/ en Wed, 30 Apr 2025 09:21:01 -0500 Tue, 22 Apr 25 14:58:52 -0500 /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 Access to Care in Vulnerable Communities /news/headline/2025-04-22-aha-issues-support-legislation-strengthen-ltch-reimbursement <p>The AHA voiced <a href="/lettercomment/2025-04-15-aha-supports-house-securing-access-care-seniors-critical-condition-act" title="senior act">support</a> for the Securing Access to Care for Seniors in Critical Condition Act (H.R.1924), legislation that would provide reimbursement for long-term care hospitals. In comments to the bill’s sponsors, Reps. Kevin Hern, R-Okla., and Brendan Boyle, D-Pa., the AHA highlighted declines in the number of LTCH standard-rate cases, providers and reimbursement. Smaller, yet sicker patient populations have also become a challenge for LTCHs.  </p> Tue, 22 Apr 2025 14:58:52 -0500 Access to Care in Vulnerable Communities /role-hospitals-uconn-health-community-outreach-program-improves-access-mammograms <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-04/ths-uconn-mammogram-700x532.jpg" data-entity-uuid data-entity-type="file" alt="UCONN Health. A patient is escorted to a mammogram screening" width="700" height="532" class="align-left"></p></div><p>The benefits of screening for breast cancer are well documented; for example, having regular mammograms can lower the risk of dying from breast cancer. Saving lives is the impetus behind a community outreach and engagement program led by UConn Health, based in Farmington, Conn.</p><p>As part of this UConn Health program, community health workers attend events in the community and at other UConn Health offices to share educational information about prevention and screening for breast cancer. They also help people who are uninsured or underinsured schedule mammogram screenings and follow-up appointments.</p><p>During a presentation at a local YWCA literacy group in New Britain, Conn., community health worker Rosa Agosto spoke with Vanessa Neira, a New Britain resident with a history of breast cancer in her family. At the time, Neira did not have insurance, so Agosto helped Neira connect with the UConn Health free mammogram program. Neira’s mammogram detected a “concerning spot,” but follow-up testing ruled out cancer. Neira remains grateful for support from the UConn Health team.</p><p>Agosto emphasizes that lack of insurance “should not be a barrier to mammograms, and here at UConn Health we are proud to be able to provide assistance to those who need mammograms, so they have access to early diagnosis, interventions and treatment.”</p><p>“To tell a woman with no insurance we can offer her a free mammogram can be life changing,” adds Kim Hamilton, program coordinator, community outreach and engagement, at UConn Health.</p><p><a class="btn btn-primary" href="https://today.uconn.edu/2024/10/uconn-health-community-programs-helping-under-insured-and-uninsured-with-breast-cancer-screenings" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Mon, 21 Apr 2025 13:50:56 -0500 Access to Care in Vulnerable Communities /role-hospitals-southeast-colorado-hospital-district-taking-skies-how-doctor-cares-patients-rural-colorado <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-04/ths-southeast-colorado-hospital-district-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Southeast Colorado Hospital District. Rural landscape under cumulus cloud-filled sky" width="700" height="532" class="align-left"></p></div><p>Many daily commutes are on the ground — car, train, bikes — but what if you took to the air? Dr. Charles Frankum has spent over two decades flying himself to some of the most remote hospitals in Colorado and Kansas, including the <a href="https://www.sechosp.org" target="_blank">Southeast Colorado Hospital District</a> in Springfield, Colo. His daily four-hour commute in his plane showcases the need and complexity of providing critical medical care to rural communities.</p><p>Frankum's journey as a pilot-doctor began in 2003, driven by the need for an efficient way to reach multiple rural hospitals. His efforts have been crucial in towns like Springfield, where the Southeast Colorado Hospital District serves as a vital health care hub. “[Frankum] comes in once a month, and just since I’ve been here the last couple of years, I know numerous people he has found cancers on or snipped polyps off of,” said Heather Burdick, chief nursing officer and nursing home administrator at the Southeast Colorado Hospital District. “His work not only saves lives but also strengthens the health care systems in these small towns.”</p><p>“My work makes it so that only one person has to travel instead of all these other people having to travel,” said Frankum, “and it allows some very rural hospitals to turn their wheels and do procedures in their town.” Frankum’s efforts, and those of many other traveling physicians, ensure that residents of these rural areas receive the medical attention they need without having to travel long distances.</p><p><a class="btn btn-primary" href="https://www.rmpbs.org/blogs/housing-transportation/charles-frankum-colorado-doctor-pilot" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 03 Apr 2025 11:57:53 -0500 Access to Care in Vulnerable Communities /lettercomment/2025-03-27-aha-letter-opposing-physician-led-and-rural-access-quality-care-act-hr2191 <p>March 25, 2025</p><p>The Honorable Morgan Griffith<br>U.S. House of Representatives<br>2110 Rayburn House Office Building<br>Washington, DC 20515</p><p>Dear Representative Griffith:</p><p>On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the ���������� Association (AHA) writes to express our opposition to H.R. 2191, the Physician Led and Rural Access to Quality Care Act.</p><p>Rural hospitals are essential access points for care, economic anchors for their communities, and the backbone of our nation’s rural communities. These hospitals have maintained their commitment to ensuring local access to high-quality, affordable care despite continued financial and workforce challenges. The AHA strongly supports legislation that would enable rural hospitals across the nation to better care for their communities. However, we believe that H.R. 2191 is misguided legislation that would skew the health care marketplace in favor of physicians who self-refer patients to hospitals they own and would destabilize rural health care while failing to improve access to quality care.</p><p>H.R. 2191 would result in additional gaming of the Medicare program, jeopardize patient access to emergency care, potentially harm sicker and lower-income patients, and severely damage the ability of 24/7 full-service community hospitals to provide care in rural areas.</p><p>Physician self-referral — whether in rural, suburban or urban communities — is the antithesis of fair competition. The problematic practice allows physicians to steer their most profitable cases to facilities they own — facilities that often call 9-1-1 to handle their emergencies and are often located in the most affluent areas. By performing the highest-paying procedures for the best-insured patients, physician-owners inflate health care costs and drain essential resources from community hospitals, which depend on a balance of services and patients to provide indispensable treatment, such as behavioral health and trauma care. By increasing the presence of these self-referral arrangements, H.R. 2191 would only further destabilize community care.</p><p>Since the Medicare Modernization Act of 2003, Congress has supported ending the egregious and costly practice of physician self-referral to hospitals they own. Current law represents a 15-year compromise that (1) allows existing physician-owned hospitals (POHs) to continue to treat Medicare patients, (2) permits the expansion of those physician-owned hospitals that meet communities’ needs for additional hospital capacity and treat low-income patients, and (3) prohibits Medicare from covering services in any new physician-owned hospitals established after Dec. 31, 2010. Congress established these guardrails to protect the Medicare program from overutilization, patient steering and the harmful patient selection practices that POHs employ.</p><p>Data have shown time and time again that POHs select only the healthiest and most profitable patients, serving lower proportions of Medicaid, dual eligible and uncompensated care than full-service acute care hospitals. The <a href="https://www.cbo.gov/sites/default/files/111th-congress-2009-2010/costestimate/amendreconprop.pdf" target="_blank" title="Congressional Budget Office Website">Congressional Budget Office</a>, the <a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/Mar05_SpecHospitals.pdf" target="_blank" title="Medicare Payment Advisory Commission">Medicare Payment Advisory Commission</a> and the <a href="https://public-inspection.federalregister.gov/2023-16252.pdf" target="_blank" title="Center for Medicare & Medicaid Services">Centers for Medicare & Medicaid Services</a> all have concluded that physician self-referral leads to greater per capita utilization of services and higher costs for the Medicare program, among other negative impacts.</p><p>For these reasons, the AHA strongly opposes the expansion of POHs — by either creating new categories of exceptions or allowing existing POHs to expand — and cannot support H.R. 2191. Congress should maintain current law, preserve the ban on physician self-referrals to new physician-owned hospitals, and retain restrictions on the growth of existing physician-owned hospitals, regardless of location.</p><p>Sincerely,</p><p>/s/</p><p>Lisa Kidder Hrobsky<br>Senior Vice President, Advocacy and Political Affairs</p> Thu, 27 Mar 2025 10:36:14 -0500 Access to Care in Vulnerable Communities /role-hospitals-mainehealth-learning-collaborative-closes-gaps-care-people-experiencing-homelessness <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-03/ths-mainehealth-homeless-700x532.jpg" data-entity-uuid data-entity-type="file" alt="MaineHealth. A homeless man sits on steps outside a building, listening to a person doing community outreach" width="700" height="532" class="align-left"></p></div><p>More than 771,000 people in the U.S. experienced homelessness in 2024 — the highest number ever recorded and an increase of 18% from 2023, according to a <a href="https://www.huduser.gov/portal/sites/default/files/pdf/2024-AHAR-Part-1.pdf" target="_blank">Department of Housing and Urban Development report</a>. The HUD report estimated that homelessness in the state of Maine dropped by 36% in 2024. But Maine government officials and housing advocates believe that statistic underestimates the actual number of people who are experiencing homelessness, including those living in cars or in the woods.</p><p>To provide outreach, engagement and safe, person-centered care to those experiencing or at risk of homelessness, the MaineHealth–Preble Street Learning Collaborative (PSLC) was founded by MaineHealth Maine Medical Center, Preble Street — a nonprofit social service agency — and other community partners in Portland in January 2017.</p><p>Overall, the PSLC helps to identify gaps in care and reduce emergency department visits that could be addressed by primary care providers. Specific services offered by the collaborative include walk-in medical services, urgent care, follow-up care and wound care; case management and care coordination with other health care organizations for additional primary and specialty care; mental health outreach; dental care; and help accessing community resources.</p><p>Another element of the PSLC is engaging Maine Medical Center medical residents, along with behavioral health, dental, pharmacy and nursing professionals in training, for on-site learning activities. By meeting a client at a soup kitchen and then accompanying them to a PSLC visit or leading a support group session addressing the stress of living on the street or in a shelter, these medical residents and students become more aware of the needs of people dealing with sustained hardship and the impact of health disparities.</p><p>Community partners involved with the PSLC include Greater Portland Health, a federally qualified health center; Community Dental; Portland Public Health; Northern Light Mercy Hospital; and VA Maine Healthcare System.</p><p><a class="btn btn-primary" href="https://www.mainehealth.org/maine-medical-center/education-research/preble-street-learning-collaborative-pslc" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Wed, 12 Mar 2025 16:32:44 -0500 Access to Care in Vulnerable Communities /role-hospitals-hartford-healthcare-enhances-translation-services-deaf-and-hard-hearing-patients <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-02/ths-hartford-asl-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Hartford HealthCare. A female doctor gestures with hands while consulting with a male patient." width="700" height="532" class="align-left"></p></div><p>Better communication between patient and provider translates into better care. Hartford HealthCare in Connecticut is partnering with the American School for the Deaf to offer in-person American Sign Language services and other translation services for deaf and hard-of-hearing patients and their companions. The health system is adding a full-time ASL/English medical interpreter to its team so that patients can understand their providers and fully participate in conversations, including asking questions and requesting advice.</p><p>Interpretation services for Hartford HealthCare patients and their companions who are deaf or hard of hearing are available in person or on video. Patients also have access to assistive listening devices or qualified notetakers, depending on their communication preferences.</p><p>Announcing the partnership, Ajay Kumar, M.D., Hartford HealthCare executive vice president and chief clinical officer, observed, “It is our privilege — and responsibility — to meet the communication needs of those who rely on us as part of our work to promote the health and healing of all. Clear communication is essential for quality and safe care.”</p><p>In addition to ASL services, Hartford HealthCare provides <a href="https://hartfordhealthcare.org/patients-visitors/patients/interpretive-services">other interpretive services</a>, as needed or requested, for all patients, designated caregivers, families and loved ones — at no cost, 24/7/365. These services include a voice remote interpreter in more than a dozen languages, over-the-phone interpreter, qualified bilingual staff and in-person certified interpreters.</p><p><a class="btn btn-primary" href="https://charlottehungerford.org/about-us/news-press/news-detail?articleid=60005" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 13 Feb 2025 12:18:53 -0600 Access to Care in Vulnerable Communities /advancing-health-podcast/2025-02-10-case-change-addressing-new-yorks-health-care-challenges <p>Key findings from a report titled "The Case for Change" have identified four drivers of some of the most pressing challenges facing health care in New York state. In this conversation, Bea Grause, R.N., J.D., president of the Healthcare Association of New York State, discusses the tough findings and partnerships needed to solve these problems, insights into the correlation between health care and legislative advocacy, and how the report’s learnings are translatable to states around the country.</p><hr><div></div><hr><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> 00:00:01:07 - 00:00:21:05<br> Tom Haederle<br> Welcome to Advancing Health. Coming up in today's episode, a conversation with Bea Grause, president of the Health Care Association of New York State, about the drivers that have health care in the Empire State perched on the edge of - quote - an existential cliff. We'll talk about what can be done and what the rest of the country can learn from how New York is handling its health care challenges. </p> <p> 00:00:21:08 - 00:00:29:27<br> Tom Haederle<br> Your host today is yours truly. I'm Tom Haederle, senior communication specialist with the AHA. </p> <p> 00:00:30:00 - 00:00:45:26<br> Tom Haederle<br> Bea, thank you so much for joining me this morning. Really appreciate your time. And, appreciate your effort in helping our listeners get into what Billy Joel might call a New York State of Mind about what health care challenges and the most effective ways to address them. So welcome. And thank you for being here. </p> <p> 00:00:45:29 - 00:00:46:27<br> Bea Grause, R.N., J.D.<br> Thank you, Tom. </p> <p> 00:00:47:00 - 00:01:05:26<br> Tom Haederle<br> You really are so well qualified to assess the challenges of today's health care from so many angles. And I'd like to just briefly share with our Advancing Health friends a little bit about your background so they know you know where you're coming from. You began your career as a nurse, an RN. You have done time on Capitol Hill as a legislative aide. </p> <p> 00:01:05:29 - 00:01:26:11<br> Tom Haederle<br> I know you're a veteran of senior positions with two other state health associations, Vermont and Massachusetts. You're a former member of AHA's board of trustees - thank you for your service. You also found time along the way to earn a law degree. So you've been a very accomplished person. And now, of course, you're president of one of the largest and most influential health care associations in the country. </p> <p> 00:01:26:13 - 00:01:44:01<br> Tom Haederle<br> And really, the purpose of our discussion today is, to discuss the concern that you and many other people have about what you see happening in New York State that's led to the production of "The Case for Change," this this new report that's kind of - frankly, a punch in the gut when it comes to - in terms of shaking things up and speaking </p> <p> 00:01:44:02 - 00:01:55:09<br> Tom Haederle<br> very candidly about some of the problems that the state is facing, what needs to be done. So let's start there. What is happening in New York state that prompted the release of The Case for Change? </p> <p> 00:01:55:12 - 00:02:23:02<br> Bea Grause, R.N., J.D.<br> Sure. I think what is happening, really was the post-pandemic reality. We realized that state and federal lawmakers wanted to move on from the pandemic. And our members - and this was true for members, for hospitals and health systems across the country - they hadn't moved on. They were not able to move on from the pandemic. The workforce shortage that was beginning to emerge, exacerbated during the pandemic. </p> <p> 00:02:23:03 - 00:02:55:10<br> Bea Grause, R.N., J.D.<br> It's now a chronic national workforce shortage. As a nurse, I recognized that demographically, New York had an aging population, which, again, I know is happening in many other states, not all, but many other states across the country. And we wanted to understand that environment better, what was actually happening at the core? Because at the core of health care, I understood, is you have patients and you have people taking care of patients. </p> <p> 00:02:55:13 - 00:03:33:00<br> Bea Grause, R.N., J.D.<br> And we knew that we were facing a crisis in both the demographics and who was able to take care of the increasing and changing demand that we saw happening and our members saw happening every day. That's why we did the report, was really to better understand that environment. And it has really helped us in creating a narrative that cuts through all the clutter and gets to a common set of facts where, rather than talking about, you know, this is, you know, a sophisticated podcast. </p> <p> 00:03:33:00 - 00:04:08:13<br> Bea Grause, R.N., J.D.<br> So rather than continuing to talk about all the symptoms of what's wrong with our system: 343B crisis, site neutral, all of the many, many, many issues that are very confusing to lawmakers, very confusing to us. You know, we're the experts in that space. And to patients and to consumers and to businesses completely impenetrable. We began this report with looking at demographic data on patients who were currently using hospitals and post-acute care </p> <p> 00:04:08:15 - 00:04:38:13<br> Bea Grause, R.N., J.D.<br> now and ten years out into the future. That was our starting place and then obviously looked at workforce data as well. And that really helped us to create the narrative that patient demand was increasing and changing. We didn't have the right number or the right type of health care worker to meet that demand. We had consistent and long standing disparities in care, urban rural poverty, haves and have nots, both on the provider space as well as the patient space. </p> <p> 00:04:38:15 - 00:05:13:27<br> Bea Grause, R.N., J.D.<br> And all of that was leading to unaffordability at every level. At the government level, at the business level and the consumer level. And without resolution in those four areas, that is the tipping point or the existential cliff that will cause our system to fail. Everything else is a symptom. We're trying to make it more understandable as well as more compelling, not just to all of us who understand all the nouns and verbs in health care, but to lawmakers and consumers and others. </p> <p> 00:05:14:00 - 00:05:35:14<br> Tom Haederle<br> Of the four drivers that you just outlined: health care demand is growing. Health disparities persist. Affordability, and lack of enough workers to provide the care that really is ever-growing. Of those four, is there one that is - they're all important - but is there one that's primary concern, that really needs the most urgent attention? </p> <p> 00:05:35:16 - 00:06:16:12<br> Bea Grause, R.N., J.D.<br> I'm going to stick with demand. Because as a clinician, to me, demand drives everything. And you'll see in that report, as I often say, there's not a HANYS ten point plan on how to fix our health care system. It's not designed for that. It is designed to, again, put out a common set of facts to bring people together, particularly, you know, for here in New York, lawmakers and others, other stakeholders to talk about what are some of the strategic things that we need to begin to work on in order to solve some of these much more difficult problems that are not being talked about or not being understood and then therefore not being resolved. </p> <p> 00:06:16:15 - 00:06:54:10<br> Bea Grause, R.N., J.D.<br> So to me, the most important one is demand. And I'll just use New York for a second. In five years we are going to have 700,000 new, net new, senior citizens in New York State. And you know, I think, as you well know, the per capita spending for senior citizens increases as people age. And so when you think about our blue H, and the brand of that blue H, I always think about that from a patient perspective as the only open door. </p> <p> 00:06:54:12 - 00:07:21:18<br> Bea Grause, R.N., J.D.<br> So if you have other open doors to get health care in a community, you will use them. But if there are none, you will go into that blue H. And if you have a medical need at any point you will go through that hospital door and then your care journey will begin from there. So that demand and you can you see it in the headlines with crowded emergency rooms, overload, nursing home closures, back up in the emergency room, the inability to get an appointment. </p> <p> 00:07:21:19 - 00:07:47:06<br> Bea Grause, R.N., J.D.<br> You're starting to see the overload in health care systems happening today. It is largely being driven by elderly patients coming in, not being able to get upstairs to get to a bed because there are no health care workers there, or there are 80 or 90 patients who would be better served in a nursing home and cannot be discharged because there's no nursing home bed. </p> <p> 00:07:47:09 - 00:08:12:06<br> Tom Haederle<br> And what is the role of community collaboration and partnership in addressing that particular problem? And frankly, all four drivers. I know one of the key takeaways of the report is that it's a joint effort that involves many different partners. And if you could talk a little bit about finding the right organizations to work with and who needs to lead that discussion, and what comes out of having these collaborative partnerships underway? </p> <p> 00:08:12:09 - 00:08:51:18<br> Bea Grause, R.N., J.D.<br> There are no right or wrong organizations that we're looking at. We're talking to other provider groups, businesses, unions. Using The Case for Change report to try to get a common understanding on the core facts and the core reasons for why our health care system is beginning to fail. And that collaboration is essential when you think about politics, state politics in this case, because you need to have, at least in New York, it is much better to get initiatives over the legislative finish line if you have a coalition, formal or informal. </p> <p> 00:08:51:24 - 00:09:02:01<br> Bea Grause, R.N., J.D.<br> But if you have broad based support, in other words, for an initiative for that year is a priority to try to get enacted. </p> <p> 00:09:02:03 - 00:09:07:25<br> Tom Haederle<br> Is there consensus around what we need to do in New York right now, or you feel or do you feel like you're getting there? </p> <p> 00:09:07:27 - 00:09:34:24<br> Bea Grause, R.N., J.D.<br> I feel like we're getting there. I have two examples. One is in the workforce space and the other is in the governor's budget, which our budget cycle has just begun. And we've been talking all year with Governor Hochul on using the case for change. And talking about the challenges that the state of New York faces with an aging population and a workforce shortage, primarily. </p> <p> 00:09:34:24 - 00:09:58:09<br> Bea Grause, R.N., J.D.<br> And, as you may know, I mean, the state of New York is already beginning to try to address disparities in care with the recent 1115 waiver. But certainly affordability is a huge problem for the state of New York. And helping them to understand that demand is going to increase for the next 25 years. The aging population will increase. </p> <p> 00:09:58:12 - 00:10:46:28<br> Bea Grause, R.N., J.D.<br> And it's not a question of if patients are going to need care, it's when and how much and where are they going to get that care. And if there's a mismatch between the capacity or the workforce gap gets worse, the cost to the state gets higher. And those kind of related messages, case for change related messages, were all part of our narrative with the governor all during last year. And in her budget and her state of the state, she did take a more strategic view, adopting many of those concepts in her budget and in her message to fund hospitals and nursing homes, but also for other across the continuum, continue to invest in workforce, </p> <p> 00:10:47:01 - 00:11:12:25<br> Bea Grause, R.N., J.D.<br> but also invest in capital so that more sites of care can be provided upstream or, you know, pre-hospital, so that patients are actually getting care outside of the hospital where they need to get care, and decreasing that expensive demand on hospital and post-acute services. So we were very pleased to see more strategic framing with the governor. So that's example number one. </p> <p> 00:11:12:25 - 00:11:48:06<br> Bea Grause, R.N., J.D.<br> Example number two is in workforce. As an advocacy organization where we are particularly and more externally or visibly focused on reaching out to other stakeholders to work on a whole host of workforce initiatives that are designed to recruit new workers, retain workers, eliminate the bottleneck in terms of not enough, faculty for, as one example, helping various health professions expand, work up to their full license. </p> <p> 00:11:48:09 - 00:12:01:29<br> Bea Grause, R.N., J.D.<br> And all of that is designed to close that gap in health care workers, particularly in the post-acute space, which hopefully will improve capacity. But it will help to bend that expense growth curve. </p> <p> 00:12:02:02 - 00:12:21:12<br> Tom Haederle<br> As we wrap up, we're almost at the end of our time, let me ask this. The concepts that are presented in The Case for Change, how translatable are they, would you say, to other systems because the four drivers that you've mentioned facing New York's system really can be found to a greater or lesser degree in every health system in the country. </p> <p> 00:12:21:12 - 00:13:11:18<br> Bea Grause, R.N., J.D.<br> 100% translatable. I mean, just imagine, Tom, if there were a case for change narratives, rather than having lawmakers and others confused around 50 different issues where you have different groups, one side opposes, the other supports, lawmakers cannot break through that noise. And I've talked to many lawmakers who find health care impossibly confusing. So I think having this common set of facts that are based in what we all care about, that we have access to care that someone's going to be there to take care of us, that we're helping communities and individuals who don't have access to care, and that we're trying to make health care more affordable over time. </p> <p> 00:13:11:21 - 00:13:38:23<br> Bea Grause, R.N., J.D.<br> That is a narrative that I think we can all relate to. And I think when people understand and look at the details in the report and again, anybody who wants to take that report and make it, you know, it's open source, take it and build on that narrative. But if we were all and when I say we, but if providers across the continuum, providers in other states or associations in other states were using that, I call it a patient forward-narrative, </p> <p> 00:13:38:23 - 00:14:15:20<br> Bea Grause, R.N., J.D.<br> and framing it that way, lawmakers would then begin to think that way. Because if they if that's all they're hearing and they're hearing that consistent message: We're concerned about access. We're concerned about ED overloading. We're concerned about a workforce shortage. We want to make sure, we think it makes good economic sense to provide health care to underserved communities. If they're hearing those messages consistently and have written documents and written reports and other information to help them to understand that, and it will start to make sense to them. </p> <p> 00:14:15:22 - 00:14:34:20<br> Tom Haederle<br> That is a great summation. Thank you so much. You have been listening to us discuss a new report called The Case for Change. This has, come from the Health Care Association of New York State. Thanks again, Bea. Really appreciate your time. And good luck with making progress on the changes facing New York State right now. </p> <p> 00:14:34:23 - 00:14:39:04<br> Bea Grause, R.N., J.D.<br> Thank you, Tom, so much. This has been such a great conversation. </p> <p> 00:14:39:07 - 00:14:47:13<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> Mon, 10 Feb 2025 08:36:45 -0600 Access to Care in Vulnerable Communities /role-hospitals-hca-florida-university-hospital-kosher-room-provides-comfort-and-support-jewish-patients-and-families <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><p><img src="/sites/default/files/2025-02/ths-hca-florida-kosher-room-700x532.jpg" data-entity-uuid data-entity-type="file" alt="HCA Florida. A lit candle in front of a Star of David." width="700" height="532" class="align-left"></p></div><p>Hospitals strive to be welcoming to all — not just when it comes to meeting patients’ physical needs, but also their mental, spiritual and cultural needs. HCA Florida University Hospital took a step in that direction by opening the Kosher Room in December 2024.</p><p>The room is designed to support Jewish patients and their families and includes kitchen facilities and food that meet kosher dietary requirements, as well as a variety of spiritual resources. Healing Hearts, a local nonprofit, ensures that the room is stocked and ready 24/7.</p><p>“The Kosher Room reflects our dedication to serving the diverse needs of our community,” said Blake Hunter, chief operating officer at the hospital. “By providing this place, we are creating a supportive environment where families can feel at ease while focusing on their loved ones’ care.”</p><p><a class="btn btn-primary" href="https://southfloridahospitalnews.com/hca-florida-university-hospital-opens-kosher-room-to-support-jewish-patients-and-families/" target="_blank" title="Learn More">LEARN MORE</a></p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/advocacy/access-and-health-coverage">Access to Care</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Wed, 05 Feb 2025 13:58:17 -0600 Access to Care in Vulnerable Communities /role-hospitals-butler-hospital-leads-research-education-and-community-outreach-alzheimers <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-6"><p><img src="/sites/default/files/2025-01/THS-butler-alzheimers-research-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP)." width="700" height="532"></p></div><p>Butler Hospital in Providence, R.I., is leading research studies on prevention, diagnosis and treatment of Alzheimer's disease and related dementia through its multifaceted Memory and Aging Program (MAP). It’s an urgent health concern as Alzheimer’s currently has no cure.</p><p>Nearly 7 million people in America are living with Alzheimer’s, the most common cause of dementia. Though the disease is not a normal part of aging, the greatest known risk factor is increasing age. It’s estimated that 1 in 3 adults over age 65 dies with Alzheimer’s or another dementia, according to the <a href="https://www.alz.org/alzheimers-dementia/what-is-alzheimers" target="_blank">Alzheimer’s Association</a>.</p><p>Part of MAP at Butler Hospital is a prevention registry for people with normal memory or mild memory loss interested in participating in a research study or clinical trial. Several active studies on preventing and treating Alzheimer’s are open for enrollment, led by MAP’s team of neurologists, neuropsychologists, research and clinical nurses, interns and post-doctoral fellows, and research assistants.</p><p>In addition, MAP is expanding its Spanish-language outreach initiatives. Hispanic people are 1.5 times more likely to develop Alzheimer's compared to non-Hispanic white individuals. MAP partners with local health clinics and community centers to offer memory screenings, educational programs on brain health and aging, and research opportunities to historically marginalized communities. Presentations and information are offered in English and Spanish.</p><p>To further increase outreach, MAP recently implemented an advance translation system that offers a wider range of languages and improved translations.</p><p>Learn more about <a href="https://www.butler.org" target="_blank">MAP</a> and its <a href="https://www.butler.org/memoryandaging/beyond-translation-the-memory-and-aging-programs-culturally-tailored-approach-to-raising-alzheimers-awareness-in-the-hispanic-community" target="_blank">community outreach efforts</a>.</p></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 21 Jan 2025 10:28:20 -0600 Access to Care in Vulnerable Communities