/ en Thu, 31 Jul 2025 07:50:52 -0500 Wed, 30 Jul 25 08:38:56 -0500 /fact-sheets/2025-02-07-fact-sheet-budget-reconciliation-101 <div class="container"><div class="row"><div class="col-md-8"><h2>The Issue</h2><p>Budget reconciliation is an optional process under the Congressional Budget Act of 1974 that allows for expedited consideration of certain fiscal legislation that makes changes to mandatory spending, revenues and/or the debt limit. This special fast-track procedure is designed to reconcile current law with assumptions contained in the annual budget resolution adopted by Congress. Reconciliation legislation is privileged and cannot be filibustered in the Senate, meaning it requires only a simple majority, instead of a three-fifths majority, to pass. The contents of a reconciliation bill are tightly controlled because the process restricts the Senate’s right to unlimited debate that exists for most other legislation. The Senate’s “Byrd rule” aims to prevent the inclusion of matter considered “extraneous” to the budgetary goals of the legislation. In recent years, reconciliation has been used to enact landmark fiscal legislation on a party line basis. The most recent examples include the Tax Cuts and Jobs Act (2017), the American Rescue Plan (2021) and the Inflation Reduction Act (2022).</p><h2>Understanding the Basics</h2><h3>Step 1: Budget Resolution</h3><ul><li>Before Congress can begin work on a reconciliation bill, it must first pass a concurrent budget resolution in the House and Senate. A budget resolution serves as a roadmap to guide fiscal decision-making in Congress. Unlike other bills, it does not go to the President’s desk for signature and does not have the force of law. A budget resolution that is being used for reconciliation will contain a series of “reconciliation instructions” to various committees of jurisdiction directing them to report legislation that meets a specified fiscal target, such as requiring a committee to reduce mandatory spending by no less than a certain amount or reduce revenue by no more than a certain amount. The numerical instructions provide the fiscal goals of the legislation and cannot dictate the substance of how the committees are to meet their instructions. Nevertheless, which committees are given instructions, and the magnitude of those instructions, can be indicative of potential areas of focus.<ul><li><span><strong>Example:</strong></span> Instructions to the Energy & Commerce Committee directing them to reduce mandatory spending by a large amount opens the door to spending cuts within health programs.</li></ul></li></ul><h3>Step 2: Committees Begin Work on Reconciliation Bill</h3><ul><li>The instructed committees begin drafting legislation consistent with their instructions from the budget resolution and then move legislation through the committee process. The Budget Committee takes each committee-reported measure and combines them into a single reconciliation bill to prepare for consideration before the House or Senate.<ul><li><span><strong>Clarifying Point:</strong></span> Committees that did not receive reconciliation instructions in the budget resolution are not involved in the process. Committees cannot include subject matter outside of their jurisdiction.</li></ul></li></ul><h3>Step 3: Debate and Passage</h3><ul><li>The House and Senate have different rules that govern how legislation is considered by the full chamber. In the House, the Rules Committee will establish guidelines for debate on the bill and decide whether members will be allowed to make amendments to the bill. A reconciliation bill is passed in the House with a simple majority consistent with their typical process.</li><li>In the Senate, debate is limited to 20 hours and only 51 votes are needed to pass the bill instead of the usual 60 votes.<ul><li><span><strong>Clarifying Point:</strong></span> Even after the 20 hours of debate has expired, senators are allowed to offer amendments and make other motions on the bill. These extra votes are often referred to as “vote-a-rama.” Amendments are voted on without debate until no more amendments are offered. At that point, the Senate will vote on final passage of the reconciliation bill.</li></ul></li></ul><h3>Step 4: Resolving Differences & Final Approval</h3><ul><li>Before the reconciliation bill can be sent to the President for signature or veto, Congress must work out any remaining differences between the House and Senate bills. Once both chambers of Congress have passed an identical bill, the bill heads to the President’s desk.<ul><li><span><strong>Example:</strong></span> The House passes the reconciliation bill first and sends it to the Senate. The Senate passes amendments making changes to the bill. The House will need to vote on this new version before sending it to the President’s desk.</li></ul></li></ul><h2>Diving Deeper: The Byrd Rule</h2><h3>The Byrd Rule sets six criteria to determine whether a provision can be included in a reconciliation bill or whether it is considered extraneous.</h3><ul><li>A provision that violates any one of the six Byrd rule tests can be removed from the bill if a senator raises a Byrd rule point of order, unless 60 senators vote to waive the point of order to allow that provision to stay in the bill.<ul><li><span><strong>Clarifying Point:</strong></span> The Presiding Officer in the Senate makes the determination whether provisions are consistent with the rules, based on advice from the Senate Parliamentarian.</li><li><span><strong>Clarifying Point:</strong></span> The Byrd Rule only applies to consideration in the Senate. However, the House must be careful in crafting their bill to ensure it follows the Byrd Rules parameters otherwise it will put the bill at risk in the Senate.</li></ul></li></ul><h3>Six Criteria Used to Determine Whether a Provision is “Extraneous”:</h3><ol><li><span><strong>No Budgetary Effect:</strong></span> Provision does not change mandatory spending or revenues.</li><li><span><strong>Not in Accordance with Instructions:</strong></span> Provision increases mandatory spending or reduces revenues, and the committee is not in compliance with its instructions.</li><li><span><strong>Outside Committee Jurisdiction:</strong></span> Provision falls outside the jurisdiction of the instructed committee.</li><li><span><strong>Incidental Budgetary Effect:</strong></span> Provision produces a change in mandatory spending or revenues that is merely incidental to its other components.</li><li><span><strong>Increases Deficit Beyond the Budget Window:</strong></span> Provision would increase the deficit in any year beyond the period covered by a committee’s reconciliation instruction (usually 10 years).</li><li><span><strong>Changes to Social Security:</strong></span> Provision makes changes to Title II of the Social Security Act.</li></ol></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/02/Fact-Sheet-Budget-Reconciliation-101-20250207.pdf" target="_blank" title="Click here to download the Fact Sheet: Budget Reconciliation 101 PDF."><img src="/sites/default/files/inline-images/Page-1-Fact-Sheet-Budget-Reconciliation-101-20250207.png" data-entity-uuid="f869be09-95e9-467e-8c28-e7fc30015205" data-entity-type="file" width="695" height="900"></a></p><p><div class="views-element-container"><div class="js-view-dom-id-599b281d2198feeca3b619a9da2a3b5c802be23114302c4dede12e52aa9e752f"> <header> <h3>The Latest on the One Big Beautiful Bill Act</h3> </header> <div class="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="/news/chairpersons-file/2025-07-28-chair-file-obbba-and-whats-next-health-care" hreflang="en">Chair File: The OBBBA and What’s Next for Health Care</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-07-28T10:16:20-05:00" title="Monday, July 28, 2025 - 10:16">Jul 28, 2025</time> </span> </div></div> <div class="views-row"> <div class="views-field views-field-field-access-level"> <div class="field-content"></div> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/news/headline/2025-07-21-cbo-projects-obbba-increase-uninsured-10-million-federal-deficit-34-trillion" hreflang="en">CBO projects OBBBA to increase uninsured by 10 million, federal deficit by $3.4 trillion</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-07-21T15:37:59-05:00" title="Monday, July 21, 2025 - 15:37">Jul 21, 2025</time> </span> </div></div> <div class="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="/lettercomment/2025-07-16-aha-expresses-support-protect-medicaid-and-rural-hospitals-act" hreflang="en">AHA Expresses Support for Protect Medicaid and Rural Hospitals Act </a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-07-16T14:21:17-05:00" title="Wednesday, July 16, 2025 - 14:21">Jul 16, 2025</time> </span> </div></div> <div class="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="/news/chairpersons-file/2025-07-16-chair-file-leadership-dialogue-continuing-work-strengthen-health-america-aha-president-and" hreflang="en">Chair File: Leadership Dialogue — Continuing the Work to Strengthen Health in America With AHA President and CEO Rick Pollack</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-07-16T10:53:03-05:00" title="Wednesday, July 16, 2025 - 10:53">Jul 16, 2025</time> </span> </div></div> <div class="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="/resources-one-big-beautiful-bill-act-signed-law-july-4-2025" hreflang="en">Resources on the One Big Beautiful Bill Act Signed Into Law July 4, 2025</a></span> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2025-07-15T14:49:30-05:00" title="Tuesday, July 15, 2025 - 14:49">Jul 15, 2025</time> </span> </div></div> <div class="more-link"><a href="/topics/budget-reconciliation">More on the One Big Beautiful Bill Act (OBBBA)</a></div> </div> </div> </p></div></div></div> h2 { color: #003087; } h3 { color: #002855; } .meta.custom-lock-position { position: relative; top: 0px; right: inherit; display: block; float: right; } .views-field-title { font-weight: bold; } .views-field-created { color: #000000 !important; } .views-row { margin-bottom: 20px; } .views-element-container { border: solid black 1px; padding-left: 20px; padding-right: 20px; padding-bottom: 20px; } Fri, 07 Feb 2025 14:23:32 -0600 Public /cybersecurity-government-intelligence-reports/2022-12-13-tlp-white-nsa-apt5-citrix-adc-threat-hunting-guidance-december-2022 <h2>Executive summary</h2><p>APT5 has demonstrated capabilities against Citrix® Application Delivery Controller™ (ADC™) deployments (“Citrix ADCs”). Targeting Citrix ADCs can facilitate illegitimate access to targeted organizations by bypassing normal authentication controls. As such, NSA, in collaboration with partners, has developed this threat hunting guidance to provide steps organizations can take to look for possible artifacts of this type of activity. Please note that this guidance does not represent all techniques, tactics, or procedures (TTPs) the actors may use when targeting these environments. This activity has been attributed to APT5, also known as UNC2630 and MANGANESE.</p><h2>Introduction</h2><p>NSA recommends organizations hosting Citrix ADC environments take the following steps as part of their investigation. Treat these detection mechanisms as independent ways of identifying potentially malicious activity on impacted systems. Artifacts may vary based on the environment and the stage of that activity. As such, NSA recommends investigating any positive result even if other detections return no findings.</p> Tue, 13 Dec 2022 11:06:06 -0600 Public /2017-12-15-aha-today <div class="container"> <div class="row"> <div class="col-md-8"><img alt="AHA Today News logo" class="align-center" src="/sites/default/files/2023-02/aha-today-logo-900.jpg" /> <p>Thank you for your interest in AHA Today, the ���������� Association’s six-day-a-week email newsletter. Each weekday you’ll get the day’s top news stories, with the context and analysis that hospital and health systems leaders need to lead their organization. And on Saturdays, AHA Today recaps the news of the week that you may have missed.</p> <p>Other regular features include:</p> <ul> <li>Podcasts</li> <li>Blogs</li> <li>Upcoming events and educational opportunities</li> <li>Links to the newest reports and insights</li> <li>Toolkits and other resources</li> <li>Stories from the field spotlighting hospitals’ important work to advance health in the communities they serve</li> </ul> <p>We love your feedback! <a href="https://www.surveymonkey.com/r/BX9J5NR" target="_blank">Take our survey to help us continue to evolve the AHA Today email newsletter.</a></p> <div>   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 2219); MktoForms2.whenReady(function(form){ if(form.getId() == 2219 ) { form.onSuccess(function(values, followUpUrl) { form.getFormElem().hide(); document.getElementById("successAndErrorMessages").innerHTML="<p>Thank you, you are now subscribed to AHA Today!<\/p>"; return false; }); }; }); <div id="successAndErrorMessages"> </div> </div> </div> <div class="col-md-4"> <p> </p> </div> </div> </div> h1 { font-size: 3em !important; } .title { font-size: 2em !important; } Fri, 15 Dec 2017 00:00:00 -0600 Public /issue-landing-page/2016-11-16-ensuring-access-vulnerable-communities-taskforce-report-and-resources <div class="container row"><div class="row"><div class="col-md-8"><div class="outlineContent clearfix"><p><img src="/images/taskforce-ban2.jpg" data-entity-uuid data-entity-type alt width="793" height="286"></p><hr><p>Millions of Americans living in vulnerable rural and urban communities depend upon their hospital as an important, and often only, source of care. However, these communities and their hospitals face many challenges. As the hospital field engages in its most significant transformation to date, many are fighting to survive – potentially leaving their communities at risk for losing access to health care services. Recognizing these challenges and the need for new integrated and comprehensive health care delivery and payment strategies, the AHA Board of Trustees created the Task Force on Ensuring Access in Vulnerable Communities. Comprised of 29 hospital and health system leaders and state hospital association CEOs, the task force held meetings, heard from policymakers and conducted field hearings to speak with hospital and community leaders during a 15-month period.<br><br>The Task Force work is ongoing. This webpage is just one of the many ways AHA will keep you connected to the latest developments and resources as we address the critical issue of ensuring access to health care services.</p><hr><h2><span class="color_aha_blue"><strong>Task Force Report</strong></span></h2><p>The task force report outlines nine emerging strategies that can help preserve access to health care services in vulnerable communities. These strategies will not apply to or work for every community and each community has the option to choose one or more that are compatible with its needs.</p><ul><li><a href="/system/files/content/16/ensuring-access-taskforce-exec-summary.pdf" target="_blank">Executive Summary</a><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf"></a></li><li><a href="/system/files/content/16/ensuring-access-taskforce-report.pdf">Full Report</a></li><li><a href="https://www.youtube.com/watch?v=v2TgJDL9O6o">Release Video</a></li><li><a href="/system/files/content/16/taskforce-charts-rural.pdf">Rural Chart Pack</a></li><li><a href="/system/files/content/16/taskforce-charts-urban.pdf">Urban Chart Pack</a></li></ul><hr><h2><strong class="color_aha_blue">Inpatient/Outpatient Transformation Strategy</strong></h2><ul><li><a href="/system/files/2018-02/inpatient-outpatient-transformation-strategy.pdf">Emerging Strategies to Ensure Access to Health Care Services – Inpatient/Outpatient Transformation</a></li></ul><hr><h2><strong class="color_aha_blue">Social Determinants of Health Strategy</strong></h2><ul><li><a href="/system/files/2018-02/social-determinants-health.pdf">Emerging Strategies to Ensure Access to Health Care Services - Social Determinants</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/AHA-community-health-initiatives.pdf">Community Health Initiatives at the ���������� Association</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2017/determinants-health-food-insecurity-role-of-hospitals.pdf">AHA Social Determinants of Health Series - Food Insecurity and the Role of Hospital</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3063">AHA Social Determinants of Health Series - Housing and the Role of Hospitals</a></li></ul><hr><h2><strong class="color_aha_blue">Virtual Care Strategies</strong></h2><ul><li><a href="/system/files/content/17/task-force-virtual-care-strategies.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Virtual Care Strategies</a></li><li><a href="/system/files/content/17/telehealth-case-examples.pdf">Telehealth — Delivering the Right Care, at the Right Place, at the Right Time: Case Examples of AHA Members in Action</a></li></ul><hr><h2><strong class="color_aha_blue">Emergency Medical Center Strategy</strong></h2><ul><li><a href="/system/files/2018-06/task-force-emergency-medical-center.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Emergency Medical Center</a></li><li><a href="/system/files/2018-05/emergency-medical-center-strategy-5-2018-jk.pdf">Comparison: Federal Policy Solutions to Ensure Access to Emergency Services</a></li><li><a href="/2018-05-07-overview-rural-emergency-medical-center-act">The Rural Emergency Medical Center Act of 2018</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Action Alert on REMC Act (members-only)</a></li><li><a href="/letter/2018-05-08-aha-rep-ron-kind-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Kind)</a></li><li><a href="/letter/2018-05-08-aha-rep-lynn-jenkins-support-rural-emergency-medical-center-act-2018-hr-5678">AHA Letter of Support of the REMC Act (Jenkins)</a></li><li><a href="/press-releases/2018-05-07-aha-applauds-introduction-rural-emergency-medical-center-act-2018">Press Release Applauds Introduction of REMC Act</a></li><li><a href="/letter/2017-05-18-aha-expresses-support-rural-emergency-acute-care-hospital-reach-act-s-1130">AHA Letter of Support Rural Emergency Acute Care Hospital (REACH) Act, S. 1130</a></li></ul><hr><h2 class="color_aha_blue">Indian Health Services Strategy</h2><ul><li><a href="/system/files/2018-01/stategies-to-ensure-access.pdf">Emerging Strategies to Ensure Access to Health Care Services - IHS</a></li><li><a href="/letter/2017-05-26-aha-reps-walden-pallone-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Walden/Pallone)</a></li><li><a href="/letter/2017-05-26-aha-sens-mullin-ruiz-re-bipartisan-indian-health-service-task-force">AHA Letter of Support for IHS Task Force (Mullin-Ruiz)</a></li></ul><hr><h2><strong class="color_aha_blue">Urgent Care Center Strategy</strong></h2><ul><li><a href="/content/17/emerging-strategies-urgent-care-centers.pdf" target="_blank">Emerging Strategies to Ensure Access to Health Care Services – Urgent Care Centers</a></li><li><a href="/content/17/urgent-care-center-discussion-guide.pdf" target="_blank">Is the Urgent Care Center the Right Strategy for your Community</a></li></ul><hr><h2><strong class="color_aha_blue">Global Budgets</strong></h2><ul><li><a href="/system/files/media/file/2019/03/task-force-global-budget-2017.pdf">Emerging Strategies to Ensure Access – Global Budgets</a></li></ul><hr><h2><strong class="color_aha_blue">Community Conversations</strong></h2><ul><li><a href="/content/17/community-conversations-toolkit.pdf">Ensuring Access in Vulnerable Communities: Community Conversations Toolkit</a></li><li><a href="/content/17/taskforcevulncomm-discussionguide.pdf">Discussion Guide for Boards and Hospital Leadership</a></li><li><a href="http://www.hpoe.org/resources/ahahret-guides/3061">A Playbook for Fostering Hospital-Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.hpoe.org/Reports-HPOE/2016/creating-effective-hospital-community-partnerships.pdf">Creating Effective Hospital Community Partnerships to Build a Culture of Health</a></li><li><a href="http://www.healthycommunities.org/Resources/toolkit.shtml#.WYjFtITyt0y">Community Health Assessment Toolkit</a></li><li><a href="/ahahret-guides/2016-06-09-engaging-patients-and-communities-community-health-needs-assessment">Engaging Patients and Communities in the Community Health Needs Assessment Process</a></li><li><a href="http://hospitalsocialmedia.tumblr.com/">A Hospital Leadership Guide to Digital and Social Media</a></li><li><a href="/advancing-health-in-america">Advancing Health in America</a></li><li><a href="/ahahret-guides/2013-01-01-engaging-health-care-users-framework-healthy-individuals-and-communities">AHA Framework for Engaging Health Care Users</a></li><li><a href="/ahahret-guides/2015-01-28-leadership-toolkit-redefining-h-engaging-trustees-and-communities">Leadership Toolkit for Redefining the H: Engaging Trustees and Communities</a></li><li><a href="/system/files/2018-02/leadership-role-nonprofit-health-systems.pdf">The Leadership Role of Nonprofit Health Systems in Improving Community Health</a></li><li><a href="/system/files/2018-02/critical-conversations-to-changing-health-environment.pdf">Critical Conversations on the Changing Health Environment: Physician Engagement</a></li></ul><hr><h2><strong class="color_aha_blue">Frontier Health System</strong></h2><ul><li><a href="/system/files/content/17/task-force-frontier-2017.pdf">Emerging Strategies to Ensure Access — Frontier Health System</a></li></ul><hr><h2><strong class="color_aha_blue">Rural Hospital-Health Clinic Integration</strong></h2><ul><li><a href="/factsheet/2018-08-02-emerging-strategies-ensure-access-health-care-services">Emerging Strategies to Ensure Access — Rural Hospital-Health Clinic Integration</a></li></ul><hr><h2><strong class="color_aha_blue">Other Resources</strong></h2><ul><li><a href="http://www.hpoe.org/Reports-HPOE/2017/improving-care-for-high-need-high-cost-patients.pdf" target="_blank">Improving Care for High-Need, High-Cost Patients</a></li><li><a href="/data-and-insights/presentation-center/ensuring-access" target="_blank">Ensuring Access in Vulnerable Communities PowerPoint Presentation</a></li></ul></div></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title"><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities">Hospitals and Health Systems Ensuring Access in Their Communities: Downloadable PDF</a></h3></div><div class="panel-body"><p><a href="/case-studies/2018-02-02-hospitals-and-health-systems-ensuring-access-their-communities"><img src="/sites/default/files/inline-images/ensuring-access-case-study-comp-rural-sm_0.jpg" data-entity-uuid="32d51105-e12e-468b-8f23-e4ae7c7aa262" data-entity-type="file" alt="Hospitals and Health Systems Ensuring Access in Their Communities cover" width="319" height="413">This is a compendium of case examples of AHA members from across the country employing the nine emerging strategies recommended by the association’s Task Force on Ensuring Access in Vulnerable Communities.</a></p></div></div></div></div></div> Wed, 16 Nov 2016 00:00:00 -0600 Public /advancing-health-podcast/2025-07-30-what-matters-most-inside-froedterts-mission-transform-geriatric-care <p>What does it take to become a truly age-friendly hospital? In this conversation, Shelley Hart, R.N., clinical nurse specialist at Froedtert Menomonee Falls Hospital, explores the hospital's inspiring journey toward delivering exceptional care for older adults. Through innovative delirium prevention programs, goals of care conversations, and simple acts of human connection, Shelley shares how the team is creating a hospital experience centered on dignity and purpose.</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> 00:00:01:02 - 00:00:26:02<br> Tom Haederle<br> Welcome to Advancing Health. About a decade ago, Froedtert Menomonee Falls Hospital in Wisconsin decided to focus on improving care and services for its geriatric population of patients. In today's podcast, we learn more from a Froedtert clinical nurse specialist about how its age-friendly journey is advancing the quality of care for older adults. </p> <p> 00:00:26:04 - 00:00:43:01<br> Jen Braun<br> Hi everyone! I'm Jen Braun, director of workforce and organizational development at the ���������� Association, and my guest today is Shelly Hart, who's the clinical nurse specialist at Froedtert Menominee Falls Hospital. Thanks for joining me, Shelly. I was wondering if you could share a little bit about yourself and what you do at Froedtert. </p> <p> 00:00:43:04 - 00:00:59:23<br> Shelley Hart, R.N.<br> As you said, I'm a clinical nurse specialist, and I've worked at Froedtert Menomonee Falls Hospital for many decades. I have geriatric background. And so I was very instrumental in when we started to develop our age-friendly status. </p> <p> 00:01:00:00 - 00:01:06:04<br> Jen Braun<br> So tell me a little bit more about how your organization began their age-friendly journey. </p> <p> 00:01:06:07 - 00:01:46:23<br> Shelley Hart, R.N.<br> I will tell you a little story because it started many, many years ago - right around 2015, 2016 - when we decided we needed to develop an ACE unit. And at that point we thought we needed to do lots of different things to be much more attuned to our geriatric patient population. So, at that point, we started training using our niche protocols and our nursing assistants and RNs learned a lot about geriatric assessments, protocols, discharge planning, etc. and then we also put into place a lot of other protocols for the providers to use. </p> <p> 00:01:46:25 - 00:02:31:21<br> Shelley Hart, R.N.<br> We are very fortunate because of our pharmacists and how we have lots of medication guidelines and other daily work that they do supporting age-friendly geriatric patient populations. And we also roped in our geriatricians and they were very supportive and did a lot of work, preparing us. So when we started looking at all of these protocols, everything that we're doing in terms of 4Ms, with mentation, with mobility, with medication and what matters, we had a lot of things already in place that we just had to pull together and look at how we were doing with that. </p> <p> 00:02:31:22 - 00:02:46:06<br> Shelley Hart, R.N.<br> How could we do better, and how could we spread this to other areas in the hospital and make this really well received by everybody and make an impact? And so that led us to our age-friendly journey. </p> <p> 00:02:46:08 - 00:03:04:03<br> Jen Braun<br> That's amazing. So it sounds like you had a lot of the pieces in place for the 4Ms, which you mentioned were what matters medications, mentation and mobility. And you just had to kind of button them up a little bit. What were some of the interventions, though, that you, that you made to help provide that age-friendly care? </p> <p> 00:03:04:09 - 00:03:30:12<br> Shelley Hart, R.N.<br> And that is really, you know, one of the really great pieces about using the 4Ms framework, because you can integrate that into lots of existing things you're already doing. So, for example, what matters in our organization as we really are leveraging our providers when they're talking about goals of care with patients. And they already had a smart phrase that was developed for that. </p> <p> 00:03:30:13 - 00:04:00:29<br> Shelley Hart, R.N.<br> So we harnessed that. We also tightened up our medication review, all the daily work our pharmacists are doing. We're really grateful that they use our Beers list criteria and all of the work when they are calling about deprescribing or changing dosing of different medications. I do have to say we did tighten up, you know, our mobility screening, mobility activities, delirium screening and delirium activities. </p> <p> 00:04:00:29 - 00:04:27:05<br> Shelley Hart, R.N.<br> And I if I could, I'd like to just explain a little bit more about our mentation and how we have a really robust delirium prevention group within our system and also within our community hospital of Menominee Falls. And, we've just developed some education around that, doing education posts every 1 to 2 weeks so everybody can look at that. </p> <p> 00:04:27:08 - 00:04:53:29<br> Shelley Hart, R.N.<br> We also developed a delirium champion program. So now we have unit champions coming. And there's many stories I could share about the delirium champions and all the work they're doing. This is just within the last year or so. We're also just celebrated our delirium awareness day. We took a wellness cart around the hospital. We talked about delirium awareness, delirium prevention, extremely well received. </p> <p> 00:04:54:00 - 00:05:04:24<br> Shelley Hart, R.N.<br> So that was with ED, ICU, our stepdown units and all of that surge. So those are all activities we've been doing that just keep spreading age-friendly. </p> <p> 00:05:04:26 - 00:05:25:27<br> Jen Braun<br> That's incredible. You've mentioned so many strategies that you've employed. And you know, health care is a team sport. And there are sounds like many, many, many teams involved, many stakeholders. So how did you get engagement and ownership with some of those key stakeholders or what strategies did you employ? </p> <p> 00:05:25:29 - 00:05:59:10<br> Shelley Hart, R.N.<br> We are really lucky because our executives actually talked about: You know what? There's this age-friendly action community going on. You guys have a lot of experience with this. You're really subject matter experts, and I'm talking about myself and our director, Sheri Katzer. Would you guys like to lead this work and include our geriatricians and our subject matter expert pharmacists and all of our interdisciplinary therapists? </p> <p> 00:05:59:10 - 00:06:19:21<br> Shelley Hart, R.N.<br> And we're like, sure, let's do it. So that was, you know, coming from executives as well as one of our vice presidents. What is their length of stay? How can we make it the best for them meeting their needs? Just employing all those and that's how we actually were propelled into doing the age-friendly submission. </p> <p> 00:06:19:25 - 00:06:34:11<br> Jen Braun<br> So it sounds like you had a lot of leadership support from the jump. Did you have any stakeholders who are a bit challenging to get, you know, over the curve there, or what did you specifically do to, do any outreach to them? </p> <p> 00:06:34:14 - 00:07:00:06<br> Shelley Hart, R.N.<br> I do think as a group meeting understanding age-friendly, really, and doing a gap analysis. What do we have? What are we working towards? Helping people understand what is what matters mean? What is the medication piece mean? What does mentation piece mean? What does this actually mean in your work? In your daily work? How can we quantify that? </p> <p> 00:07:00:09 - 00:07:09:08<br> Shelley Hart, R.N.<br> How can we make it work and improve it? And how can we spread it to the hospital? And at this point, we want to spread it into the system. And what's the next steps for that? </p> <p> 00:07:09:15 - 00:07:12:06<br> Jen Braun<br> And so, speaking of, what are the next steps for that? </p> <p> 00:07:12:08 - 00:07:38:13<br> Shelley Hart, R.N.<br> And you know, it's great that we're here and there's people really looking forward to us bringing back all the information from today. We really want to talk about dashboards, metrics, quantifying data. We're looking at the CMS, age-friendly measure. How is that impacting things? What can we do to improve? Let's set us up for success. And of course, the patient. That, you know, that's the primary center of everything. </p> <p> 00:07:38:15 - 00:07:49:13<br> Jen Braun<br> So how is participating in an AHA age-friendly health systems action community contributed to your work or Froedtert'success? </p> <p> 00:07:49:15 - 00:08:18:25<br> Shelley Hart, R.N.<br> Lots and lots of older adults come into the hospital, so we want to make it the best experience for them. We want to make it, what matters to them a lot. A lot of dignity involved in what's going on for the patient, what's going on for their family. And, really, that helps with success of the organization in terms of the patient satisfaction, family satisfaction, all the health care workers working best practice. </p> <p> 00:08:18:27 - 00:08:37:01<br> Shelley Hart, R.N.<br> And it's every patient, every time. So it's really an exciting time. And I think everybody should take advantage of age-friendly because there's energy in it. So that's a big piece of it too, is you focus the energy on age-friendly and we're all working towards the same goal. </p> <p> 00:08:37:04 - 00:08:46:24<br> Jen Braun<br> You mentioned some of the impacts that you've seen from delivering age-friendly care. Are there any impacts that you want to specifically call out that you're really proud of? </p> <p> 00:08:46:26 - 00:09:12:02<br> Shelley Hart, R.N.<br> Well, there's a lot of patient stories I could go into about how training of nurses, training of nursing assistants, providers, and how they centered care around what matters to the patient. From you know, couples that are in the hospital in different places at the same time and how we're getting them together for lunch and people making that happen. </p> <p> 00:09:12:04 - 00:09:33:25<br> Shelley Hart, R.N.<br> Families, you know, thinking, you know, mom hasn't been doing so well over the course of the months. Can I talk about this? We need to really talk about this and someone listening and say, yeah, let's get together. We're going to have a family meeting about this, and they get the right players involved to make it best for the patient. </p> <p> 00:09:33:27 - 00:09:42:14<br> Shelley Hart, R.N.<br> Those are just a couple, like, stories that happen all the time, and that is not possible unless you're all in sync. </p> <p> 00:09:42:17 - 00:09:57:03<br> Jen Braun<br> So, Shelly, I just want to thank you for sharing all the work that Froedtert has done, and you have done to implement the 4Ms at your system to ensure that older adults are receiving quality care. So I really want to thank you for sharing your story and your time here today. </p> <p> 00:09:57:06 - 00:10:03:04<br> Shelley Hart, R.N.<br> You're very welcome. I am really happy to be here and to share stories. </p> <p> 00:10:03:07 - 00:10:11:18<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, 30 Jul 2025 08:38:56 -0500 Public /h-isac-white-reports/2025-07-29-h-isac-tlp-white-threat-bulletin-russia-nexus-threat-actors-may-retaliate-against-ukraine <div class="container row"><div class="row"><div class="col-md-8"><p>In an update on July 28, the US has shortened the deadline to 12 days, putting more pressure on Russia to broker a deal with Ukraine.</p><p>Today, it was also announced by pro-Ukrainian threat actors that they were responsible for attacking Russia’s largest airline. The two events are likely to create a flare-up in tensions between the US and Russia, which is likely to manifest itself in the form of cyber attacks against US and NATO critical infrastructure.</p></div><div class="col-md-4"><div><p><strong>For help with Cybersecurity and Risk Advisory Services exclusively for AHA members, contact:</strong></p><h3><a href="/system/files/media/file/2020/11/AHA-Riggi-Senior-Advisor-for-Cyber-and-Risk-Bio-08102020.pdf">John Riggi</a></h3><h4>National Advisor for Cybersecurity and Risk, AHA</h4><h4><a href="mailto:jriggi@aha.org?subject=Cybersecurity and Risk Advisory Services Query">jriggi@aha.org</a></h4><h4>(O) <a href="tel:1-202-626-2272">+1 202 626 2272</a></h4><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2020/11/AHA-Riggi-Senior-Advisor-for-Cyber-and-Risk-Bio-08102020.pdf" target="_blank">More on John Riggi</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2018-06-15-cybersecurity-and-risk-advisory-services" target="_blank">Learn more about AHA's Cybersecurity and Risk Advisory Services</a></div></div></div></div></div> Tue, 29 Jul 2025 09:19:56 -0500 Public /aha-center-health-innovation-market-scan/2025-07-29-how-4-providers-successfully-launched-hospital-home-programs <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/How-4-Providers-Successfully-Launched-Hospital-at-Home-Programs.png" data-entity-uuid="39b44c89-49ec-4344-a777-d762def894df" data-entity-type="file" alt="How 4 Providers Successfully Launched Hospital-at-Home Programs. The gloved hand of a clinician holds up a home with a large heart on the front of it below a window." width="620" height="381"><p>As the U.S. health care system faces rising capacity constraints and challenges in care access, hospital-at-home and telehealth programs have emerged as powerful tools for delivering patient-centered, evidence-based care beyond hospital walls.</p><p>Clinical and administrative leaders across the country shared how their organizations are scaling these solutions during the 2025 ���������� Association Leadership Summit last week. They shared how they are improving outcomes, reducing readmissions and eliminating disparities.</p><h2><img src="/sites/default/files/inline-images/Advocate-Health.png" data-entity-uuid="72a51778-3fd0-4e58-830a-f728fc93b55c" data-entity-type="file" alt="Advocate Health labcoat with stethoscope and health record clipboard." width="468" height="650" class="align-left">Advocate Health: <span>Rapid HaH Launch</span></h2><p>Advocate Health, for example, rapidly launched its <a href="https://homehealthcarenews.com/2020/11/atrium-health-boosts-capacity-with-virtual-hospital-at-home-model/" target="_blank" title="Home Care Health News: Atrium Health Boosts Capacity with Virtual Hospital-at-Home Model">Hospital at Home (HaH) program</a> at the start of the COVID-19 pandemic — a 10-day sprint from concept to first admission. Since then, <a href="https://www.advocatehealth.com/health-services/advocate-health-at-home" target="_blank" title="Advocate Health Care: Advocate Health at Home">the program</a> has expanded to 12 facilities across two metropolitan areas, serving more than 16,500 patients and avoiding more than 60,000 inpatient bed days, said Daniel E. Davis, M.D., senior medical director of continuing health at the Charlotte, N.C., site.</p><p>The hybrid model combines twice-daily in-home visits from nurses or paramedics with daily virtual provider check-ins, remote monitoring, access to lab services, specialty consults and pharmacy support.</p><p>The result: hospital-grade care delivered in the comfort of home, with better outcomes and higher patient satisfaction. Advocate’s 2024 readmission rate for HaH patients was 0.93, outperforming traditional hospital settings (1.09), and patient satisfaction scores were significantly higher than that of brick-and-mortar hospitals.</p><p>Advocate’s program is payer-agnostic — focused not on insurance coverage, but on clinical appropriateness.</p><p>“When you look at total value, the ROI is clear,” Davis said. “You create capacity, reduce readmissions and have almost zero utilization of skilled nursing facilities. You’re creating a safe place for patients to land in the continuum of care.”</p><h2><img src="/sites/default/files/inline-images/Mass-General-Brigham.png" data-entity-uuid="9400f1ce-8a27-420d-9e33-99d911b7471d" data-entity-type="file" alt="Mass General Brigham hospital building." width="468" height="650" class="align-left">Mass General Brigham: <span>Outscoring Apple on Satisfaction</span></h2><p>Mass General Brigham (MGB) likewise has built one of the nation’s largest home hospital programs, unified across five hospitals and serving more than 80% of eligible patients in its service area. Heather O’Sullivan, R.N., president of <a href="https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/healthcare-at-home" target="_blank" title="Mass General Brigham: Healthcare at Home">Healthcare at Home</a>, emphasized MGB’s conviction that home is the best site of care whenever possible — not just for comfort, but for quality and equitable health outcomes.</p><p>A randomized controlled trial of its program found a 7% 30-day readmission rate vs. 23% for inpatient care, with zero inappropriate medication errors and fewer safety events.</p><p>Patients in the MGB program benefit from a full spectrum of clinical and ancillary services, from remote monitoring and 24/7 command center support to in-home labs, X-rays, physical therapy and medically tailored meal delivery. “Our Net Promoter Score is higher than Apple, and we’re very proud of that,” O’Sullivan said. Patients report better rest, more personalized care and higher levels of trust.</p><p>MGB also provides fair and just access to care by adapting its care model to support unhoused patients. In partnership with the New England Center and Home for Veterans, MGB began providing hospital-level care on-site at a <a href="https://homehealthcarenews.com/2024/11/mass-general-brigham-home-hospital-program-brings-acute-care-to-homeless-veterans/" target="_blank" title="Home Health Care News: Mass General Brigham Home Hospital Program Brings Acute Care To Homeless Veterans ">VA Safe Haven residence</a> for veterans experiencing homelessness. The initiative reflects the session’s theme of addressing structural barriers to care and expanding home hospital access to all populations.</p><h2><img src="/sites/default/files/inline-images/OSU-Wexner-Medical-Center.png" data-entity-uuid="827eaf8a-0eb9-4c8a-b6bd-34546beeb920" data-entity-type="file" alt="OSU Wexner Medical Center hospital building." width="468" height="650" class="align-left">OSU Wexner Medical Center: <span>Reaching Patients Where They Are</span></h2><p>The Ohio State University Wexner Medical Center has seen similar success with its <a href="https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/hospital-care-at-home" target="_blank" title="The Ohio State University Wexner Medical Center: Ohio State Hospital Care at Home provides hospital-level care in the comfort of patients' homes">Hospital Care at Home (HCaH) model</a>, launched in 2023. The program serves patients in disadvantaged neighborhoods using a hybrid insource/outsource model, and has enrolled more than 500 patients to date.</p><p>Rachit Thariani, chief administrative officer of post-acute and <a href="http://wexnermedical.osu.edu/post-acute-and-home-care-services/home-based-care-services" target="_blank" title="The Ohio State University Wexner Medical Center: Home-Based Care Services">home-based care</a>, said patients enrolled in HCaH had significantly lower 30-day readmission rates — just 6.5% in FY2024 and 9.2% in FY2025 — compared with more than 15% among those who declined participation. Importantly, HCaH patients reported overwhelming satisfaction, with 95% rating their experience a 9 or 10 out of 10.</p><h2><img src="/sites/default/files/inline-images/Iris-Telehealth.png" data-entity-uuid="0f87a59c-3b8a-4600-b7bb-479b75226fc0" data-entity-type="file" alt="Iris Telehealth. A brain that is half biological and half mechanical. A digital hand shaking a human hand." width="468" height="650" class="align-left">Iris Telehealth: <span>Improving Patient and Provider Satisfaction</span></h2><p>In tandem with hospital-at-home programs, behavioral telehealth is transforming access to mental health care. Tom Milam, M.D., chief medical officer of <a href="https://iristelehealth.com/" target="_blank" title="Iris Telehealth homepage">Iris Telehealth</a> and president of Iris Medical Group, shared how the company supports systems across the care continuum — from emergency departments (EDs) and inpatient units to outpatient therapy and primary care — with on-demand and scheduled virtual behavioral health services.</p><p>Telehealth has helped organizations reduce psychiatric ED consult times by more than 60%, lower inpatient length of stay and improve depression symptoms by 38%. In one example, Texas Health Resources saw a 60% reduction in wait times from referral to first visit, with 18,000 visits delivered in the program’s first year.</p><p>Milam noted that Iris’ integrated telehealth solutions — supported by a <a href="https://iristelehealth.com/services/" target="_blank" title="Iris Telehealth: Behavioral Health Services">behavioral health command center</a>, risk scoring and revenue cycle analytics — allow health systems to scale behavioral care delivery efficiently while enhancing both patient and provider satisfaction.</p><p>All four speakers emphasized that the future of health care lies in scalable, tech-enabled, home-based solutions that close gaps in access to care.</p></div><div class="col-md-4"><div class="sticky"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } div.sticky { position: sticky; top: 0; } Tue, 29 Jul 2025 06:15:00 -0500 Public /aha-center-health-innovation-market-scan/2025-07-29-5-innovators-take-center-stage-aha-leadership-summit <div class="container"><div class="row"><div class="col-md-8"><img src="/sites/default/files/inline-images/5-Innovators-Take-Center-Stage-at-the-AHA-Leadership-Summit.jpg" data-entity-uuid="f2fdd26d-80e6-445e-9c64-8e417eb56edc" data-entity-type="file" alt="5 Innovators Take Center Stage at the AHA Leadership Summit. A speaker at the recent 2025 AHA Leadership Summit, the Advancing Innovation Showcase." width="1280" height="853"><p>At the recent 2025 AHA Leadership Summit, the Advancing Innovation Showcase offered a rapid-fire glimpse into the future of care delivery, workforce support and digital transformation. Featuring five venture-backed companies, the session highlighted innovations built for direct, measurable impact in hospitals and health systems.</p><p>The showcase introduced practical solutions to pressing challenges like clinician burnout, emergency department (ED) crowding, patient engagement and closing gaps in behavioral health and men’s health care. Each presentation offered candid perspectives on potential hurdles and real-world applications.</p><h2><span>Posterity Health:</span> Reimagining Men’s Health through Virtual-First Care</h2><p>Matt Lenz, chief growth officer of <a href="https://posterityhealth.com/" target="_blank" title="Posterity Health homepage">Posterity Health</a>, kicked off the session by addressing a long-overlooked population: men. With 87% of men facing a health concern and 40% lacking a primary care provider, Posterity Health built a virtual-first platform focused on fertility, hormone therapy and preventive care across a man’s life span.</p><p>Posterity’s model combines telehealth, at-home diagnostics and in-person options — allowing patients to access care within 72 hours. The platform has delivered more than 32,000 appointments with an 85+ Net Promoter Score. For employers and health systems, the return on investment is compelling: Early male fertility evaluation can cut time to conception and reduce the need for expensive interventions like in vitro fertilization.</p><h2><span>Therify:</span> Closing the Behavioral Health Gap after Discharge</h2><p>Warren Sadler, CEO of <a href="https://www.therify.co/" target="_blank" title="Therify homepage">Therify</a>, laid bare the crisis in post-discharge behavioral health care. Up to 50% of patients with behavioral health needs are discharged with no follow-up care, which could lead to costly readmissions and poorer outcomes, Sadler said. Therify’s continuity model solves this with smart matching and AI-powered coordination, connecting patients to in-network, culturally aligned therapists within five days of discharge.</p><p>Integrated directly into hospital workflows, Therify supports care teams, manages reminders and follow-ups, and provides closed-loop feedback to clinicians. The result: reduced readmissions, freed inpatient capacity and an 83% appointment show rate driven by identity-aligned care that builds patient trust.</p><h2><span>Loyal Health:</span> Turning Digital Engagement into Measurable Growth</h2><p>Nanette Oddo, CEO of <a href="https://loyalhealth.com/" target="_blank" title="Loyal Health homepage">Loyal Health</a>, addressed a reality that health systems can’t ignore: Patients expect seamless digital experiences and will switch providers if they don’t get them. With one in five patients reporting poor digital engagement as a reason for leaving their providers, Loyal’s platform helps hospitals transform clicks into conversions.</p><p>Loyal’s Care Activation Platform powers provider search, scheduling, CRM outreach and reputation management, all integrated with real-time electronic health record (EHR) data. In one case study, a large health system replaced more than 20 vendors with Loyal’s centralized tools and increased self-scheduled appointments by 46%. Across its clients, Loyal has supported more than 6 million provider searches and 70,000+ scheduled appointments.</p><h2><span>Mednition:</span> AI That Saves Lives And Reduces Burnout</h2><p>ED crowding and nurse burnout can impact patient safety and health system finances. Deena Brecher, chief nursing officer at <a href="https://mednition.com/" target="_blank" title="Mednition homepage">Mednition</a>, introduced KATE AI — a nurse-first, real-time risk intelligence platform that integrates directly into clinical workflows with no extra steps.</p><p>KATE continuously scans EHR data to flag high-risk patients and alert care teams in real time. The platform has helped hospitals reduce ED length of stay by 10%, cut inpatient stay for sepsis patients by 24 hours and increase high-risk patient identification by 93%.</p><h2><span>Pieces:</span> Lightening Clinician Workloads with Voice-to-Voice AI</h2><p>Ruben Amarasingham, M.D., CEO of <a href="https://www.piecestech.com/" target="_blank" title="Pieces Tech homepage">Pieces</a>, shared how documentation burdens are driving clinician burnout. Physicians spend nearly seven hours completing EHRs during an eight-hour clinic day, with 81% reporting that documentation interferes with care, he said. Pieces' AI platform acts as a virtual assistant by transforming quick voice conversations into ready-to-sign notes, discharge summaries and task updates.</p><p>From inpatient to discharge, Pieces supports clinicians with real-time summaries and SafeRead, its AI-powered review system that ensures documentation accuracy. The result: a 31% reduction in cognitive load and 80% to 92% physician adoption.</p></div><div class="col-md-4"><div class="sticky"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } div.sticky { position: sticky; top: 0; } Tue, 29 Jul 2025 06:00:00 -0500 Public /news/chairpersons-file/2025-07-28-chair-file-obbba-and-whats-next-health-care <p>The recently enacted One Big Beautiful Bill Act will bring big changes to health care. AHA President and CEO Rick Pollack joined me for a Leadership Dialogue conversation earlier this month to talk about the key provisions that apply to health care. If you missed that episode, you can <a href="/news/chairpersons-file/2025-07-16-chair-file-leadership-dialogue-continuing-work-strengthen-health-america-aha-president-and">watch the video or listen to the podcast</a>.</p><p>Our health care field, supported by patch after patch since 1965, is not sustainable for today’s world of 2025. Some of the patches that we needed to keep going are gone, and it’s unrealistic to think they’re coming back. This time doesn’t just feel different, it is different. So what should we be focused on as hospitals and health systems?</p><p>First, we have to accept reality and make the smartest choices we can with the resources and constraints we have to maximize our delivery on our mission. The AHA has already begun some of this work and will be assisting hospitals to help individuals retain eligibility for coverage, as well as sharing best practices for improvements and operational efficiencies. We also are looking ahead at several hospital priorities that will need to be addressed before the end of the year — from waivers for telehealth and hospital at home, Medicaid disproportionate share hospital cuts, the Medicare rule making process, regulatory relief and more. Now more than ever, we are here to help you do what you do best: care for our communities.</p><p>While the AHA is pulling all the levers in Washington, D.C., to advocate for priorities that advance health, all of us have an important role to play in engaging our legislators. There’s nothing more powerful than hearing from you, their constituents, about the impact certain policies will have on the people they represent. You can find resources and more information on how to best do this below.</p><p>Our second, and most important, job is to actually reform and transform health care for the long term. We need to do the hard work and create a health care model that is sustainable for the world of 2065, not 1965. We have to start putting proposals on the table that challenge the status quo yet move us forward.</p><p>At the AHA Leadership Summit in Nashville last week, I heard so many incredible stories of how you have started this work. As a field, we are using technology and innovation to transform care delivery, improve quality and patient safety, and meet people where they need care. And that is what makes me hopeful and optimistic.</p><p>We’ve been dealt a difficult hand, but it’s our opportunity to open the door wide for transformation and innovation. We owe it to ourselves, our team members, our patients and our communities to make the very best choices we can today — and to transform our health care system for tomorrow.</p><h2>Helping You Help Communities — Key AHA Resources</h2><ul><li><a href="/resources-one-big-beautiful-bill-act-signed-law-july-4-2025">Advocacy Resources on OBBBA</a></li><li><a href="/advocacy/action-center">AHA Action Center</a></li><li><a href="/advocacy-issues">Key Advocacy Issues and Resources</a></li><li><a href="/advocacy/working-with-congress">Guide to Working with Congress</a></li></ul> Mon, 28 Jul 2025 10:16:20 -0500 Public /fact-sheets/2022-08-30-fact-sheet-rural-hospital-support-act-s4009-assistance-rural-community <div class="container"><div class="row"><div class="col-md-8"><h2><span>Background</span></h2><p>Medicare pays most acute care hospitals under the inpatient prospective payment system (IPPS). Some of these hospitals receive additional support from Medicare to help address potential financial challenges associated with being rural, geographically isolated and low volume. These programs are Medicare-dependent Hospitals (MDHs), Low-volume Adjustment (LVA) and Sole Community Hospitals (SCHs).</p><p><span><strong>Without action from Congress, the enhanced LVA and MDH programs will expire Sept. 30, 2025.</strong></span></p><h3><span>Why are these programs important?</span></h3><p>The network of providers that serves rural Americans is financially fragile and more dependent on Medicare revenue due to the high percentage of Medicare beneficiaries who live in rural areas. Rural residents also on average tend to be older, have lower incomes and higher rates of chronic illness than urban counterparts. This greater dependence on Medicare may make certain hospitals more financially vulnerable. Indeed, Medicare only pays 82% of hospital costs on average according to our latest analysis. Additionally, over 150 rural hospitals have closed or converted to other provider types since 2010. These designations protect the financial viability of small, rural hospitals to ensure they can continue providing patients access to care.</p><h3><span>Medicare-dependent Hospitals</span></h3><p>Congress established the MDH program in 1987 to help support small rural hospitals for which Medicare patients make up a significant percentage of inpatient days or discharges. MDHs are small, rural hospitals where at least 60% of their admissions or patient days are from Medicare patients. MDHs receive the IPPS rate plus 75% of the difference between the IPPS rate and their inflation-adjusted costs from one of three base years.</p><h3><span>Low-volume Adjustment</span></h3><p>Certain factors beyond providers’ control can affect the costs of furnishing services, including patient volume. This is particularly relevant in small and isolated communities where providers frequently cannot achieve economies of scale like larger hospitals. Congress established the LVA program in 2005 to help isolated, rural hospitals with a low number of discharges. Currently under the enhanced program, they must be more than 15 miles from another IPPS hospital and have fewer than 3,800 annual total discharges. These LVA hospitals receive a payment adjustment based on a sliding scale formula to ensure the patients and communities these hospitals serve continue to have access to care.</p><h3><span>Sole Community Hospitals</span></h3><p>The SCH program was created to maintain access to needed health services for Medicare beneficiaries in isolated communities. In order to be eligible for the program, SCHs must show that because of distance or geographic boundaries between hospitals, they are the sole source of inpatient hospital services reasonably available in a certain geographic area. They receive increased payments based on their cost per discharge in a base year.</p><h2><span>AHA Position — Cosponsor the Rural Hospital Support Act (S.335) & the Assistance for Rural Community Hospitals (ARCH) Act</span></h2><p>The Rural Hospital Support Act (S.335) includes the following important AHA-supported policies to ensure access to care:</p><ul><li>Permanently extends the MDH program and adds an additional base year that hospitals may choose for calculating payments.</li><li>Permanently extends the enhanced LVA program, which would continue to allow hospitals more than 15 miles from another IPPS hospital and have fewer than 3,800 annual total discharges to be eligible.</li><li>Adds a base year that SCHs may select for calculating their payments.</li></ul><p>The ARCH Act helps rural hospitals continue to serve their patients and communities by extending the current MDH and LVA programs by five years and will soon be reintroduced in the House.</p></div><div class="col-md-4"><a href="/system/files/media/file/2022/08/fact-sheet-rural-hospital-support-act-s4009-the-assistance-for-rural-community-hospitals-act-hr8747.pdf" target="_blank" title="Click here to Download the Fact Sheet: Rural Hospital Support Act (S.4009) & the Assistance for Rural Community Hospitals Act (H.R.8747)"><img src="/sites/default/files/inline-images/Page-1-fact-sheet-rural-hospital-support-act-the-assistance-for-rural-community-hospitals-act-20250205.png" data-entity-uuid="60a4126d-3db7-4725-81d8-adc2020afcef" data-entity-type="file" alt="Fact Sheet: Rural Hospital Support Act (S.1110) & the Assistance for Rural Community Hospitals Act (H.R.6430) page 1." width="681" height="900"></a></div></div></div> Fri, 25 Jul 2025 11:28:44 -0500 Public