is an essential pillar of care in this community, which includes rural and agricultural areas where access to care is a barrier to well-being. AHBD offers a range of services, including a comprehensive heart institute, a nationally certified stroke center, and the AIS Cancer Center.</p><p>Adventist Health Bakersfield is a member of Adventist Health, a faith-based, nonprofit integrated health system that serves more than 80 communities on the West Coast and in Hawaii. Constantly striving to meet its community's needs, Adventist Health acquired the Bakersfield Heart Hospital to expand its capacity in the city by 47 beds with three additional operating rooms, four cardiac catheterization laboratories, and one new medical building in an area where tertiary-level services are of utmost necessity to the community.</p><h2><span>Patient–Payer Mix</span></h2><p>The population of the Bakersfield service area is unique, with 57% of the population of Hispanic heritage (including many migrant farmworkers) and 68% younger than 44 years old. A high number of area residents are low-income. The largely rural community has high rates of children in poverty (27.6%), and housing and transportation costs account for nearly three-fifths of the average household's spending.</p><p>Approximately three-quarters of the hospital's patients are insured by public payers, including 42% by Medicare, 23% by Medi-Cal, the state's Medicaid program, and 7% by other government payers who cover the justice-involved population. Just 26% of patients are covered by commercial insurance plans. In 2022, Adventist Health Bakersfield provided $4.2 million in free and discounted care, $1.6 million in community health improvement, $31 million in aid to the historically marginalized population, $36 million in assistance to adults 65+, and $24 million in subsidized low-cost community health care. All of this accounted for $100 million in total care.</p><h2><span>Adventist Health Bakersfield's Unique Approach to Care</span></h2><p>Recognizing the unique characteristics and challenges associated with serving this community, Adventist Health Bakersfield has worked hard to expand services to help advance health equity across its diverse community.</p><h3><span>Providing Care Closer to Home</span></h3><p>As in many rural communities, some patients in the Central Valley must travel many miles to reach their health care providers. To improve access to care, the hospital operates two mobile units that travel to historically marginalized areas across the Central Valley. Operating from shopping center parking lots and other accessible locations, the Children’s Mobile Immunization Program offers free vaccinations with assistance from First 5 Kern funding. A second unit acts as a mobile health clinic, providing primary care in rural areas where access is difficult. Through private and local grants and supplemental dollars from AHBD, the mobile clinic also participates in outreach efforts, offering free cancer screenings and school physicals.</p><p>Additionally, the AIS Cancer Center has established satellite locations closer to patients' homes, reducing the need to travel to Bakersfield for essential services like access to infusion services and specialists such as breast surgeons and medical oncologists. This helps alleviate the burden of transportation many of the area's residents face.</p><blockquote><h3><span><em>"Adventist Health Bakersfield has been a treasured part of the health care landscape in Bakersfield for more than 100 years. We proudly serve as part of the safety net of care for the entire Central Valley."</em></span></h3><p><span><strong>Jason Wells, MBA, CMPE, FACHE</strong></span><br>President of Adventist Health<br>Central California Network</p></blockquote><h3><span>Holistic Well-being Programs</span></h3><p>The hospital has established a holistic approach to health and healing, a further testament to its progressive vision for community development. By forging meaningful partnerships, Adventist Health boosts the scope and impact of its wellbeing initiatives, aligning itself with a broader social fabric of empowerment and shared prosperity.</p><p>Specifically, Adventist Health Bakersfield supports the Blue Zones Project Bakersfield, which has taken a strategic approach to implementing well-being improvement strategies in 13 domains focused on people, places, and policy. Achieving these targets will allow the community to reach a tipping point so that positive environmental changes become ingrained in the community and the healthy choice becomes the easy choice for all residents. The project identified key performance indicators that will be tracked to demonstrate community-wide economic impact and well-being improvement, including the percentage of adults diagnosed with diabetes, the adult obesity rate, and the number of traffic-related pedestrian fatalities.</p><p>Adventist Health Bakersfield also supported the establishment of edible gardens at California State University, Bakersfield, and Bakersfield College to address food insecurity among students. These gardens provide thousands of pounds of fresh fruits and vegetables, promoting healthier eating habits and reducing health risks associated with unhealthy diets. When surveyed, a significant percentage of students on both campuses faced food insecurity, highlighting the importance of these initiatives. The gardens serve as a food source and offer educational opportunities to students. At Bakersfield College, the public can participate in a comprehensive Edible Education Garden Certificate program, teaching essential gardening skills and management practices, fostering a connection to nature and potential career pathways.</p><p>Despite the challenges, Adventist Health Bakersfield is committed to doing what is best for the community, even navigating persistent workforce shortages. In the Central Valley, the absence of a medical school poses challenges, as the hospital relies on recruiting physicians from other areas, which can be difficult due to the attractiveness of coastal and urban regions in California.</p><p>Adventist Health Bakersfield recognizes the importance of investing in the local community. The hospital has developed strong partnerships with Bakersfield College and California State University, Bakersfield to serve individuals interested in residing and working within Bakersfield and its neighboring areas. Despite having a robust nursing program, it remains challenging to retain trained professionals, as many often choose to work in other cities after completing their education. To attract more physicians, Adventist Health Bakersfield is working to establish a Graduate Medical Education (GME) program and hopes to welcome its first residents in 2025.</p><h2><span>Metropolitan Anchor Hospitals Need Support</span></h2><p>Amid the burgeoning demands of their mission, MAHs must deftly respond to evolving community needs and navigate financial pressures stemming from the rapidly rising costs of providing care, which requires significant resources and economic stability. Through additional financial support, MAHs like Adventist Health Bakersfield can continue to provide high-quality healthcare for the Bakersfield community and the Central Valley of California and remain a cornerstone in the communities it serves.</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/2024/01/AHA-MAH-Case-Study-Adventist-Health-Bakersfield.pdf" title="Click here to download the Adventist Health Bakersfield, California, Metropolitan Anchor Hospital (MAH) Case Study PDF."><img src="/sites/default/files/inline-images/Page-1-AHA-MAH-Case-Study-Adventist-Health-Bakersfield.png" data-entity-uuid="73c986c4-1ae0-4d53-a87b-dedb5891f72c" data-entity-type="file" alt="Adventist Health Bakersfield, California, 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-29fd3cb462d640016c47d28c630ca425a5622dfb67970b5f947150dab10ad924 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> Thu, 04 Jan 2024 08:41:22 -0600 Metropolitan Anchor Hospital (MAH) /case-studies/2023-12-05-henry-ford-hospital-michigan <div class="container"><div class="row"><div class="col-md-8"><h2><span>Overview</span></h2><p><img src="/sites/default/files/inline-images/Henry-Ford-Hospital-Michigan.jpg" data-entity-uuid="e1644f78-1c53-462c-8025-126ae65f15ae" data-entity-type="file" alt="Henry Ford Hospital in Michigan seen from an elevated view." width="345" height="210" class="align-right">Henry Ford Hospital in Detroit, Michigan, is the flagship hospital of Henry Ford Health, one of the nation's largest integrated health care systems. For more than 100 years, the not-for-profit organization has been headquartered in Detroit and is committed to serving the city and metro area’s diverse population, the needs of which are at the heart of Henry Ford’s commitment to providing a full continuum of care and community services.</p><p>Henry Ford Hospital maintains 877 beds and is distinguished for its exceptional performance in cardiology and cardiovascular surgery, neurology and neurosurgery, orthopedics and sports medicine, transplant procedures, and cancer care. As a leading academic medical center, Henry Ford instructs over 4,000 medical students, residents, and fellows annually through more than 50 accredited programs, mainly at the campus in Detroit. The organization consistently ranks among Michigan’s top five National Institutes of Health-funded institutions.</p><h2><span>Commitment to Health Equity and Diversity</span></h2><p>Henry Ford’s commitment to equity in serving Detroit’s diverse community is evident through impactful initiatives centered at the flagship hospital, including:</p><h3><span>Advancing Maternal Health Equity</span></h3><p>Women’s Health Services implemented the Reducing Unconscious Bias curriculum to address disparities in Black maternal health. Through its Women-Inspired Neighborhood (WIN) Network: Detroit, Henry Ford connects women to clinical and social services to address social determinants of health.</p><h3><span>Utilizing Community Health Workers</span></h3><p>An innovative approach implemented at Henry Ford Hospital involves the integration of community health workers (CHW) in departments such as maternal care units. Within this framework, CHWs conduct home visits and aid individuals during the initial year following childbirth.</p><h3><span>Diversifying Research</span></h3><p>The health system leads the Participatory Action for Access to Clinical Trials (PAACT) project to enhance Black representation in cancer clinical trials.</p><h3><span>Serving Detroit’s Underserved</span></h3><p>Henry Ford partners with the Community Health and Social Services (CHASS) Center, Inc., a well- established organization with over 40 years of experience offering primary health, dental, and wellness care to Detroit's uninsured and underinsured populations.</p><h3><span>Advancing LGBTQ+ Rights</span></h3><p>The hospital’s visitation policies grant equal visitation for LGBTQ+ patients and families, along with training for providers and employees on LGBTQ+ patient-centered care and unconscious bias, the provision of all-gender restrooms in care facilities, and the establishment of Employee Resource Groups like PRIDE, which focuses on recruiting talented LGBTQ+ employees.</p><h2><span>Putting the Community at the Forefront of Care</span></h2><p>Henry Ford’s community outreach programs are designed to address the specific health needs of Detroiters. These initiatives encompass a wide range of services, including food pantries, exercise programs, tobacco cessation programs, vaccination clinics, and cancer screenings. One such program is Generation With Promise, a community health program that aims to promote healthy lifestyles among Detroit's youth, families, and communities. The program collaborates with local schools to improve students' health behaviors, partnering with organizations like Gleaners Community Food Bank, to offer Cooking Matters™ nutrition education and cooking curriculum to families and faith-based groups.</p><h2><span>Patient–Payer Mix and Community Benefits</span></h2><p>As a Metropolitan Anchor Hospital (MAH), Henry Ford Hospital serves a diverse patient-payer mix. Half of Henry Ford's revenue comes from Medicare, while 20% of the patient population is covered by Medicaid, and 30% by commercial insurance. With most patients relying on government payers for their health care coverage, a burden is placed on the organization’s finances because Medicare and Medicaid reimburse at levels much lower than the actual costs of providing care. In 2022, Henry Ford provided $1 billion in community benefits, including uncompensated care; much of this came from Henry Ford Hospital.</p><h2><span>Serving as an Economic Anchor Institution</span></h2><p>Henry Ford Hospital is more than a health care organization; it is an economic anchor in the Detroit community. In 2023, in collaboration with Tom Gores and the Detroit Pistons, and Michigan State University, Henry Ford unveiled a multibillion-dollar development plan for Detroit's New Center neighborhood. The plan includes a major expansion of Henry Ford Hospital, a cutting-edge medical research facility, and enhanced partnerships between the involved parties. The development envisions economic growth, health care advancements, commitments to environmental sustainability, and a revitalized urban environment.</p><p>Henry Ford Hospital’s community investments positively impact Detroit neighborhoods through hiring, purchasing, and community programming. Henry Ford is a founding member of the <a href="https://healthcareanchor.network/about-the-healthcare-anchor-network/" target="_blank" title="Healthcare Anchor Network: About the Healthcare Anchor Network (HAN)">Healthcare Anchor Network (HAN)</a>, a collaboration of 65 leading health care systems aiming to create inclusive and sustainable local economies to address economic and racial inequities that contribute to poor health. HAN's mission involves leveraging health systems' assets like hiring, purchasing, and investing to foster economically and racially equitable communities.</p><p>In partnership with other health systems, Henry Ford has committed to an "Impact Purchasing Commitment" pledge to support local, minority, women-owned, and small businesses. The organization also has a commitment to hiring from within the local community, with 10% of frontline employees coming from three ZIP codes adjacent to the Detroit hospital.</p><h2><span>Metropolitan Anchor Hospitals Need Support</span></h2><p>Henry Ford’s commitment to community-based care and dedication to patient well-being make the organization an essential anchor institution in Detroit and beyond. As a MAH, Henry Ford Hospital faces financial challenges due to its patient-payer mix and reliance on government payers. Hospitals are underpaid by Medicare and Medicaid and continued threats to state and federal provider reimbursement represent an ongoing concern. This impacts Henry Ford Hospital's ability to improve access to care for historically marginalized communities. Additional, sustained funding for MAHs is essential to sustaining the hospital’s comprehensive health care services and its ability to serve its community.</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/2023/12/AHA-MAH-Case-Study-Henry-Ford-Hospital.pdf" target="_blank" title="Click here to download the Henry Ford Hospital, Michigan: Metropolitan Anchor Hospitals (MAH)case study PDF."><img src="/sites/default/files/inline-images/Page-1-AHA-MAH-Case-Study-Henry-Ford-Hospital.png" data-entity-uuid="3762d12e-334c-4ba9-99e8-158a9bcead98" data-entity-type="file" alt="Henry Ford Hospital, Michigan: 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-8791eadab3bbe7e9bd17f8149218840ef904154cf90e22566b821a1842f99d91 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, 05 Dec 2023 10:22:49 -0600 Metropolitan Anchor Hospital (MAH) /case-studies/2023-10-25-denver-health-system-colorado <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>Overview</span></h2> <p><img alt="Denver Health System, Colorado." data-entity-type="file" data-entity-uuid="addd4893-7bf8-4c75-b345-5567f89d744e" src="/sites/default/files/inline-images/Denver-Health-System-Colorado.jpg" width="351" height="310" class="align-right">Denver Health has been treating and healing the people of Denver, Colorado for more than 160 years. Founded as City Hospital in 1860 to serve the health care needs of the rapidly developing city, Denver Health has since grown alongside the community to become a complete health care system.</p> <p>Denver Health provides health care services to one in three residents of the metropolitan area. Many of its patients have complex health care and social needs, including the uninsured, people experiencing poverty, people living with substance use disorder, pregnant teens, victims of violence, people experiencing homelessness, and victims of trauma. The health system delivers preventive care, primary care, and acute care services, with a focus on integration to ensure the best, most cost-effective care possible. Denver Health provides hospital and emergency care to the public regardless of ability to pay, providing hundreds of millions of dollars in uncompensated care annually.</p> <h2><span>Patient–Payer Mix</span></h2> <p>As Colorado’s primary metropolitan anchor hospital (MAH), Denver Health faces a challenging patient-payer mix. More than 80% of Denver Health’s patient visits and 83% of discharges are individuals with Medicare, Medicaid, or without any insurance.</p> <p>Further, revenues from these same patient groups represent 80% of Denver Health’s gross patient revenue. In 2022, Denver Health incurred $120 million of uncompensated care cost — for which the city's annual fixed payment of $29.7 million covered less than 25%. According to the Colorado Department of Health Care Policy and Financing (HCPF) 2023 Hospital Expenditure Report, Denver Health's “Percentage of Total Care for Uninsured” was 15.9%––significantly greater than other hospitals in the Front Range region. Like other MAHs, Denver Health faces significant financial challenges caused by low margins and workforce shortages, both of which have been exacerbated by the COVID-19 pandemic.</p> <h2><span>Denver Health's Unique Approach to Care</span></h2> <p>Despite these challenges, Denver Health has found innovative ways to serve the community and holistically care for patients.</p> <h3><span>Addressing Social Determinants of Health</span></h3> <p>Denver Health recognizes that many of the care needs addressed in its hospital system are linked to social determinants of health, such as neighborhood safety, systemic racism, housing, food security, and limited transportation. Denver Health works closely with the City and County of Denver, as well as its civic, business, and nonprofit partners, to identify and address community needs through a range of programs and initiatives. One recent example is a partnership with the Denver Housing Authority to develop a transitional housing unit so patients experiencing homelessness have a place to heal and recover from the hospital.</p> <h3><span>Finding Innovative Ways to Reach Vulnerable Communities</span></h3> <p>Denver Health is constantly finding new ways to reach historically marginalized community members. For example, the recently launched Mobile Health Centers (MHCs) have been an invaluable tool in efforts to bring COVID-19 testing and vaccinations into some of Denver’s hardest-hit neighborhoods and deliver care to people who otherwise might not have access. Once COVID-19 efforts are no longer necessary, the MHCs will be used to deliver other primary care services, including important health screenings.</p> <h3><span>Serving as an “Anchor Institution”</span></h3> <p>Denver Health seeks to leverage its economic power alongside its human and intellectual resources to improve the long-term health and social well-being of its community. Recent efforts include:</p> <ul> <li>Establishing a Workforce Development Center to provide low-income employees with financial education and individualized counseling, career pathing, and access to social services.</li> <li>A partnership with Emily Griffith Technical College to manage the OMC CafĂ©, providing students with employment while helping them learn new skills that can lead to a career.</li> <li>Hiring a local, minority-owned real estate firm to handle the sale of Denver Health properties.</li> <li>Starting a supportive enrollment process to help families enroll in SNAP, WIC, and other programs they may qualify for, with the goal of helping to stabilize families and make sure children can flourish.</li> <li>Providing job opportunities with growth potential by partnering with local community organizations to place people in positions at Denver Health.</li> </ul> <h2><span>Metropolitan Anchor Hospitals Need Greater Support</span></h2> <p>Despite the financial challenges MAHs face, Denver Health has continued to expand programs, increase patient visits, and develop innovative ways to provide care. But to be more impactful, MAHs like Denver Health need adequate and sustained federal support. This will ensure all MAHs are better positioned to expand successful programs, increase capacity, invest in urgent capital needs, and continually adapt to meet their communities’ evolving medical needs.</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/Denver-Health-System-MAH-Case-Study.pdf" target="_blank" title="Click here to download the Denver Health System, Colorado: Metropolitan Anchor Hospitals (MAH)case study PDF."><img alt="Denver Health System, Colorado: Metropolitan Anchor Hospital (MAH) case study page 1." data-entity-type="file" data-entity-uuid="50b5251b-f409-489d-9e62-a44104ccd4f4" src="/sites/default/files/inline-images/Page-1-Denver-Health-System-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-b45d18f45a2587b6a93c848c9b60a109b76dad292a41a1959ef4607e25406e16 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, 25 Oct 2023 06:00:00 -0500 Metropolitan Anchor Hospital (MAH) /education-events/urban-hospital-sustainability-strategic-leadership-group Wed, 18 Oct 2023 10:07:30 -0500 Metropolitan Anchor Hospital (MAH) /lettercomment/2023-10-05-aha-recommendations-house-ways-means-committee-improving-health-care-access-rural-and-underserved <div class="container"> <div class="row"> <div class="col-md-8"> <p>October 5, 2023</p> <p>The Honorable Jason Smith Chairman<br> Ways and Means Committee<br> U.S. House of Representatives<br> 1139 Longworth House Office Building<br> Washington, DC 20515</p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/10/AHA-Recommendations-to-House-Ways-Means-Committee-on-Improving-Health-Care-Access-in-Rural-and-Underserved-Areas.pdf" target="_blank" title="Click here to download the AHA Recommendations to House Ways & Means Committee on Improving Health Care Access in Rural and Underserved Areas letter PDF.">Download the Letter PDF</a></div> </div> </div> <div class="row"> <div class="col-md-8"> <p><strong><em>Re: Request for Information: Improving Access to Health Care in Rural and Underserved Areas</em></strong></p> <p>Dear Chairman Smith and the Ways and Means Health Subcommittee:</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 şÚÁĎŐýÄÜÁż Association (AHA) welcomes the opportunity to comment on ways to improve access to care in rural and underserved areas. We share the subcommittee’s interest in ensuring that Americans in these rural and underserved areas have high-quality, affordable health care.</p> <p>Hospitals and health systems are the lifeblood of their communities and are committed to ensuring local access to health care. At the same time, many hospitals including those in rural and underserved areas are experiencing unprecedented challenges that jeopardize access and services. These include the aftereffects of a worldwide pandemic, crippling workforce shortages, soaring costs of providing care, broken supply chains, severe underpayment by Medicare and Medicaid, and overwhelming regulatory burdens.</p> <p>Rural hospitals make up about 35% of all hospitals in the U.S. Nearly half of rural hospitals have 25 or fewer beds, with just 16% having more than 100 beds. Given that rural hospitals tend to be much smaller, patients with higher acuity often travel or are referred to larger hospitals nearby. As a result, in rural hospitals, the acute care occupancy rate (37%) is less than two thirds of their urban counterparts (62%). Compared to their non-rural counterparts, a significantly higher percentage of rural hospitals are owned by state and local governments — 35% compared to just 13% of urban hospitals.</p> <p>Below are a series of proposals and suggestions for the Ways and Means Committee to consider as it looks for avenues to broaden access to health care for patients in rural and underserved regions.</p> <h2>Sustainable Provider and Facility Financing</h2> <p>To mitigate rural hospital closures and improve health care in rural communities, sustainable financing for rural hospitals and health systems is imperative. Although rural hospitals have long faced circumstances that have challenged their survival, those dangers are more severe than ever. As a result, rural hospitals require increased attention from state and federal government to address barriers and invest in new resources in rural communities.</p> <p>Providing certainty and stability in rural Medicare hospital payments is essential to creating a sustainable rural financing system. Low reimbursement, low patient volume, sicker patients and challenging payer mix common at many rural hospitals puts added financial pressure on those facilitates. The AHA supports <strong>policies that support sustainable hospital and health system financing models, including flexible payment options that address financing challenges faced by the full spectrum of rural hospitals, including the following.</strong></p> <ul> <li> <h3>Making Permanent the Medicare-dependent Hospital (MDH) and Low-volume Adjustment (LVA)</h3> <p>MDHs are small, rural hospitals where at least 60% of admissions or patient days are from Medicare patients. MDHs receive the inpatient prospective payment system (IPPS) rate plus 75% of the difference between the IPPS rate and their inflation-adjusted costs from one of three base years. AHA supports making the MDH program permanent and adding an additional base year that hospitals may choose for calculating payments. The LVA provides increased payments to isolated, rural hospitals with a low number of discharges. AHA also supports making the LVA permanent. The MDH designation and LVA protect the financial viability of these hospitals to ensure they can continue providing access to care.</p> </li> <li> <h3>Reopen the Necessary Provider Designation for Critical Access Hospitals (CAHs)</h3> <p>The CAH designation allows small rural hospitals to receive cost-based Medicare reimbursement, which can help sustain services in the community. Hospitals must meet several criteria, including a mileage requirement, to be eligible. A hospital can be exempt from the mileage requirement if the state certified the hospital as a necessary provider, but only hospitals designated before Jan. 1, 2006, are eligible. AHA urges Congress to reopen the necessary provider CAH program to further support local access to care in rural areas.</p> </li> <li> <h3>Improve Access to Capital</h3> <p>Access to capital is important to stabilizing a vulnerable hospital or advancing innovations in others. AHA supports expanding the USDA Community Facilities Direct Loan & Grant Program and creating a new Hill-Burton like program to update rural hospitals to ensure continued access in rural communities.</p> </li> <li> <h3>Strengthen the Rural Emergency Hospital (REH) Model</h3> <p>REHs are a new Medicare provider type to which small rural and critical access hospitals can convert to provide emergency and outpatient services without needing to provide inpatient care. REHs are paid a monthly facility payment and the outpatient prospective payment system (OPPS) rate plus 5%. AHA supports strengthening and refining the REH model to ensure sustainable care delivery and financing.</p> </li> <li> <h3>Rebase Sole Community Hospitals (SCHs)</h3> <p>SCHs must show they are the sole source of inpatient hospital services reasonably available in a certain geographic area to be eligible. They receive increased payments based on their cost per discharge in a base year. AHA supports adding an additional base year that SCHs may choose for calculating their payments.</p> </li> </ul> <p><strong>Medicare and Medicaid each pay less than 90 cents for every dollar spent caring for patients, according to the latest AHA data. Given the challenges of providing care in rural areas, reimbursement rates across payers need to be updated to cover the cost of care.</strong></p> <p><strong>AHA supports the following policies to ensure fair and adequate reimbursement.</strong></p> <ul> <li> <h3>Medicare Advantage Payment Parity for Critical Access Hospitals</h3> <p>The Medicare Advantage (MA) program has grown significantly in the past decade. MA enrollment, which traditionally has grown slower in rural areas, is now surpassing the growth rate in urban areas. For example, MA enrollment quadrupled between 2010 to 2023 in rural counties, compared to metropolitan areas which doubled in enrollment during the same period. Yet, MA plans are not required to pay rural providers, such as critical access hospitals, at the same cost basis as fee-for-service Medicare; and they are increasingly paying below costs, straining the financial viability of many rural providers. Further, MA plans also have the additional burden of prior authorization and other health plan requirements with which rural providers must increasingly contend  requirements that do not exist to nearly the same extent in fee-for-service Medicare and add additional costs for rural providers to comply. We support policies that support the long-term health of providers and facilities that care for patients in rural areas, which will need to consider the impact of MA enrollment in those communities.</p> </li> <li> <h3>Wage Index Floor</h3> <p>AHA supports the Save Rural Hospitals Act (S. 803) to place a floor on the area wage index, effectively raising the area wage index for hospitals below that threshold with new money.</p> </li> <li> <h3>Make the Ambulance Add-on Payments Permanent</h3> <p>Rural ambulance service providers ensure timely access to emergency medical care but face higher costs than other areas due to lower patient volume. We support permanently extending the existing rural, “super-rural” and urban ambulance add-on payments to protect access to these essential services.</p> </li> <li> <h3>Reverse Rural Health Clinic (RHC) Payment Cuts</h3> <p>RHCs provide access to primary care and other important services in rural, underserved areas. AHA urges Congress to repeal payment caps on provider-based RHCs that limit access to care.</p> </li> <li> <h3>Flexibility for CAHs</h3> <p>We urge Congress to pass legislation to extend waiver flexibility for the 96-hour average length of stay condition of participation. Many CAHs have had to increase their average length of stay because of challenges transferring patients to other sites of care, among other factors outside their control. We also support permanently removing the 96-hour physician certification requirement for CAHs. Removing the physician certification requirement would allow CAHs to serve patients needing critical medical services that have standard lengths of stay greater than 96 hours.</p> </li> <li> <h3>Commercial Insurer Accountability</h3> <p>Systematic and inappropriate delays of prior authorization decisions and payment denials for medically necessary care by commercial insurers are putting patient access to care at risk. We support regulations that streamline and improve prior authorization processes, which would help providers spend more time on patients instead of paperwork. We also support a legislative solution to address these concerns. In addition, we support policies that ensure patients can rely on their coverage by disallowing health plans from inappropriately delaying and denying care, including by making unilateral mid-year coverage changes.</p> </li> <li> <h3>Maternal and Obstetric Care</h3> <p>We urge Congress to continue to fund programs that improve maternal and obstetric care in rural areas, including supporting the maternal workforce, promoting best practices and educating health care professionals. We continue to support the state option to provide 12 months of postpartum Medicaid coverage.</p> </li> <li> <h3>Behavioral Health</h3> <p>Implementing policies to better integrate and coordinate behavioral health services will improve care in rural communities. We urge Congress to:</p> <ul> <li>fully fund authorized programs to treat substance use disorders, including expanding access to medication assisted treatment;</li> <li>implement policies to better integrate and coordinate behavioral health services with physical health services;</li> <li>enact measures to ensure vigorous enforcement of mental health and substance use disorder parity laws;</li> <li>permanently extend flexibilities under scope of practice and telehealth services granted during the COVID-19 public health emergency; and</li> <li>increase access to care in underserved communities by investing in supports for virtual care and specialized workforce.</li> </ul> </li> </ul> <h2>Bolstering the Workforce</h2> <p>Recruitment and retention of health care professionals is an ongoing challenge and expense for rural hospitals. Nearly 70% of the primary health professional shortage areas are in rural or partially rural areas. Targeted programs that help address workforce shortages in rural communities should be supported and expanded. Workforce policies and programs also should encourage nurses and other allied professionals to practice at the top of their license. Below are listed a variety of different proposals and pieces of legislation Congress should consider enacting to tackle the workforce shortage crisis.</p> <ul> <li> <h3>Graduate Medical Education</h3> <p>We urge Congress to pass the Resident Physician Shortage Reduction Act of 2023 (H.R. 2389/S. 1302), legislation to increase the number of Medicare-funded residency slots, which would expand training opportunities in all areas including rural settings to help address health professional shortages.</p> </li> <li> <h3>Conrad State 30 Program</h3> <p>We urge Congress to pass the Conrad State 30 and Physician Access Reauthorization Act (H.R. 4942/S. 665) to extend the Conrad State 30 J-1 visa waiver program, which waives the requirement to return home for a period if physicians holding J-1 visas agree to stay in the U.S. for three years to practice in federally-designated underserved areas.</p> </li> <li> <h3>International Workforce</h3> <p>The AHA supports the recapture of and expedited visas for foreign-trained nurses and doctors.</p> </li> <li> <h3>Loan Repayment Programs</h3> <p>We urge Congress to pass the Restoring America’s Health Care Workforce and Readiness Act (S. 862) to significantly expand National Health Service Corps funding to provide incentives for clinicians to practice in underserved areas, including rural communities. AHA also supports the Rural America Health Corps Act (H.R. 1711/S. 940) to directly target rural workforce shortages by establishing a Rural America Health Corps to provide loan repayment programs focused on underserved rural communities.</p> </li> <li> <h3>Boost Nursing Education</h3> <p>We urge Congress to invest significant resources to support nursing education and provide resources to boost student, faculty and preceptor populations, modernize infrastructure and support partnerships and research at schools of nursing. AHA also supports expanding the National Nurse Corps.</p> </li> <li> <h3>Health Care Workers Protection</h3> <p>We urge Congress to enact the Safety from Violence for Healthcare Employees Act (H.R. 2584/S. 2768) to provide federal protections for health care workers against violence and intimidation.</p> </li> </ul> <h2>Metropolitan Anchor Hospitals (MAHs)</h2> <p>The AHA urges Congress to create a special statutory designation for MAHs to ensure that patients served by these hospitals can continue to receive vital services and remain sustainable. To be designated as a MAH, a hospital must be located in a core-based statistical area (CBSA), have a Medicaid Inpatient Utilization Rate (MIUR) greater than the statewide average, and meet at least one of the requirements: have a disproportionate patient percentage (DPP) of 70% or higher; have a DPP of at least 35% and average uncompensated care costs (UCC) of at least $35,000 per bed (averaged over the last three years); or be designated by the state as a “necessary provider” of health care services to residents in the area.</p> <p>Metropolitan Anchor Hospitals (MAHs) would serve as a lifeline to communities who have a significant proportion of Medicare, Medicaid and underinsured patients who are often challenged in accessing comprehensive, quality health care. MAHs are in areas dealing with sustained hardships and whose patient populations have historically been marginalized. Seventy-five percent of MAHs are in counties where uninsured and poverty rates exceed the national average. MAHs are critical access points for primary care, preventive services and specialized health care services, including trauma and burn care, neonatal and pediatric intensive care, substance use disorder treatment, and HIV/AIDS care. MAHs bring tremendous value to the patients and communities they serve and to the nation’s health care system overall.</p> <h2>Telehealth Extensions</h2> <p>At the outset of the COVID-19 pandemic, the federal government moved quickly to ensure hospitals and health systems were able to respond efficiently and effectively to a wave of unprecedented need. These actions included CMS waiving certain regulatory requirements and Congress providing significant legislative support to ensure hospitals and health systems could manage the numerous challenges facing them, including by an increased ability to administer virtual care. These swift actions provided hospitals and health systems with critical flexibilities to care for patients throughout the pandemic.</p> <p>Spurred in large part by these waivers and legislative support, virtual care and telehealth services have increased dramatically. A report from the Department of Health and Human Services found that in 2020, telehealth services increased by over 51 million encounters, representing a 63-fold increase from 2019.<sup><a href="#fn1">1</a></sup> There is a growing body of evidence to suggest that for most specialties, telehealth services provided during the pandemic were not duplicative of in-person services. For example, most recently, a study of over 35 million records by Epic found that for most telehealth visits across 33 specialties, there was not a need for an in-person follow-up visit within 90 days of the telehealth visit.<sup><a href="#fn2">2</a></sup> In many cases, telehealth served as an effective substitute for in-person care and did not result in duplicative care.</p> <p>Expansion of virtual care has transformed care delivery, expanded access for millions of Americans and increased convenience in caring for patients. There also are significant projected shortages of <a href="https://www.aamc.org/news/press-releases/aamc-report-reinforces-mounting-physician-shortage" target="_blank">physicians</a> and allied health and behavioral health care <a href="https://www.mercer.com/about/newsroom/press-releases/?size=n_15_n&sort-field=publication_date&sort-direction=desc" target="_blank">providers</a>, which will likely be felt even more strongly in areas serving structurally marginalized urban and rural communities. Telehealth holds tremendous potential to leverage geographically dispersed provider capacity to support patient demand. <strong>We applaud efforts by Congress to reduce barriers to care delivery by extending many telehealth flexibilities through the end of 2024 as a part of the Consolidated Appropriations Act that passed in December 2022. AHA continues to urge that certain of these telehealth waiver provisions be made permanent.</strong></p> <p>We thank you for the opportunity to comment on ways to improve access to care in rural and underserved areas and look forward to continuing to work with you on this important issue. Please contact me if you have questions or feel free to have a member of your team contact Devin Gerzof, AHA’s senior associate director of federal relations, at <a href="mailto:dgerzof@aha.org?subject=RE: AHA Recommendations to House Ways and Means Committee on Improving Health Care Access in Rural and Underserved Areas letter">dgerzof@aha.org</a>.</p> <p>Sincerely,</p> <p>/s/</p> <p>Lisa Kidder Hrobsky<br> Senior Vice President Advocacy and Political Affairs</p> <hr> <ol> <li id="fn1"><a href="https://www.cms.gov/newsroom/press-releases/new-hhs-study-shows-63-fold-increase-medicaretelehealth-utilization-during-pandemic" target="_blank">https://www.cms.gov/newsroom/press-releases/new-hhs-study-shows-63-fold-increase-medicaretelehealth-utilization-during-pandemic</a></li> <li id="fn2"><a href="https://epicresearch.org/articles/telehealth-visits-unlikely-to-require-in-person-follow-up-within-90-days" target="_blank">https://epicresearch.org/articles/telehealth-visits-unlikely-to-require-in-person-follow-up-within-90-days</a></li> </ol> </div> <div class="col-md-4"> <p><a href="/system/files/media/file/2023/10/AHA-Recommendations-to-House-Ways-Means-Committee-on-Improving-Health-Care-Access-in-Rural-and-Underserved-Areas.pdf" target="_blank" title="Click here to download the AHA Recommendations to House Ways & Means Committee on Improving Health Care Access in Rural and Underserved Areas letter PDF."><img alt="AHA Recommendations to House Ways & Means Committee on Improving Health Care Access in Rural and Underserved Areas letter page 1." data-entity-type="file" data-entity-uuid="390e94db-3240-4e22-9110-195e8e78bbf6" src="/sites/default/files/inline-images/Page-1-AHA-Recommendations-to-House-Ways-Means-Committee-on-Improving-Health-Care-Access-in-Rural-and-Underserved-Areas.png" width="692" height="900"></a></p> </div> </div> </div> Thu, 05 Oct 2023 09:17:11 -0500 Metropolitan Anchor Hospital (MAH) /case-studies/2023-05-12-broadlawns-medical-center-iowa <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>Overview</span></h2> <p><img alt="Broadlawns Medical Center, Iowa" data-entity-type="file" data-entity-uuid="26c31c38-24aa-4bce-b8c6-050c5a3af70f" src="/sites/default/files/inline-images/Broadlawns-Medical-Center-Iowa.jpg" width="513" height="253" class="align-right">Broadlawns Medical Center of Des Moines treats a diverse population of patients, addressing the medical, societal, and behavioral health needs of local citizens – from the greater Des Moines area – serving more than 72,757 patients in fiscal year 2022. Supported by the taxpayers of Polk County and governed by an elected board of trustees, it is the only public county hospital in the state of Iowa. Located in one of Iowa’s lowest-income zip codes, Broadlawns is the cornerstone of its community, particularly for patients lacking insurance coverage and those with limited resources.</p> <p>Broadlawns Medical Center was established in 1903 as part of Drake University’s School of Medicine and later incorporated as the Miners’ and Industrial Workers’ Hospital in 1916. Today, Broadlawns has more than 1,600 employees, including 209 physicians and 420 licensed nurses who work together to provide high-quality health care to the community, through acute hospital care, emergency, inpatient and outpatient services, lab and radiology services, mental health care, specialty clinics, dentistry, and 24-hour crisis services.</p> <p>Broadlawns also offers a wide variety of other health care services, such as addiction treatment, residential care, behavioral health, urgent care, dental care, obstetrical care, and health education. It is the largest WIC provider in the state and cares for more refugees than any other hospital in Iowa.</p> <blockquote> <h3><span><em>“At Broadlawns, we are redefining what it means to be a county hospital.”</em></span></h3> <p><span><strong>Anthony B. Coleman</strong></span><br> DHA, President and CEO</p> </blockquote> <h2><span>Patient–Payer Mix</span></h2> <p>Broadlawns has a diverse patient population, with 32.24% of patients identifying as a person a color. Broadlawns is proud to provide care to the largest volume of refugees in the state.</p> <p>To provide culturally competent care to this diverse population, Broadlawns has a team of 10 staff interpreters and offers 24/7 access to audio and virtual interpreter services. On average, more than 40 different languages are spoken throughout the medical campus each week. Last year our patients spoke over 100 different languages.</p> <p>Two-thirds of Broadlawns’ patients are insured by Medicare, Medicaid, or both. In 2020, 83% of patient visits, 86% of patients discharges and 55% of net patient revenue were from patients insured by the Medicare and Medicaid programs. In 2022, Broadlawns provided an estimated $11.6 million in uncompensated charity care to help individuals from across the state.</p> <p>The state of Iowa has not increased its Medicaid rates since 2013, so payments to Broadlawns for care rendered to Medicaid patients have not kept up with significant increases in the cost of labor, pharmaceuticals, and supplies for almost a decade. The fact that nearly 40% of Broadlawns patients are insured by Medicaid underscores the need for increased support for this hospital.</p> <h2><span>Broadlawns' Unique Approach to Care</span></h2> <h3><span>Produce Prescription Program</span></h3> <p>The Polk County Produce Prescription Program (PCPPP) connects diabetic patients from Broadlawns’ Family Health Center to medical providers who write prescriptions for free vouchers for fruits and vegetables. By helping lower-income families purchase fresh, nutritious foods instead of processed or fast food, the program has seen measurable results.</p> <p>Serving 179 individuals, nine in ten participants rated the program as positive or very positive, and a majority reported eating more fruits and leafy vegetables after receiving the prescription for six months. Additionally, self-reported patient data, evaluated by the Broadlawns medical team, has demonstrated significant impact on patient health, including decreases in hemoglobin A1C and cholesterol. To build on the program’s success, Broadlawns was awarded additional funding to introduce the program in its Pediatric Clinic.</p> <h3><span>TEACH & TECH Program</span></h3> <p>Broadlawns’ TEACH and TECH (Training and Education for a Career in Healthcare) job training programs were established in 2016 to raise awareness of health care career opportunities among youth and adults in the Des Moines community.</p> <p>Participants are introduced to Broadlawns’ work culture, explore career paths, and complete basic and advanced Certified Nursing Assistant (CNA) training. The majority of participants are selected from the neighboring community, whose residents have the highest poverty and unemployment levels in Des Moines. Over the past six years, more than 130 individuals have graduated from the TEACH/TECH job training program, including nearly half of whom were hired by Broadlawns following graduation and continue working for the hospital to this day.</p> <h3><span>The Health Ambassador Program</span></h3> <p>Broadlawns’ Health Ambassador program links health coaches and pharmacy educators with community members to train them to share information, recognize potential health concerns, and help improve health literacy. The program holds community enrollment events to attract individuals living with diabetes and/or hypertension. Health ambassadors staff enrollment events and follow up regularly with individuals who enroll in the program, which has the capacity to serve roughly 100 Iowans.</p> <h2><span>Metropolitan Anchor Hospitals Need Support</span></h2> <p>Metropolitan Anchor Hospitals (MAHs) like Broadlawns attend to the sickest, poorest, and those high-need individuals who benefit most from community-based programs and support services. MAHs serve patients who have high rates of chronic diseases and complex health conditions. With more stable resources, MAHs like Broadlawns can expand their innovative programs, improve patient outcomes, and further enhance their communities’ health. To respond to community needs and financial pressures, MAHs need additional financial support to help address rapidly rising health care costs.</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/2023/05/Broadlawns-Medical-Center-Iowa-MAH-Case%20Study.pdf" target="_blank" title="Click here to download the Broadlawns Medical Center, Iowa: Metropolitan Anchor Hospitals (MAH)case study PDF."><img alt="Broadlawns Medical Center, Iowa: Metropolitan Anchor Hospital (MAH) case study page 1." data-entity-type="file" data-entity-uuid="07a5526c-cf80-458f-96c2-b050a94856d3" src="/sites/default/files/inline-images/Page-1-Broadlawns-Medical-Center-Iowa-MAH-Case%20Study.png" width="695" height="900"></a></p> <hr><div class="views-element-container"> <section class="top-level-view js-view-dom-id-fbd3bf9dceb50e461040779195fa02ed9bbfaf06f7c1425566098740f527858e 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> Fri, 12 May 2023 15:13:18 -0500 Metropolitan Anchor Hospital (MAH) /case-studies/2023-05-10-mlk-community-healthcare-california <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>Overview</span></h2> <p><img alt="MLK Community Healthcare, California." data-entity-type="file" data-entity-uuid="e4328679-be7a-4b3c-b3cb-38c3f985f17e" src="/sites/default/files/inline-images/MLK-Community-Healthcare-California.jpg" width="513" height="227" class="align-right">When MLK Community Healthcare – a hospital and health system – opened in South Los Angeles in 2015, its leadership made a bold promise: to deliver a state-of-the-art facility with talented and culturally-aligned clinicians and staff in one of the nation’s most marginalized communities. As its founding mission, MLK Community Healthcare provides quality collaborative care to its patients. Its vision is to improve the health of the entire community.</p> <p>Today, MLK Community Healthcare provides inpatient care that includes highly specialized services, including award-winning diabetes care and maternity care its all-digital, 131-bed hospital. Its nonprofit physician group, MLK Community Medical Group, provides community-based care through a network of outpatient practice sites, offering the kind of primary and specialty care, behavioral health, and education that residents throughout South Los Angeles have historically lacked to address chronic conditions that are prevalent at three times the state average.</p> <blockquote> <h3><span><em>"For MLK Community Healthcare, delivering quality care is an act of social justice.”</em></span></h3> <p><span><strong>Dyan Sublett</strong></span><br> President, MLK Community Health Foundation</p> </blockquote> <p>MLK Community Healthcare was established through a public-private partnership unique in the state of California. Largely due to its private management organizational structure, the hospital is able to innovate, respond nimbly to patient needs, invest in cutting-edge technology, and maintain high-quality standards. MLK Community Healthcare has earned multiple awards and distinctions for its commitment to quality care, including a HIMMS level 7 rating for its use of health information technology and a five-star rating for quality from the Centers for Medicare & Medicaid Services (CMS). Notably, only 6.4% of hospitals in the nation are at HIMMS 7. In addition, only 13% of all hospitals receive a CMS five-star rating; it is even more rare among hospitals whose patient populations are predominantly covered by Medicaid or Medi-Cal.</p> <h2><span>Patient–Payer Mix</span></h2> <p>As a Metropolitan Anchor Hospital (MAH), MLK Community Healthcare continues to be guided by the belief that all patients – no matter their insurance status – deserve access to high-quality primary and specialty care services. MLK Community Healthcare is located in federally designated Medically Underserved and Healthcare Professional Shortage Areas, and it experiences a challenging patient-payer mix. Ninety-six percent of MLK Community Healthcare patients are publicly insured or uninsured, placing an extreme burden on the finances of a health system unable to crosss-ubsidize with commercial insurance.</p> <p>MLK Community Healthcare serves one of the most diverse communities in the state—94% of its patients in 2022 were Black or Brown. Decades of systemic racism and neglect are reflected in the community’s disproportionately high health and social needs. For example, life expectancy in MLK Community Healthcare’s service area is ten years lower than the rest of California and the median per capita income is $16,927—less than half of the state average.</p> <p>Chronic health conditions are disproportionately prevalent in the MLK Community Healthcare service area. The rate of diabetes is three times that of the rest of the state, while mortality from diabetes is 72% higher. Amputations and diabetic wound care are among the most commonly performed procedures at the hospital. In 2022, the prevalence of substance use disorder among MLK Community Healthcare patients was three times the state rate, and the number of patients with heart failure was twice as high as the statewide average. This high prevalence of chronic conditions means that MLK Community Healthcare’s patients are at an increased risk for complications, including severe symptoms from COVID-19. During the height of the pandemic, MLK Community Healthcare saw more COVID-19 patients than hospitals three to four times its size throughout Los Angeles County and was included by Becker’s Review among the 14 most highly impacted hospitals for COVID-19 in the nation.</p> <h2><span>MLK Community Healthcare's Unique Approach to Care</span></h2> <p>MLK Community Healthcare offers numerous programs to promote equal access to care and address community members’ basic and emergent health care needs:</p> <h3><span>Emergency Department</span></h3> <p>Given the lack of health care resources outside the walls of MLK Community Healthcare, community members often come to the Emergency Department to receive basic services. Even women seeking routine pregnancy-related services are cared for—and given follow-up appointments— to ensure their health and recovery. The hospital is also renowned for its triage services. Due to the use of MLK Community Healthcare’s ED for both urgent and primary care services, a department designed for 40,000 patients each year has stretched its resources to serve up to 116,000 patients annually. Yet, this has not compromised its performance. Due to process innovations, wait times are less than two hours and the Left Without Being Seen rate is the lowest among all hospitals in the area.</p> <h3><span>Investment in a Service-Oriented Health Care Workforce</span></h3> <p>Wealthy communities in Los Angeles have ten times the number of physicians located in the community than that which MLK Community Healthcare serves. To bridge this gap, MLK Community Healthcare secured over $20 million in private philanthropy to subsidize doctors’ and nurses’ salaries – helping attract a strong, service-oriented workforce, including specialists in the chronic health conditions that are disproportionately prevalent among MLK Community Healthcare’s patients.</p> <h3><span>Disease Management</span></h3> <p>For many MLK Community Healthcare patients living with multiple chronic conditions, health care services must extend beyond primary care. That’s why MLK Community Healthcare has invested in the creation of a Diabetes Center of Excellence, implementing a range of services designed to prevent avoidable ED visits and slow the progression of disease through self-management, specialized education, peer support, and a fresh produce program for food insecure patients.</p> <h3><span>Integrated Behavioral Health</span></h3> <p>An average of 10,000 patients come to the MLK Community Healthcare ED with behavioral health needs each year. With philanthropic support, MLK Community Healthcare tested an innovative pilot program integrating medical and behavioral health care in the emergency and inpatient environment with long-term follow-up treatment in the outpatient environment. The pilot program was successful and is now a signature approach for effective behavioral health care.</p> <h2><span>Metropolitan Anchor Hospitals Need Support</span></h2> <p>Since its opening, MLK Community Healthcare has provided consistent, quality care to individuals in the historically underserved communities of South Los Angeles. Serving 1.3 million residents, MLK Community Healthcare continues to be guided by the unwavering belief that all communities deserve equal access to quality care and services. Its five-star CMS rating, cutting-edge technology, culturally aligned staff and renowned medical professionals demonstrate its commitment to this principle of health equity.</p> <p>The costs of treating highly complex patients without supplemental payments necessary to adequately cover their care exacerbate the heightened financial challenges MLK Community Healthcare faces from rising labor costs and inflation – threatening its ability to invest in new technologies, attract staff through competitive compensation packages, and offer much-needed preventive and specialized care services.</p> <p>While MLK Community Healthcare is committed to providing a high standard of care and is taking steps to halt decades-long trends of neglect and poor health outcomes, a federal Metropolitan Anchor Hospital designation and more adequate, sustained financial support are critical to realizing this mission.</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/2023/05/MLK-Community-Healthcare-California-MAH-Case%20Study-" target="_blank" title="Click here to download the MLK Community Healthcare, California: Metropolitan Anchor Hospitals (MAH)case study PDF."><img alt="MLK Community Healthcare, California: Metropolitan Anchor Hospital (MAH) case study page 1." data-entity-type="file" data-entity-uuid="6155c4ad-1696-45a4-8897-4ffe55dccd7d" src="/sites/default/files/inline-images/Page-1-MLK-Community-Healthcare-California-MAH-Case%20Study.png" width="695" height="900"></a></p> <hr><div class="views-element-container"> <section class="top-level-view js-view-dom-id-04f957a2d8baa31daf71e85dc220a0e55a96161e53647e0a68076a8aa693a153 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, 10 May 2023 08:48:40 -0500 Metropolitan Anchor Hospital (MAH) /news/perspective/2023-01-06-advancing-health-america-bipartisan-goal-we-can-all-get-behind <p>The convening of the 118th Congress this week is a reminder of Washington’s highly-charged political environment.</p> <p>The once-in-a-century floor tussle over the Republicans’ selection for Speaker of the House; the narrow Democratic majority in the Senate and slim GOP majority in the House; and the specter of the 2024 presidential election looming over everything all point to a challenging period ahead.</p> <p>But we also know our country – and our nation’s hospitals and health systems – are facing significant challenges that will require bipartisan compromise and bold action.</p> <p><strong>Preserving the ability of hospitals and health systems to continue to advance health for individuals and communities is not a Republican issue or a Democratic issue. It is an American issue that transcends party politics. And that’s why the AHA will continue to approach and frame all of our initiatives in a manner that can gain bipartisan support.</strong></p> <p>In fact, thanks in large part to hospital leaders’ efforts to share their stories, many members of both parties have already shown their recognition of the immense pressure America’s hospitals, health systems and caregivers are facing.</p> <p>Just a few weeks ago, Congress passed and President Biden signed legislation that prevented massive new Medicare cuts, mitigated physician payment reductions, extended critical regulatory flexibilities provided under the Public Health Emergency for telehealth and the Acute Hospital Care at Home program, extended vital rural health programs, improved access to behavioral health, and put into place a practical glide-path for dealing with Medicaid – that protects historically marginalized populations – as we approach the expected end of the PHE, among other provisions. See our detailed <a href="/special-bulletin/2022-12-20-appropriations-committees-release-omnibus-spending-bill-health-provisions?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today" target="_blank">summary of provisions</a> included in the legislation.</p> <p>While we were pleased to secure some very important provisions, we recognize this is just a part of what needs to be done to support hospitals and those on the front lines caring for patients.</p> <p>Hospitals and health systems just concluded the most difficult financial year since the start of the pandemic. These financial struggles are expected to continue this year as the field continues to experience exorbitant increases for the costs of caring for patients, including labor, drugs and supplies.</p> <p>This year, the AHA will work with Congress – including the seven new senators and 75 new representatives – and the Administration in a bipartisan manner to educate them on the challenges facing the field and enact provisions that have bipartisan support to advance health for patients and communities. Be certain, we will be working to educate these new legislators and you can also play a role in doing that. Starting later this month, we’ll be offering new tools and resources that can assist you in your advocacy efforts with your lawmakers, including tips on engagement and outreach to enhance your relationships.</p> <p>We will work to:</p> <ul> <li>Establish a temporary per-diem payment targeted to hospitals to address the issue of hospitals not being able to discharge patients to post-acute care or behavioral facilities because of staffing shortages.<br />  </li> <li>Create a designation for metropolitan anchor hospitals that assist hospitals that have extremely high volumes of Medicare, Medicaid and uninsured patients and typically serve historically marginalized communities.<br />  </li> <li>Examine the method of updating Medicare payment rates through the market basket when the cost of caring or input prices hospitals are forced to absorb outstrip annual adjustments.<br />  </li> <li>Protect the 340B drug pricing program.<br />  </li> <li>Strengthen the workforce, including protecting health care workers from violence and increasing the talent pipeline for the future.<br />  </li> <li>Relieve the field of unnecessary regulatory and other administrative burdens and hold commercial health plans accountable for policies that compromise patient safety and add burden to care providers.</li> </ul> <p>These are only a few of our priorities for 2023. We’re continuing to work on our short-term agenda for financial relief with the AHA Board of Trustees, and state and metropolitan hospital associations. Watch for our detailed 2023 Advocacy Agenda later this month.</p> <p>At the same time, our Board of Trustees also will be focusing on the long-term strategies necessary to secure our future. These require innovative, bold and creative solutions to ensure that hospitals remain key players in delivering care in their communities not only for today but for tomorrow too.</p> <p>America needs strong hospitals and health systems so we can have healthy and thriving communities. We must do everything we can to support our caregivers and ensure that the care will always be there.</p> Fri, 06 Jan 2023 09:56:51 -0600 Metropolitan Anchor Hospital (MAH)