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SOCIAL DETERMINANTS OF HEALTH: Prescribing fruits and vegetables with added nutrition teaching component

The effectiveness of a fruit and vegetable prescription program (FVRx) model called “Prevention Produce” developed at the Penn State College of Medicine has been studied in a pilot program at Penn State Hershey Medical Center (Hershey, PA).  This model combines vouchers for produce purchases with nutrition teaching done by medical students.  Daily fresh produce consumption was found to increase.  A coincidental increase in exercise frequency was also found although this was not a formal part of the curriculum.

Source: Forbes, J.M., Forbes, C.R., Lehman, E., and George, D.R. (2019). “Prevention produce”: Integrating medical student mentorship into a fruit and vegetable prescription program for at-risk patients. Permanente Journal, 23.  Click here for full text: http://www.thepermanentejournal.org/files/2019/18-238.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

COST OF HEALTH CARE: Specialist visits to hospitalized Medicare patients cost over $1.3 billion in 2014

What is the cost to the nation to bring in specialists to consult on hospitalized Medicare patients?  This question was studied based on analysis of over 700,000 discharges from over 4500 U.S. hospitals in 2014.  Medicare Part B payment for consultative care was found to represent 41.3 percent of all physician visits during the hospital stays.  The total dollar amount was estimated to be $1.3 billion.  These figures are thought to be underestimates because the patients studied excluded surgical patients and because there was no analysis of downstream costs – such as additional diagnostic testing and follow-up visits.  Characteristics of hospitals which were found to be more likely to have higher rates of consultative visits included those in the Northeast, those in urban areas and teaching hospitals.

Source: Ryskina, K.L., Association of Medicare spending with subspecialty consultation for elderly hospitalized adults. JAMA Network Open, 2(4).  Click here for full text:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2729802 Posted by AHA Resource Center (312) 422-2050 rc@aha.org

ED VISITS: Comparing utilization in urban and rural areas

Changes in emergency department utilization rates from 2005 to 2016 in urban versus rural areas were studied based on data from the National Hospital Ambulatory Medical Care Survey.  The data used in the analysis are representative of the nation as a whole.  Here are the changes in visits per 100 population over the time period studied:

  • Rural areas: 36.5 visits/100 population (2005) to 64.5 visits/100 population (2016)
  • Urban areas: 40.2 visits/100 population (2005) to 42.8 visits/100 population (2016)

Reasons for the larger growth in the utilization rate per 100 population in rural areas are discussed.

Source: Greenwood-Ericksen, M.D., and Kocher, K. (2019, April 12). Trends in emergency department use by rural and urban populations in the United States. JAMA Network Open, 2(4). Full text here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2730472  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

 

BCBS Association: The Health of America Report Understanding Health Conditions Across the U.S.

In partnership with Moody’s Analytics, the Blue Cross Blue Shield Association has published a report on understanding health conditions across the U.S. The report sets out to address these questions:

  • Why are some communities healthier than others?
  • Which factors are most important in keeping a population healthy: economics, healthy behaviors, or access to quality care?
  • How does the importance of these factors change when measuring different health conditions?

The report analyzes and scores the impact of population demographics, socio-economic factors, healthy behaviors, and access to care and other health care considerations for each of the following conditions:

  • Substance abuse
  • Depression
  • Hypertension
  • High cholesterol
  • Coronary artery disease
  • Chronic obstructive pulmonary disease (COPD)
  • Hyperactivity
  • Breast cancer
  • Lung cancer

Source: Blue Cross Blue Shield Association: Health of America Report-Understanding Health Conditions across the U.S. December, 2017. https://www.bcbs.com/sites/default/files/file-attachments/health-of-america-report/BCBS.HealthOfAmericaReport.Moodys_02.pdf.

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

Drug Discount: Characteristics of Hospitals Participating and Not Participating in the 340B Program

The U.S. Government Accountability Office (GAO) released a report on the results of the study that analyzes the characteristics of hospitals that participate or do not participate in the 340B drug discount program. The GAO conducted this study due to the sixty percent increase from 2011 to 2016 in program participation, as well as the impact of Medicaid expansion on 340B participation.

The study was focused on three of the six hospital types, as they accounted for ninety five percent of U.S. hospitals participating in the 340B program. These three hospital types include:

  • Critical Access Hospitals (CAH)
  • Sole Community Hospitals (SCH)
  • General Acute Care Hospitals (Also Known As 340B DSH)

The full report can be found on the U.S. Government Accountability Office website, https://www.gao.gov/products/GAO-18-521R.

Posted by the 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