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AHA Survey on Plan Denials, Network Adequacy Deadline Extended to Sept. 15

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The deadline to respond to the American Hospital Association survey requesting information on private plan utilization management practices and network adequacy has been extended to Sept. 15. California hospitals’ response rate has been low to date, and participation in this survey is important to our collaborative advocacy efforts. CHA will receive the California data. 

CHA DataSuite Releases Analyses of 2020 Long-Term Care and Skilled-Nursing Facility Final Rules

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CHA DataSuite has issued two hospital-specific analyses — one detailing the Centers for Medicare & Services (CMS) federal fiscal year (FFY) 2020 long-term care hospital (LTCH) prospective payment system (PPS) final rule, and the other detailing FFY 2020 Medicare skilled-nursing facility PPS final rule.

California Hospital Volunteer Impact Questionnaire

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The California Association of Hospitals and Health Systems has developed a multi-year, phased approach to volunteer data-gathering — and we need your help. 

Until now, hospital volunteer organizations have lacked a single data measurement tool that can support a collective, statewide database. Each hospital maintains its own style of calculating volunteer statistics or has no electronic system for gathering and comparing volunteer data. Hospitals have unique volunteer organizational structures, staffing and programs. This questionnaire represents an important first step toward building a robust California hospital volunteer database that will allow organizations to compare their data to those of similar hospitals. Because these data are intended for our collective benefit, individual responses will not be disclosed. 

Your input on the California Hospital Volunteer Impact Questionnaire© is crucial.  Thanks for taking this first step with us — click here to begin. The submission deadline has been extended. Your response is requested by October 11, 2019.

For further information, contact CAHHS Volunteer Services at (916) 552-7544 or
volunteers@calhospital.org.

Updates for the Week of Sept. 2

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The Centers for Medicare & Medicaid Services has released the following information:

Provider Claims Must Include Medicare Beneficiary Identifiers by End of Year
CMS Listening Session on Potential Changes to Overall Hospital Quality Star Ratings, Sept. 19  
Inpatient Rehabilitation Facility Appeals Settlement Option: Deadline Sept. 17
Quality Payment Program: Merit-based Incentive Payment System Targeted Review Request Deadline Sept. 30
Skilled-Nursing Facility Prospective Payment System Patient Driven Payment Model: Get Ready for Implementation on Oct. 1
Developing a Hospice Patient Assessment Tool Special Open Door Forum — Sept. 12

CHA Home Page Features Timely Content From Our Health California

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The CHA website now prominently features Our Health California — CHA’s digital community of more than 1 million supporters — with links to stories that positively position hospitals, as well as health-related articles, data, and more.

The Values of Hospitals

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Over the Labor Day weekend, The New York Times published a column critical of hospital spending. It called, ahead of the Democratic Primary debates, for elected officials and candidates to “address the elephant in the room and tell us how they plan to rein in hospital excesses.”

The data the author uses to form her call to action were carefully selected to support her position, and as is too often the case, fail to account for the myriad cost drivers beyond the control of hospital leaders, such as the high price of labor.

The American Hospital Association has already submitted a response to The New York Times, and has debunked some of the incorrect points in its blog.

We can argue data validity all day, and that work has its place. What’s more important, however, than simply correcting the record for this column – and hundreds of others like it in the past year – is that we take heed of a growing shift in how real people experience their hospital. Despite its many problems, the NYT column sadly does capture the sentiment of millions of Americans.

In June, NPR published “When Hospitals Sue for Unpaid Bills, It Can Be ‘Ruinous’ for Patients.” The piece offered multiple tales of the impact on patients and their families of garnished wages resulting from medical debt lawsuits.

Their stories are heartbreaking.

In the NPR story, the reporter interviewed Martin Makary, a surgeon and researcher at Johns Hopkins Medicine.

“Hospitals were built — mostly by churches — to be a safe haven for people regardless of one’s race, creed or ability to pay,” Markey said. “…They’re supposed to be community institutions.”

Markey is partially right when he says hospitals are supposed to be community institutions. There’s nothing “supposed” about it. You are community institutions.

You are there, 24/7, through all manner of emergencies, disasters, and more. You are economic pillars in your cities and counties. You wake up each day thinking about how to serve people better.

Even the NYT piece concedes: “…when their operations generate huge surpluses…they plow the money back into the system…build another cancer clinic…buy the newest scanner (whether it’s needed or not).”

It’s that last sentence that is troubling. Are we really at the point where we should think that building a cancer clinic or buying a scanner is a bad thing? These are investments that save and change lives. They are made solely with that purpose in mind.

It’s saddening that for some, the impact of not doing these things isn’t considered.

Which brings us back to the experience people have with their hospital and how they feel about that experience. There’s a joke about the airline industry here that is relevant. It goes something like this:

“There you are, 30,000 feet in the air, flying in an aluminum cylinder across the country to see your loved ones in just a few short hours, and all you do is complain that the movie selection is weak and the peanut bag is small. Where’s the appreciation for the miracle of flight itself?”

In 2019, this is our call to action as hospital leaders: to not only perform the daily medical miracles, but also to meet people where they are – so their hospital experience is one that matches your values of service, healing, and hope.

— Carmela

Applications for $38 Million in Graduate Medical Education Funding Available This Month

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Applications for $38 million in grants to expand graduate medical education (GME) in California primary care and emergency medicine residency programs will be available beginning Sept. 23. The funding – which will give priority to programs in medically underserved areas and that serve medically underserved populations – is being awarded through Physicians for a Healthy California’s GME program, CalMedForce.