On Monday, the American Hospital Association (AHA) delivered to the leaders of the U.S. Senate and House of Representatives a letter outlining priorities for hospitals for the remainder of this year, a lame-duck session following the Nov. 8 midterm election.
Included among the issues is a push to mitigate backlogs for patient discharge — a major concern for California hospitals as well as those throughout the nation — by establishing a federal per diem payment for these patients. From AHA’s letter:
“Significant workforce shortages at facilities, such as those in post-acute and behavioral health, are making it more difficult for acute care hospitals to discharge patients to the appropriate care setting. This means patients must remain in inpatient beds longer than is medically necessary. As a result, hospitals must bear the costs of caring for patients for those excess days without any reimbursement. We ask Congress to establish a temporary per diem payment targeted to hospitals to address this issue.”
This is an important advocacy initiative for patients — having them linger in suboptimal care settings means not only are they not getting treatment in the most appropriate facility, but also that patients who need care in hospitals face longer wait times.
In addition to supporting this federal effort through advocacy with California’s congressional delegation (watch for an alert from CHA when Congress returns after the election; it will be critical for your representatives to hear from you on this important issue), CHA is working to address similar backlogs caused by other administrative issues at the state level.
For example, patients experiencing psychiatric crisis being treated in emergency departments often languish as they await procedural approvals from county mental health officials; that is a process that must be expedited to make sure patients get the right care, in the right setting, as quickly as possible.
Another, recent change can further ameliorate the procedural morass that too often slows appropriate care delivery. A new process, developed by CHA with the Department of Health Care Services, enables hospitals to report to health plan regulators challenges with prior authorization that lead to delays in treatment.
The federal push and state work come at a time when hospitals are in dire financial straits. Regrettably, the goodwill that hospitals had built up during your collective response to COVID-19 has dissipated for policymakers. They — like much of the public — would like to move beyond the pandemic, regardless of the long-term damage it has done to community pillars like hospitals and the long clean-up that now falls to you.
It’s our job, with your help, to make sure they don’t forget what you’ve done and to educate them about what patients and communities could lose in the future without their help today.