/ en Fri, 25 Apr 2025 22:54:08 -0500 Tue, 15 Oct 24 22:53:55 -0500 /issue-brief/2024-10-15-issue-brief-building-safe-workplace-and-community-community-violence-intervention <div class="container row"><div class="row"><div class="col-md-8"><h2>Introduction</h2><p>The ºÚÁÏÕýÄÜÁ¿ Association’s Hospitals Against Violence (HAV) Advisory Group developed the Building a Safe Workplace and Community <a href="/system/files/media/file/2021/10/building-a-safe-workplace-and-community-framework-for-hospitals-and-health-systems.pdf" target="_blank" title="Building a Safe Workplace and Community framework">framework</a> to guide health care leaders in their efforts to prevent and mitigate violence. The framework focuses on four pillars necessary for implementing a comprehensive violence mitigation strategy: culture of safety, violence intervention, trauma support and risk mitigation. For each pillar, the advisory group developed an issue brief.</p><p>View the detailed report below.</p></div><div class="col-md-4"><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/system/files/media/file/2024/10/issue-brief-building-a-safe-workplace-and-community-community-violence-intervention-october-2024.pdf"><strong>Download the PDF</strong></a><br> </p><p><a href="/system/files/media/file/2024/10/issue-brief-building-a-safe-workplace-and-community-community-violence-intervention-october-2024.pdf" target="_blank"><img src="/sites/default/files/2024-10/cover-issue-brief-community-violence-intervention-october-2024-765-px.png" alt="Issue Brief Cover" width="765" height="989"></a></p></div></div></div> Tue, 15 Oct 2024 22:53:55 -0500 Issue Brief /member-issue-brief-implementing-patient-out-pocket-cost-estimators <div class="row"><div class="col-md-8"><p>Patients have many questions when planning for their care. An important one is: How much is this going to cost me? While hospitals and health systems have generally relied on financial advisors to help patients with inquiries about what they may pay for care, technological advances are enabling them to help patients find this information in new ways, particularly through online tools. This issue brief lays out the key components of effective online tools used by hospitals and health systems to help patients understand their potential out-of-pocket costs and highlights several different approaches providers have taken. View the entire issue brief <a href="/system/files/media/file/2020/10/member-issue-brief-advancing-price-transparency.pdf" target="_blank">here</a>. Also see case studies below.</p></div><div class="col-md-4"><p><a href="/system/files/media/file/2020/10/member-issue-brief-advancing-price-transparency.pdf" title="Click to download Implementing Patient Out-of-pocket Cost Estimators issue brief"><img src="/sites/default/files/inline-images/member-issue-brief-implementing-patient-out-of-pocket-cost-estimators-440.png" alt="Implementing Patient Out-of-pocket Cost Estimators cover" width="442" height="571" title="Click to download Implementing Patient Out-of-pocket Cost Estimators"></a></p><p><a href="/system/files/media/file/2020/10/member-issue-brief-advancing-price-transparency.pdf" title="Click to download Implementing Patient Out-of-pocket Cost Estimators issue brief"></a></p><p><a href="/system/files/media/file/2020/10/member-issue-brief-advancing-price-transparency.pdf" title="Click to download Implementing Patient Out-of-pocket Cost Estimators issue brief"></a><a class="btn btn-wide btn-primary" href="/system/files/media/file/2020/10/member-issue-brief-advancing-price-transparency.pdf">Download Issue Brief</a></p></div></div> Mon, 12 Aug 2024 16:51:07 -0500 Issue Brief /issue-brief/2024-05-14-issue-brief-building-safe-workplace-and-community-violence-mitigation-culture-safety <div class="container row"><div class="row"><div class="col-md-8"><h2>Introduction</h2><p>In 2021, the ºÚÁÏÕýÄÜÁ¿ Association’s <a href="/hospitals-against-violence-havhope" target="_blank" title="AHA Hospitals Against Violence Web site.">Hospitals Against Violence</a> (HAV) Advisory Group developed the Building a Safe Workplace and Community <a href="/system/files/media/file/2021/10/building-a-safe-workplace-and-community-framework-for-hospitals-and-health-systems.pdf" target="_blank" title="Building a Safe Workplace and Community Framework">framework</a> to guide health care leaders in their efforts to mitigate workplace violence. The framework established four essential pillars of a comprehensive violence mitigation strategy: (1) culture of safety; (2) violence intervention; (3) trauma support; and (4) risk mitigation. Leadership is at the center of the framework and employs data, education, and accountability to advance these pillars. For each pillar, the Advisory Group develops an issue brief that does a deep dive into that area of focus.</p><p>This issue brief, the third of four in the series, examines how hospitals’ violence mitigation efforts can fit effectively into an organization’s culture of safety strategy. The brief includes thought provoking questions to facilitate discussion of how violence mitigation can be integrated seamlessly into the larger framework of patient and worker safety initiatives, supporting an overall culture of safety. It also explores strategies that leaders could take to best support a culture that mitigates violence as part of larger enterprise efforts.</p><p>View the detailed report below.</p></div><div class="col-md-4"><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/system/files/media/file/2024/05/building-a-safe-workplace-and-community-violence-mitigation-in-a-culture-of-safety-issue-brief.pdf"><strong>Download the PDF</strong></a></p><p><a href="/system/files/media/file/2024/05/building-a-safe-workplace-and-community-violence-mitigation-in-a-culture-of-safety-issue-brief.pdf" target="_blank"><img src="/sites/default/files/2024-05/cover-hav-issue-brief-culture-of-safety-765-r.png" width="765" height="989"></a></p></div></div></div> Tue, 14 May 2024 12:02:08 -0500 Issue Brief <div class="row"><div class="col-md-9"><p>Unparalleled workforce shortages, negative margins and increasing labor expenses are creating multiple challenges for hospitals and health systems — but integrating physical and behavioral health services can reduce the total cost of care, improve outcomes and improve workforce satisfaction. Integrated care can decrease the impact of these and other challenges. There are at least six positive impacts of integrated care:</p><ul><li>Improved patient outcomes</li><li>Reduced total cost of care</li><li>Increased access to behavioral health services</li><li>Enhanced patient satisfaction</li><li>Better workforce productivity and satisfaction</li><li>Reduced health care disparities and stigma</li></ul><p>The push for integrated care is not new, but the time to act is now. Government and commercial payers are increasing coverage and consumers are demanding more timely access to behavioral health care. Integration improves outcomes, reduces the total cost of care and enhances workforce satisfaction.</p><p>The AHA’s vision is of a just society of healthy communities, where all individuals reach their highest potential for health. Integration of physical and behavioral health services can help us move closer to achieving the vision.</p><p>Download this issue brief to learn more.</p><a href="/system/files/media/file/2023/09/AHA-BH-Integration-TimeisNow-whitepaper-september-2023.pdf"><img src="/sites/default/files/inline-images/bh-integration-time-is-now.png" data-entity-uuid="665c6718-5373-4be9-8d17-0cfd8ac65fc4" data-entity-type="file" alt="issue brief cover image" width="400" height="519" class="align-center"></a><p class="text-align-center"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/09/AHA-BH-Integration-TimeisNow-whitepaper-september-2023.pdf" title="Download Issue Brief: Integrating Physical and Behavioral Health: The Time is Now">Download Issue Brief</a></p></div><div class="col-md-3"><div class="panel"><h4><u>Behavioral Health Strategic Priorities</u></h4><h4><a href="/behavioral-health-community-partnerships">Community Partnerships</a></h4><h4><a href="/behavioral-health-physical-behavioral-health-integration-resources">Integration</a></h4><h4><a href="/stigma">Stigma</a></h4><h4><a href="/suicideprevention">Suicide Prevention</a></h4><hr><h4><a href="/advocacy/access-and-health-coverage/access-behavioral-health">More Behavioral Health Resources ></a></h4></div></div></div> Wed, 13 Sep 2023 14:21:14 -0500 Issue Brief /issue-brief/2023-04-20-building-safe-workplace-and-community-mitigating-risk-violence <div class="container row"> <div class="row"> <div class="col-md-8"> <p>The ºÚÁÏÕýÄÜÁ¿ Association’s Hospitals Against Violence (HAV) initiative hosted the American Society for Health Care Risk Management (ASHRM) for a facilitated dialogue to explore challenges and current strategies to mitigate the risk of violence. The discussion fostered an exchange of ideas and solutions that informed this issue brief and accompanying case studies.</p> <h2>Introduction</h2> <p>In 2021, HAV developed the <a href="/system/files/media/file/2021/10/building-a-safe-workplace-and-community-framework-for-hospitals-and-health-systems.pdf" target="_blank">Building a Safe Workplace and Community</a> framework to guide health care leaders in their efforts to prevent and mitigate violence. This issue brief examines risk mitigation and marks the first in a series that expand on each domain of the framework: culture of safety, violence intervention, trauma support and risk mitigation.</p> <p>This issue brief is an outgrowth of a series of discussions between hospital and risk management leaders. The brief shares considerations when assessing potential risks, strategies to mitigating violence and insights on making the care environment safer.</p> <p><img alt="Building a Safe Workplace and Community: A Framework for Hospital and Health System Leadership. Leadership should push for greater data collection, collective accountability, and ongoing education and training. With this approach, we can achieve the four pillars necessary for implementing a comprehensive violence mitigation strategy: trauma support, violence intervention, culture of safety and mitigating risk. In this infographic, Mitigating Risk is emphasized." data-entity-type="file" data-entity-uuid="8247aabe-009a-4193-8918-79763f7d55cd" src="/sites/default/files/inline-images/Building-a-Safe-Workplace-and-Community-Mitigating-the-Risk-of-Violence-infographic.png" width="731" height="762"></p> <p><strong><em><a href="/system/files/media/file/2023/04/Building-a-Safe-Workplace-and-Community-Mitigating-the-Risk-of-Violence.pdf" title="Click here to download the Building a Safe Workplace and Community: Mitigating the Risk of Violence Issue Brief PDF."><span>Download the full Issue Brief.</span></a></em></strong></p> </div> <div class="col-md-4"> <div><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/04/Building-a-Safe-Workplace-and-Community-Mitigating-the-Risk-of-Violence.pdf" target="_blank" title="Click here to download the Building a Safe Workplace and Community: Mitigating the Risk of Violence issue brief PDF.">Download the PDF</a></div> <div class="panel module-typeC"> <div class="panel-body"> <h3>Definitions to Know</h3> <h4>Workplace Violence</h4> <p>According to:</p> <ul> <li><strong>Occupational Safety and Health Administration (OSHA):</strong> Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It can affect and involve workers, clients, customers and visitors.</li> <li><strong>CDC’s National Institute for Occupational Safety and Health:</strong> Violent acts (including physical assaults and threats of assaults) directed toward persons at work or on duty. Examples of violence include threats, which are expressions of intent to cause harm, including verbal threats, threatening body language and written threats.</li> <li><strong>The Joint Commission:</strong> An act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threatening, intimidating, harassing, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.</li> </ul> <h4>Risk Assessment (RA)</h4> <p>A part of the overarching process of risk management that identifies, analyzes and evaluates risks that may have a negative influence on the health care organizations’ quality and safety of care delivered.</p> <h4>Threat Assessment</h4> <p>A behavior-based inquiry process that helps organizations respond to a threat of targeted violence and identify those who may be moving toward an intentional harmful event; it is a multi-disciplinary approach to identifying, assessing, and mitigating concerns of intentional violence.</p> </div> </div> </div> </div> </div> Thu, 20 Apr 2023 11:16:48 -0500 Issue Brief /issue-brief/2022-12-05-patients-and-providers-faced-increasing-delays-timely-discharges <div class="container"> <div class="row"> <div class="col-md-8"> <h2>The Issue</h2> <p>Patients requiring additional care after a hospitalization — such as skilled nursing, behavioral health or therapy-at-home — face growing delays in accessing that care. Delays in discharges as patients move through the continuum of care can cause harm to patients’ health outcomes and can impact their quality of life by slowing their recovery. These delays also put incredible strain on hospitals and health systems as they must bear the costs of caring for patients during those excess days without appropriate reimbursement, and they also add burden on an already thin workforce. This strain comes atop the ongoing toll of the COVID-19 pandemic and recent economic trends that have exacerbated hospitals’ financial challenges, including significant increases in the <a href="/system/files/media/file/2022/04/2022-Hospital-Expenses-Increase-Report-Final-Final.pdf">costs of providing care</a> to patients.</p> <p>It is clear these delays are occurring concurrently with severe health care workforce shortages among both clinical and non-clinical workers. These shortages have been challenging for acute care hospitals as well as post-acute care and other providers receiving patient transfers from acute care hospitals, such as psychiatric hospitals. As a result, post-acute care and other providers have been unable to accept new patients, creating patient bottlenecks at acute care hospitals. Rehabilitation and long-term care hospitals also report similar patient bottlenecks with difficulties discharging their patients to other post-acute care providers, such as skilled nursing facilities.</p> <h2>Patients Waiting for Discharge to Post-acute Care Providers Are Staying Longer in the Hospital</h2> <p><img alt="Figure 1: Percent Change in CMI-adjusted ALOS 2019-2022, by discharge location. All Post-Acute: 15.4%. Home Health: 12.6%. IP Rehab: 14.4%. LTAC: 11.1%. Psych: 28.9%. SNF: 20.2%." data-entity-type="file" data-entity-uuid="1cb4cfbc-0b6b-4627-9273-b8ee4a433366" src="/sites/default/files/inline-images/Figure-1-Percent-Change-in-CMI-adjusted-ALOS-2019-2022-by-discharge-location.jpg" width="451" height="361" class="align-right">Data from Strata Decision Technology, a health care technology and consulting firm, show that the average length-of-stay (ALOS) in hospitals has increased 19.2% across the board for patients in 2022 as compared to 2019 levels. The increase is <strong>more pronounced for patients being discharged to post-acute care providers — with an increase in ALOS of nearly 24% from 2019 to 2022.</strong> This remains true even after accounting for <a href="/system/files/media/file/2022/08/pandemic-driven-deferred-care-has-led-to-increased-patient-acuity-in-americas-hospitals.pdf">patients being sicker</a> and requiring more complex and intensive care now as compared to pre-pandemic levels, as measured by the case mix index (CMI).</p> <p><strong>Additionally, CMI-adjusted ALOS has increased for patients being discharged from acute care hospitals to post-acute care providers, with a 12.6% increase for patients being discharged to home health agencies and a 20.2% increase for patients being discharged to skilled-nursing facilities (SNFs). Similarly, patients being discharged from acute care hospitals to other hospital settings have also seen increases, with a 28.9% increase for discharges to psychiatric hospitals. (See Figure 1 above).</strong></p> <h2>Support Needed for Hospitals</h2> <p>These costs are further straining hospitals across the country that are already dealing with a range of financial pressures from historic levels of inflation to skyrocketing costs, as well as their own workforce challenges. <a href="/guidesreports/2022-09-15-current-state-hospital-finances-fall-2022-update">Data from the health care consulting firm Kaufman Hall</a> found that hospitals’ expenses are projected to increase by $135 billion in 2022 alone, with 68% of hospitals projected to end the year operating at a financial loss.</p> <p><strong>To help mitigate the costs of caring for patients for these excess days in the hospital and to ensure that patients are getting the most appropriate care possible, the AHA is asking Congress to establish a temporary per diem Medicare payment targeted to hospitals, including acute, long-term care, rehabilitation, and psychiatric, to ease capacity issues.</strong> This per diem payment would be made for cases identified and assigned with a specific discharge code that fall under such type of long stays where the patient is documented to be ready for discharge but is unable to be discharged appropriately. The solution could be modeled after an existing per diem Medicare payment mechanism and be temporary with a cap on payments.</p> <p><strong>It is critically important to ensure that hospitals and health systems remain financially stable, so that they can continue to provide high quality care to patients and communities throughout the country.</strong></p> </div> <div class="col-md-4"> <p><a href="/system/files/media/file/2022/12/Issue-Brief-Patients-and-Providers-Faced-with-Increasing-Delays-in-Timely-Discharges.pdf" target="_blank" title="Clear here to download the Issue Brief: Patients and Providers Faced with Increasing Delays in Timely Discharges PDF."><img alt="Issue Brief: Patients and Providers Faced with Increasing Delays in Timely Discharges page 1." data-entity-type="file" data-entity-uuid="53d7a601-2e68-4c9e-b5e7-207289cffe50" src="/sites/default/files/inline-images/Page-1-Issue-Brief-Patients-and-Providers-Faced-with-Increasing-Delays-in-Timely-Discharges-900x600.png" width="695" height="900"></a></p> </div> </div> </div> Mon, 05 Dec 2022 11:38:14 -0600 Issue Brief /issue-brief/2022-11-17-value-initiative-issue-brief-measuring-value-team-based-care-dashboard-health-care-organizations <p>Interdisciplinary team-based care – where health professionals from various disciplines collaborate to care for patients – is an effective lever to improve value by affecting all three components of AHA’s value equation.</p> <p>For many hospitals and health systems, implementing or expanding their teambased care strategies requires reimagining how to organize care, deciding how health professionals should interact – both with each other and with patients – and reconsidering how to train health care providers. To invest the time, resources and staff needed to implement team-based care, hospitals need champions who can articulate how such investment improves outcomes, enhances the patient experience and reduces cost.</p> Thu, 17 Nov 2022 12:58:35 -0600 Issue Brief /2018-02-01-issue-briefs <p>AHA's Issue briefs frame the issue of affordability and can be used by hospitals and health systems to initiate conversations with stakeholders in their communities.</p> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td> <p><a href="/system/files/media/file/2022/11/issue-brief-measuring-the-value-of-team-based-care.pdf" target="_blank"><img alt="Issue Brief Cover" data-entity-type="file" data-entity-uuid="eb4c3cd4-4b2f-415c-9cad-591af1224a85" src="/sites/default/files/inline-images/cover-issue-brief-measuring-the-value-of-team-based-care-242px.png" width="242" height="313"></a></p> </td> <td> <h4><a href="/system/files/media/file/2022/11/issue-brief-measuring-the-value-of-team-based-care.pdf" target="_blank">Measuring the Value of Team-based Care: A Dashboard for Health Care Organizations</a></h4> <p>Learn about real-life examples of hospitals that have utilized team-based care to improve value. This dashboard deeper provides health care leaders with metrics that their organizations can use to make the case for team-based care. It demonstrates the value of team-based care in four domains: process and culture; quality and outcomes; patient experience; and costs.</p> </td> </tr> <tr> <td><a href="/system/files/media/file/2020/12/issue-brief-creating-value-by-bringing-hospital-care-home_0.pdf" target="_blank"><img alt="The Value Initiative Issue Brief: Creating Value by Bringing Hospital Care Home Image 242px" src="/sites/default/files/2020-12/issue-brief-creating-value-by-bringing-hospital-care-home-242.png"></a></td> <td> <h4><a href="/system/files/media/file/2020/12/issue-brief-creating-value-by-bringing-hospital-care-home_0.pdf" target="_blank">Creating Value by Bringing Hospital Care Home</a></h4> <p>As hospitals consider how and where they deliver care to patients, many are seeing the hospital-at-home model as a promising approach to improve value. This issue brief explores how hospitals can provide acute-level care in patients’ homes, and highlights case examples of hospitals that successfully improved value through their home hospital programs.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/media/file/2020/09/value-initiative-issue-brief-team-based-care-creates-value.pdf" target="_blank"><img alt="The Value Initiative Issue Brief: Team-based Care Creates Value Image 243px" src="/sites/default/files/2020-09/value-initiative-issue-brief-team-based-care-creates-value-242px.png"></a></td> <td> <h4><a href="/system/files/media/file/2020/09/value-initiative-issue-brief-team-based-care-creates-value.pdf" target="_blank">Team-based Care Creates Value</a></h4> <p>To better support patients and their families through an acute or chronic illness, hospitals are adopting team-based models of care that encompass patients’ medical and social needs across the care continuum. Team-based care is a promising, low-tech approach that allows health care workers from varying professional disciplines to provide customized, patient-centered care to manage the physical, psychological and spiritual needs of their patients. This issue brief also highlights AHA Team Training and discusses how hospitals have utilized care teams during the COVID-19 pandemic.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/media/file/2020/08/value-initiative-issue-brief-10-creating-value-with-age-friendly-health-systems.pdf" target="_blank"><img alt="The Value Initiative Issue Brief: Creating Value with Age-Friendly Health Systems page 1" data-entity-type="file" data-entity-uuid="0ec6c757-5e82-46c5-a17d-04b6d86cf6ae" src="/sites/default/files/inline-images/tvi-issue-brief-afhs-10-creating-age-friendly-health-systems.jpg" width="243" height="313"></a></td> <td> <h4><a href="/system/files/media/file/2020/08/value-initiative-issue-brief-10-creating-value-with-age-friendly-health-systems.pdf" target="_blank">Creating Value with Age-Friendly Health Systems</a></h4> <p>With the number of older adults in the United States projected to double in the next 40 years, hospitals and health systems are adapting low-tech, value-based strategies to improve patient outcomes for older adults. This issue brief highlights ways that age-friendly care’s 4Ms Framework and measures enable value, along with case examples and considerations for becoming an Age-Friendly Health System.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/issue-brief/2020-03-04-value-initiative-issue-brief-creating-high-value-telehealth-strategy"><img alt="Value Initiative Issue Brief 8 Image" src="/sites/default/files/2020-03/value-initiative-issue-brief-creating-high-value-telehealth-strategy-242.png"></a></td> <td> <h4><a href="/system/files/media/file/2020/03/value-initiative-issue-brief-creating-high-value-telehealth-strategy-3-4-2020.pdf">Creating a High-value Telehealth Strategy</a></h4> <p>This issue brief examines how hospitals and health systems are utilizing telehealth to improve patient outcomes and the patient experience, and reduce cost. It looks are barriers to widespread adoption as well as AHA advocacy efforts. The brief also discusses ways to tailor an organization’s telehealth strategy to meet patient and community needs.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/media/file/2019/12/value-initiative-issue-brief-8-low-tech-solutions-advance-value.pdf"><img alt="Value Initiative Issue Brief 8 Image" src="/sites/default/files/2019-12/value-initiative-issue-brief-8-low-tech-solutions-advance-value-image-236.jpg"></a></td> <td> <h4><a href="/system/files/media/file/2019/12/value-initiative-issue-brief-8-low-tech-solutions-advance-value.pdf">Low-tech Solutions that Advance Value</a></h4> <p>As hospitals and health systems implement value-based strategies, they also are adopting innovative, low-tech approaches to improve value. This issue brief examines characteristics of low-tech solutions and includes examples of hospitals implementing several low-tech approaches. Beginning in 2020, as part of The Value Initiative’s <a href="/from-paper-to-action">From Paper to Action</a> effort, the AHA will focus on widespread implementation of four specific low-tech value-based strategies.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/media/file/2019/12/value-initiative-issue-brief-integrated-behavioral-health-high-value-care.pdf"><img alt="Value Initiative Issue Brief 1 Image" src="/sites/default/files/2019-12/value-initiative-issue-brief-integrated-behavioral-health-high-value-care-image-238.jpg"></a></td> <td> <h4><a href="/system/files/media/file/2019/12/value-initiative-issue-brief-integrated-behavioral-health-high-value-care.pdf">Integrated Behavioral Health is High-value Care</a></h4> <p>Integrating physical and behavioral health care services can help hospitals and health systems overcome patient barriers to accessing behavioral health services while improving outcomes and value. This issue brief examines how integration can take various forms based on provider, patient and community needs and how telebehavioral health can help in areas with shortages of behavioral health professionals. The brief also provides examples from specific hospitals and health systems and links to additional AHA behavioral health resources.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/advocacy-issues/affordability/value-initiative-issue-brief-1.pdf"><img alt="Value Initiative Issue Brief 1 Image" data-entity-type="file" data-entity-uuid="f7f8cf06-a595-4ba9-9839-eec3792f6ec9" src="/sites/default/files/inline-images/value-initiative-issue-brief-1-image_0.jpg" width="238" height="312" class="align-center"></a></td> <td> <h4><a href="/system/files/advocacy-issues/affordability/value-initiative-issue-brief-1.pdf">Framing the Issue of Affordable Health Care</a></h4> <p>Affordability is one of the most important challenges influencing Americans’ ability to access health care. A number of factors affect the affordability of health care, including housing, transportation, education, personal choices, and the cost of health insurance, prescription drugs, and hospital services. Leaders from the ºÚÁÏÕýÄÜÁ¿ Association, hospitals, and health systems understand these challenges, have strategies to address them, and are deeply committed to ensuring that patients and consumers have access to affordable health care.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td> <p><a href="/system/files/2018-04/value-initiative-issue-brief-2.pdf"><img alt="Issue Brief 2 image" data-entity-type="file" data-entity-uuid="0a1cfe25-76cf-45d9-b88f-6c78be3d57f3" src="/sites/default/files/inline-images/value-initiative-issue-brief-2-image_0.jpg" width="236" height="309"></a></p> </td> <td> <h4><a href="/system/files/2018-04/value-initiative-issue-brief-2.pdf">What Does Value Mean?</a></h4> <p>There has been significant interest in and discussion around what value in health care delivery means. Yet, despite an increasing focus on value, there is no agreed-upon definition or expectation across the health care field. Perspectives vary widely, are at times inconsistent and, in many instances, do not align amongst various stakeholders involved with the delivery of health care. In this issue brief, we identify various definitions of value, explain why it is so difficult to define, and share how the AHA intends to address the value equation.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/2018-11/value-initiative-issue-brief-3-equity.pdf"><img alt="Value Initiative Issue Brief 3" data-entity-type="file" data-entity-uuid="2d75458f-7404-484a-bc10-ecef4fae1da8" src="/sites/default/files/inline-images/value-initiative-issue-brief-3-image.jpg" width="236" height="310" class="align-center"></a></td> <td> <h4><a href="/system/files/2018-11/value-initiative-issue-brief-3-equity.pdf">Connecting the Dots: Value and Health Equity</a></h4> <p>How are value and health equity connected? The best way to examine the connection between health equity and value is to start by understanding health equity. Health equity is achieved by providing care that does not vary in quality by personal characteristics such as gender, ethnicity, geographic location and socioeconomic status. Therefore, achieving health equity requires a concerted effort to increase opportunities to be healthier for everyone, including those for whom obstacles are the greatest. Research has shown that improvements in health equity can provide tremendous value to patients, hospitals and the health care delivery system. And, hospitals and health systems are employing a number of approaches to improve health equity and promote value.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/2019-02/value-initiative-issue-brief-4-rural-hospitals.pdf"><img alt="Value Initiative Issue Brief 4 Image" data-entity-type="file" data-entity-uuid="03b07ae5-e525-4eed-8cb0-bdfd3c6f3c7c" src="/sites/default/files/inline-images/value-initiative-issue-brief-4-image.jpg" width="236" height="307" class="align-center"></a></td> <td> <h4><a href="/system/files/2019-02/value-initiative-issue-brief-4-rural-hospitals.pdf">How Rural Hospitals Improve Value and Affordability</a></h4> <p>Rural hospitals are a crucial local access point for urgent medical services, primary care and prevention in their communities. Despite multi-faceted and complex challenges, rural hospitals continue to transform and adapt to meet the needs of their populations. This Issue Brief highlights four strategies rural hospitals are using to improve value by reducing cost, improving quality or enhancing the patient experience.</p> </td> </tr> </tbody> </table> <hr> <table border="0" cellpadding="3" cellspacing="3"> <tbody> <tr> <td><a href="/system/files/media/file/2019/08/the-value-initiative-issue-brief-5-improving-value-for-patients-with-a-serious-illness.pdf"><img alt="Value Initiative Issue Brief 5 Image" src="/sites/default/files/2019-08/the-value-initiative-issue-brief-5-image-238.jpg" class="align-center"></a></td> <td> <h4><a href="/system/files/media/file/2019/08/the-value-initiative-issue-brief-5-improving-value-for-patients-with-a-serious-illness.pdf">Improving Value for Patients with a Serious Illness</a></h4> <p>The U.S. spends $909 billion annually on patients with serious illness, such as cancer, COPD or dementia. Palliative care – a specialized care model for individuals living with serious illness - is an effective approach to address patients’ medical and psychosocial needs while reducing cost. It is based on the patient’s needs, not prognosis. This Issue Brief examines how a palliative care promotes value for patients, hospitals and communities, and includes case examples and resources.</p> </td> </tr> </tbody> </table> Thu, 17 Nov 2022 11:50:57 -0600 Issue Brief /issue-brief/2019-09-18-real-affordability-solutions-front-lines-caring <div>.body { font-size: 16px } </div><div class="container"><div class="row"><div class="col-md-12"><div class="col-md-5"><p><a href="/costsofcaring" target="_blank" title="Download the Cost of Caring 2022 report."><img src="/sites/default/files/inline-images/Page-1-2022-Hospital-Expenses-Increase-Report-Final-Final.png" data-entity-uuid data-entity-type alt="Cost of Caring October 2022 page 1." width="1700" height="2200"></a></p></div><p>Consumers are seeking greater value for their health care dollars. Concerns around the affordability of health care will only grow as overall health care spending continues to rise to meet the needs of an aging America.</p><p>The women and men of America’s hospitals and health systems—physicians, nurses and other caregivers—understand and share consumer’s concerns, and are working hard to make care more affordable by transforming the way health care is delivered in our communities.</p><p>But we cannot do it alone. It will take a real effort by everyone involved—providers, the government, employers and individuals, device makers, drug manufacturers, insurers and others. With health insurance prices climbing and drug spending rising, insurers and drug companies can do more to address increased health care costs.</p><h2>Specifically, America’s hospital and health systems are working to:</h2>.group div{ min-height: 275px; margin-bottom:25px } .group img{ border: solid 1px #D9D9D6 } .group p{ text-align: left ; font-size: 1.1em; font-family: univers, arial, sans-serif; line-height: 1.25em; font-weight:700 } .group p a{ color: #333; } <div class="row group"><div class="col-md-3 col-sm-4"><p><a href="/drug-prices/home"><img src="/sites/default/files/inline-images/Drug-prices.jpg" data-entity-uuid="dd6adb60-9627-4e03-8029-a6f1d55df241" data-entity-type="file" alt="Drug Prices stock" width="943" height="628"></a></p><p><a href="/drug-prices/home">Rein in Skyrocketing Drug Prices</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/advocacy/access-and-health-coverage"><img src="/sites/default/files/inline-images/Transparency.jpg" data-entity-uuid="243aea5d-8f3f-4931-a626-011c4554f65f" data-entity-type="file" alt="Mark Information Available on Price and Quality" width="1055" height="702"></a></p><p><a href="/advocacy/access-and-health-coverage">Improve Access to Quality Health Coverage</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/makingcareaffordable"><img src="/sites/default/files/inline-images/Social-determinants.jpg" data-entity-uuid="c698a352-b453-499d-a84f-918472e29998" data-entity-type="file" alt="Invest in Public Health to Improve Overall Health stock" width="943" height="628"></a></p><p><a href="/makingcareaffordable">Make Information Available on Price and Quality</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/guidesreports/2019-05-15-social-determinants-health-and-value"><img src="/sites/default/files/inline-images/Coverage-access2_0.jpg" data-entity-uuid="8e07714e-fae7-44c0-b191-2fea8ea696e2" data-entity-type="file" alt="Access to Quality Health Coverage stock" width="1078" height="722"></a></p><p><a href="/guidesreports/2019-05-15-social-determinants-health-and-value">Invest in Public Health to Improve Overall Health and Well-being</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/advocacy/access-and-health-coverage/access-behavioral-health"><img src="/sites/default/files/inline-images/Access-to-behavioral-health-care.jpg" data-entity-uuid="a8811c11-5d41-48d4-a5f3-118ea1727960" data-entity-type="file" alt="Increase Access to Behavioral Health Care stock" width="1009" height="673"></a></p><p><a href="/advocacy/access-and-health-coverage/access-behavioral-health">Treat the Whole Person—Increase Access to Behavioral Health Care</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/regulatory-relief/regulatory"><img src="/sites/default/files/inline-images/Regulatory-relief.jpg" data-entity-uuid="26eec337-9235-419b-9855-2de2972e842d" data-entity-type="file" alt="Reduce Red Tape from Government Regulation stock" width="1431" height="954"></a></p><p><a href="/regulatory-relief/regulatory">Reduce Red Tape from Government Regulation</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/bibliographylink-page/2018-04-20-value-hospital-mergers"><img src="/sites/default/files/2019-09/Hospital-realignment2b.jpg" data-entity-uuid data-entity-type alt="Remove Outdated Laws that Impede Communications and Collaboration stock" width="1055" height="702"></a></p><p><a href="/hospital-mergers" target="_blank">Remove Outdated Laws that Impede Communication and Collaboration between Hospitals and Other Providers</a></p></div><div class="col-md-3 col-sm-4"><p><a href="/topics/commercial-insurer-accountability"><img src="/sites/default/files/2021-10/commercial-insurer-accountability-520x350.jpg" data-entity-uuid data-entity-type alt="Commercial Insurer Accountability. A woman reviews her insurer's explanation of benefits." width="520" height="350"></a></p><p><a href="/topics/commercial-insurer-accountability">Hold Commercial Insurers Accountable</a></p></div></div>.group2 p{ font-family: univers, arial, sans-serif; font-weight:700 } .group2 p a{ color: #333; } <div class="col-md-6 col-md-offset-3"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title">Resources</h3></div><div class="panel-body group2"><p><a href="/affordability-advocacy-agenda" target="_blank" title="Click here to view the AHA Affordability Advocacy Agenda 2021.">Affordability Advocacy Agenda</a></p><p><a href="/costsofcaring">Fact Sheet: Cost of Caring</a></p><p><a href="/340b-drug-savings-program" target="_blank">The 340B Drug Savings Program</a></p><p><a href="/standardsguidelines/2021-10-08-partnerships-mergers-and-acquisitions-can-provide-benefits-certain" target="_blank">Partnerships, Mergers, and Acquisitions Can Provide Benefits to Certain Hospitals and Communities</a></p><p><a href="/guidesreports/2021-09-21-financial-effects-covid-19-hospital-outlook-remainder-2021" target="_blank">Financial Effects of COVID-19: Hospital Outlook for the Remainder of 2021</a></p><p><a href="/guidesreports/2021-09-09-results-2018-tax-exempt-hospitals-schedule-h-community-benefit-reports" target="_blank">Results from 2018 Tax-Exempt Hospitals’ Schedule H Community Benefit Reports</a></p><p><a href="/news/perspective/2021-10-08-perspective-confronting-commercial-insurers-practices-threaten-patient" target="_blank">Perspective: Confronting Commercial Insurers’ Practices that Threaten Patient Care</a></p><p><a href="/news/blog/2021-07-12-lown-institute-report-hospital-community-benefits-falls-short" target="_blank">Lown Institute Report on Hospital Community Benefits Falls Short</a></p><p><a href="/news/headline/2021-09-28-study-health-insurance-market-becoming-more-concentrated">Study: Health insurance market becoming more concentrated</a></p><p><a href="https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-insurance-research">Report: American Medical Association Report on Competition in the Health Insurance</a></p></div></div></div></div></div></div> Wed, 24 Aug 2022 14:32:40 -0500 Issue Brief /2022-07-12-understanding-cms-changes-hospital-overall-star-ratings <div class="container"> <div class="row"> <div class="col-md-4"> <div class="panel module-typeC"> <div class="panel-body"> <h3 class="text-align-center"><span>Key Findings</span></h3> <ul> <li><strong><span>CMS’ new star ratings methodology preserves some year-to-year stability, but ratings remain volatile for hospitals reporting fewer measures.</span></strong></li> <li><strong><span>Under CMS’ new peer grouping approach, 74% of hospitals are scored on all five measure groups with the remaining 26% split across the 14 combinations of measure groups.</span></strong></li> <li><strong><span>Star ratings remain volatile for hospitals reporting fewer measures, especially smaller, rural hospitals and critical access hospitals (CAHs).</span></strong></li> <li><span><strong>Ongoing systematic assessment of the methodology is vital, and CMS should evaluate potential approaches that make the basis of ratings more equitable</strong>.</span></li> </ul> </div> </div> </div> <div class="col-md-8"> <p>The Centers for Medicare & Medicaid Services (CMS) in 2020 overhauled the Hospital Overall Star Ratings methodology to make ratings more transparent, equitable, stable and predictable. To improve transparency the agency moved away from the statistically heavy and difficult to interpret latent variable modeling approach and instead employed a simple average of measure to calculate measure group scores. As a way to attempt to achieve more equitable comparisons, CMS also created peer groupings by number of reported measures. To improve the stability and predictability of star ratings the weights applied to the different measures would be set in advance by CMS. On the whole, while CMS expected the new methodology could change the overall ratings distribution, it believed period-to-period changes would remain fairly stable.</p> <p>AHA commissioned KNG Health to assess whether these methodological changes have fully achieved CMS' goals, while also estimating expected performance variation and drivers of performance and variation under the new methodology. The KNG analysis entailed:</p> <ul> <li>Comparing 2020 (old methodology) to 2021 (new methodology) hospital star ratings performance reported by CMS, assessing differences in ratings by hospital characteristics.</li> <li>Assessing the stability of CMS’ new methodology by comparing hypothetical 2020 performance under the new methodology to 2021 actual performance; and</li> <li>Assessing the equitability of the ratings through analyses of peer groupings.</li> </ul> <p>Overall the new methodology preserves some year-to-year stability. When applying the new methodology to both 2020 and 2021 the distribution of ratings are similar (see Figure 1). Sixty percent of hospitals could have expected to receive the same score in 2020, with 36% seeing an increase or decrease of one star rating. </p> <p>View the detailed issue brief below. </p> <p> </p> </div> </div> </div> Wed, 13 Jul 2022 16:22:20 -0500 Issue Brief