2013 AHA Policy Research

AHA research reports examine key issues to inform the policy making process.  These include the TrendWatch series, a periodic AHA publication that reports on the latest trends affecting hospitals and the health care system (now conducted in collaboration with Avalere Health* www.avalerehealth.net), as well as other AHA sponsored studies.

How Hospital Mergers and Acquisitions Benefit Communities, The Center for Healthcare Economics and Policy, September 2013
Only a small fraction of hospitals have been involved in a transaction such as a merger or acquisition between 2007-2012, according to a new report from the American Hospital Association (AHA) and the Center for Healthcare Economics and Policy.  The report highlights how these transactions benefitted patients and the community by retaining vital services. 

The RAC Burden: How a Well-Intentioned Federal Program Has Become a Drain on Hospitals
The national Recovery Audit Contractor (RAC) program began in 2010 with the goal of ensuring accurate payments to Medicare providers. However, 4 years later, the program requires fundamental reform.

Hospitals Face Challenges Using Electronic Health Records to Generate Clinical Quality Measures
AHA commissioned a study to investigate hospital experiences with implementation of meaningful use stage 1 electronic clinical quality measures (eCQMs).  The study describes the experience with and impact of eCQM implementation in four hospitals.  Based on the experiences, the current approach to automated quality reporting does not yet deliver on the promise of feasibility, validity and reliability of measures or the reduction in reporting burden placed on hospitals. Specific policy changes are needed, starting with meaningful use stage 2, to redirect the electronic clinical quality reporting requirements to focus on a small set of well-tested measures supported by a mature policy infrastructure. 

Issue Brief: Hospitals Widely Expect to Meet ICD-10 Requirements by October 2014,  July, 2013
The AHA recently surveyed hospitals on their readiness to meet the October 1, 2014 deadline for the transition to the new ICD-10 classification systems for clinical diagnoses and procedures.  More than 94% of hospitals surveyed were fairly confident that they would meet the implementation date, and most are also working with their affiliated clinicians to ease the transition.  The issue brief highlights competing priorities – most notably meaningful use of EHRs – and possible risks to a successful transition.

Issue Brief: Sicker, More Complex Patients are Driving up Intensity of ED Care
Policymakers have noted an upward shift in the intensity of services provided to fee-for-service (FFS) Medicare beneficiaries in hospital emergency departments (EDs), as reflected in the level of evaluation and management (E/M) visits coded.  This report examines a number of factors contributing to this trend.

Read the full report 

Hospital Field Realignment Not Driving High Premium Increases, April 2013
Features of the Patient Protection and Affordable Care Act (ACA) and other market trends are driving a major realignment of the health care system.  Hospitals are strengthening ties to each other and physicians in an effort to respond to new global and fixed payment schemes as well as incentives for improved quality and efficiency, implementation of electronic medical records and care that is more coordinated across the continuum.  Much of this realignment involves mergers and acquisitions.  Health insurance plans are claiming that consolidation in the hospital field is leading to higher prices, which, in turn, will drive higher premium growth.  These allegations are completely inconsistent with data showing spending and price growth at record lows. 

The Economic Contribution of Hospitals, January 2013
Most people understand the role that hospitals play in providing vital health care services to their communities. In 2011, America's hospitals treated 129 million people in their emergency departments, provided care for 526 million other outpatients, performed 27 million surgeries, and delivered nearly 4 million babies. However, many people do not know that hospitals also play an important role in the economy. Nationally, hospitals employ almost 5.5 million people, support an additional 10 million jobs elsewhere in the economy, and annually create more than two trillion dollars in economic activity. Hospitals are also an economic mainstay, providing stability and even growth during times of recession – an important message for policy-makers, the business community and the public.  The AHA has released an issue brief  revealing the extensive state and national economic contribution made by hospitals.

Workforce Roles in a Redesigned Primary Care Model, January 2013
In September 2011, the American Hospital Association convened a roundtable of clinical and health systems experts to examine the future primary care workforce needs of patients, as well as the role hospitals and health care systems can play in effectively delivering primary care.

Issue Brief: Moving Towards Bundled Payment, January 2013
There has been a growing interest over the past several years in the concept of payment bundling, whereby services for physicians, hospitals, post-acute care providers and others would be "bundled" together into a single payment covering an episode of care over a specified period of time. This brief explores the key areas providers need to evaluate in consideration of bundled payments, including care episode development, cost distribution and variation, patient care pathways and pricing a bundle.



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