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State Telehealth Laws & Reimbursement Policies

The Center for Connected Health Policy, the National Telehealth Policy Resource Center, has released its latest biannual update on state telehealth laws, regulations, and policies, with a primary focus on Medicaid fee-for-service programs. However, managed care/private payer laws are also covered when available.

Telehealth policy trends are briefly summarized from a national perspective, followed by detailed state profiles. Each state profile on telehealth reimbursement includes:

  • Key state agencies/organizations
  • State policy overview
  • Definitions
  • Live video, store-and-forward, and remote patient monitoring
  • Eligible providers, sites, geographic limits, facility/transmission fees, services/specialties
  • Consent
  • Professional regulation/health and safety, including cross-state licensing and online prescribing

States vary considerably on telehealth policies. Overall, the report noted live video Medicaid reimbursement is far more prevalent than reimbursement for store-and-forward and remote patient monitoring. Other trends noted for some states are specific documentation and/or privacy and security guidelines; the addition of home and schools as eligible originating sites; and the inclusion of teledentristy and substance abuse services as qualifying specialties.

State telehealth laws & reimbursement policies; a comprehensive scan of the 50 states & the District of Columbia. Center for Connected Health Policy, Spring 2019. https://www.cchpca.org/sites/default/files/2019-05/cchp_report_MASTER_spring_2019_FINAL.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Rural Obstetric Services: Access, Workforce, and Impact

A new research briefing looks at declining access for rural women to obstetric services. Between 2004 and 2014, 179 rural counties in the U.S. lost hospital-based obstetric services, with over half of rural counties now lacking these services. The distribution of rural counties without obstetrics services varies widely geographically, from 78% in Florida to 9% in Vermont.

Access to obstetric service factors may be related to lower birthrates, a limited rural obstetric workforce, Medicaid eligibility, and socio-economic factors. The impact of limited OB services is also briefly covered.

Links to the nine reports covered by the research overview — all from the University of Minnesota Rural Health Research Center — are  provided.

Source: Rural obstetric services: access, workforce, and impact. Rural Health Research Recap, Rural Health Research Gateway, April 2019. https://www.ruralhealthresearch.org/recaps/8

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

Acute Care Hospital Closures and Openings, 2010-2016

The Medicare Payment Advisory Commission [MedPAC] has updated its annual chart on the number of openings and closures of acute care hospitals participating in the Medicare program:

According to the latest FY2017 AHA Annual Survey Database, about 98% of the nation’s acute care, non-federal hospitals participate in the Medicare program.

Source: MedPAC Databook: Section 6. Medicare Payment Advisory Commission, June 2018. http://www.medpac.gov/docs/default-source/data-book/jun18_databooksec6_sec.pdf?sfvrsn=0

Related source: North Carolina Rural Health Research Program. Rural hospital closures: January 2010-present. University of North Carolina, Cecil G. Sheps Center for Health Services Research, accessed April 9, 2019 at http://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

Investing in social services as a core strategy for health organizations: developing the business case

Social determinants of health — economic stability, neighborhood and physical environment, education, food, transportation, community and social context — can all impact health outcomes. With the growing emphasis on population and community health, how do hospitals and health systems make the business case for investing in social services to improve the health of their patients and communities?

A new report from the KPMG Government Institute focuses on building the business case for social services investment by healthcare organizations of all types. After defining social services investment and its common barriers, the guide focuses on these six steps:

  1. Identifying what to invest in
  2. Determining what success is by selecting the care outcomes
  3. Measuring costs of care
  4. Determining the appropriate investment model
  5. Setting up the return on investment approach
  6. Sensitivity analysis and investment kick-off

The appendices include several short business case examples from different types of healthcare organizations.

Source: Investing in social services as a core strategy for healthcare organization: developing the business case – a practical guide to support health plan and provider investments in social services. March. 2018. http://www.kpmg-institutes.com/ content/dam/kpmg/governmentinstitute/pdf/2018/investing-social-services.PDF. Also available from the Commonwealth Fund at http://www.commonwealthfund.org/~/media/files/publications/other/2018/investingsocialservices_pdf.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

The Importance of Health Insurance Coverage

Why is health insurance coverage important?

  • It improves access to care
  • It’s associated with improved health outcomes
  • It supports appropriate health care utilization
  • It improves individuals’ and families’ financial well-being

A new briefing from the American Hospital Association discusses each of these facets on the impact of health coverage on consumers and the overall health system. The report also provides recent data trends on the number of insured and uninsured and a reference list for further information.

Source: The importance of health coverage. American Hospital Association, Nov. 2017. http://www.aha.org/content/17/importance-of-health-coverage-report.pdf

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

2018 Calendar of Health Observances and Recognition Days

Want to find out when Healthy Weight Week is? Brain Injury Awareness Month? Medical Laboratory Professionals Week or International Orthopaedic Nurses Day?

You can find the answers for these and hundreds of other health observances or professional recognition days throughout the year. For each calendar listing, descriptive information is provided with sponsor contact information for more details.

Source: 2018 Health observances & recognition days. Society for Healthcare Strategy & Market Development of the American Hospital Association, 2017. https://www.surveymonkey.com/r/HEALTHCAL2018 [free registration required to view/download]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

 

How Well Does Insurance Coverage Protect Consumers from Health Care Costs?

In 2016, over a quarter of insured adults in the U.S. were underinsured — more than double the 2003 rate and and currently an estimated 41 million people. This is the finding from the latest Commonwealth Fund’s biennial health insurance survey that looked at the number of insured adults that had high out-of-pocket expenses and deductibles relative to their incomes.

The underinsured rates were highest [44-47%] for those purchasing individual coverage directly or through a Marketplace exchange and for the disabled under age 65 covered by Medicare.

The share of privately insured adults that had health plans without deductibles has shrunk by nearly half since 2003, while deductible amounts have increased. The number of insured adults with deductibles of $3000 or more has grown from 1% in 2003 to 13% in 2016.

Underinsured adults may defer needed medical care because of the costs and/or face medical debt and long term financial issues.

The survey report also discusses health policy implications of its findings.

Source: Collins SR and others. How well does insurance coverage protect consumers from health care costs? Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016. Commonwealth Fund Issue Brief, Oct. 2017. http://www.commonwealthfund.org/~/media/files/publications/issue-brief/2017/oct/collins_underinsured_biennial_ib.pdf 

Posted by AHA Resource Center (312) 422-2050, rc@aha.org