Eight Ways HAP Is Helping Clear the Path toward Health Care’s Future
May 10, 2018 | By: Andy Carter
We all know health care is changing, with even bigger changes ahead. I described the four most likely “alternate realities” for the future of hospitals and health care, and the strategies being used to prepare, in this earlier blog.
In many ways, hospitals and health systems are feeling the brunt of these changes. As the leader of Pennsylvania’s hospital association, it’s my job to empower hospitals and health systems and their leaders as they get ready for a very different, but still uncertain, future.
With the guidance of its board, the association has identified eight key strategies to help hospitals and health systems survive and thrive—regardless of which for four “alternate realities” materialize.
- Embracing consumerism—and transparency—around quality, billing, and more
We can look at any recent public opinion poll and see that consumers find navigating the health care system difficult and decision-making daunting. A HAP 2014 public opinion study shows that Pennsylvanians are searching for someone to trust, to be on their side, to help them sort out the unknown.
Patient-provider trust is at the heart of successful health care experiences. That trust includes open, honest conversation about health conditions, treatments, outcomes, and costs.
To improve transparency around these complex issues, HAP has been working with hospitals and health systems to:
- Advance consumer-focused guidelines for hospital financial services—such as easier-to-understand billing and financial information
- Provide useful consumer information through the Care in Pennsylvania website, with its quality and charge information, and Healthy Me PA’s digital content designed to help consumers navigate the health care system
- Partner with the Pennsylvania Library Association and the Pennsylvania Insurance Department to improve consumer health and health insurance literacy
- Develop a position on surprise balance billing so that consumers seeking care from an in-network provider are not surprised by a bill from an out-of-network clinician
- Maintaining stable Medicaid and Medicare payments in an unstable political environment
Hospitals and health systems are configuring themselves for the future, investing in new ways of delivering care, while at the same time continuing to serve their patients and communities with existing facilities and services.
Stable, predictable Medicaid and Medicare hospital payments are crucial for navigating this dual track. HAP is working across party lines at the state and federal levels to protect the government programs needed to maintain these payments.
For six years now, Pennsylvania’s hospital Quality Care Assessment has provided additional funding for the state, and, through matching federal dollars, improved Medicaid payments to hospitals and health systems. By working together as a hospital community, we’ve been able to keep these payments stable through several reauthorizations of the assessment.
Now the assessment must be renewed by June 30. HAP is working with its members to advocate for a plan that improves payments for outpatient care.
In Washington, HAP has worked with the Pennsylvania congressional delegation to make sure key Medicaid and Medicare hospital payment policies are supported through successive funding resolutions. Despite the political chaos, we’ve been successful to date, due in large part to unprecedented collaborative advocacy across health care constituencies.
- Stepping up collaboration with health care partners to speak with a strong, focused, unified voice
HAP worked with 30 other Pennsylvania-based health care provider and professional organizations to advocate successfully against a repeal of the Affordable Care Act and to offer ideas that would fix some of its short-comings. When the House voted on repeal, a large share (20%) of Republican “no” votes came from Pennsylvania congressmen.
HAP also worked with the state, community health centers, health plans, and others to protect:
Assaults on Medicaid and Medicare funding and hospital payments are far from over. HAP will continue to foster collaboration among the health care stakeholders working to protect Pennsylvanians’ access to coverage and heath care.
- Funding for Medicaid expansion
- Tax credit subsidies for the health insurance marketplace
- Funding for the Children’s Health Insurance Program
- Simplifying value-based payment programs
Pretty much every commercial health plan as well as government Medicare and Medicaid payors have their own definitions of quality and value, and how to measure and reward them. HAP has studied the proliferation of methods and measures—and is advancing solutions.
HAP is also supporting hospital efforts to connect with health information exchanges in order to share data, better coordinate care, and track utilization across different hospitals and health care systems.
- Convening to improve quality and safety
Through HAP’s Hospital Improvement Innovation Network, we are supporting 97 Pennsylvania hospitals as they collaborate on effective ways to reduce harm and prevent readmissions, and perform well in value-based payment programs.
- Enhancing the health care team and transforming the workforce
HAP is working with the state legislature to sponsor a study of the health care workforce “big picture.” We have also have established a task force to look at what can be done through policy or other means to support hospitals as they work to transform their workforces.
- Reducing the regulatory burdens impeding progress
As hospitals and health systems prepare for the health care of the future, they are running up against out-of-date laws and regulations better suited to the past. HAP is working to remove these roadblocks, including:
- Federal laws thwarting clinical integration: In new, value-based health care models, federal Anti-kickback and Stark Laws are holding back the clinical collaboration needed to improve health and health care and tamp down health care spending. HAP is advocating for common sense proposals to remove these roadblocks.
- Outdated state licensure regulations: Current regulations date back to the 1980s. HAP is working with government and other partners to modernize hospital licensure, support innovation, and allow for more efficient governance of health systems.
- Payment policies limiting the use of telemedicine: This new way of delivering health care gives patients more convenient “virtual” access to services and allows providers to share clinical expertise instantly. HAP is pressing for regulations and legislation to support greater adoption of telemedicine, including state legislation that would require commercial insurers to pay for a health care service provided via telemedicine if they pay for that same service provided in person.
- Supporting strong advocacy efforts while limiting member dues increases
In line with the financial and operational pressures hospitals and health systems are experiencing, HAP is developing new sources of revenue to support strong advocacy efforts through a sustainable business model.
The recent launch of HAPevolve is one such effort. HAP’s new, for-profit business unit offers customized, on-demand solutions to meet specific needs and challenges facing both member and non-member health care organizations. It’s an à la carte menu of services designed to address specific organizational pain points while bringing additional non-dues revenue to HAP.
Let us know what you think about these strategies. Which ones are most important for success? What more could we do?