AHA Unveils New Strategies on Ensuring Access to Health Care in Vulnerable Communities

The American Hospital Association (AHA) today unveiled a report outlining a menu of options for communities, hospitals and policymakers to ensure that vulnerable rural and urban communities have access to essential health care services. As the hospital field engages in its most significant transformation to date, 1 out of 3 hospitals is fighting to survive – potentially putting communities at risk for losing their access to local health care services.

“Many hospitals face challenges maintaining access to health care services in their communities and this report provides a pathway to ensure every hospital has an opportunity to be an access point and an anchor of service,” said AHA President and CEO Rick Pollack. “The strategies outlined in this report can serve as a roadmap for all communities as hospitals begin to redefine how they provide more integrated care.”

The AHA Board of Trustees recognized the challenges facing vulnerable rural and urban communities and the need for new integrated and comprehensive health care delivery and payment strategies, and created the Task Force for Ensuring Access to 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.

“As hospitals explore how to meet the needs of patients they serve, they will need to create strong ties to community stakeholders and this report offers alternatives for collaborative work to promote healthier communities,” said Jim Skogsbergh, president and CEO of Advocate Health Care and AHA Board Chairman.

“Our goal is to address the varying healthcare issues within our country’s diverse communities,” said Robert Henkel, president and CEO of Ascension Healthcare. “The solution to improved care is not ‘one size fits all,’ and we must continue to take into account the unique needs of individuals in both urban and rural areas. We have to continue advocating for access to quality healthcare services in the most appropriate settings for all.”

“Access to care in urban and small rural communities is critical to improve health in America, and we look forward to examining the work of the task force and their recommendations,” said Patrick Conway, M.D., Deputy Administrator for Innovation & Quality, CMS Chief Medical Officer.

“The Task Force has provided a menu of creative options, with corresponding policy recommendations, with which hospitals in vulnerable communities could lead positive transformation in health care delivery. Without such efforts, in the current environment, health care in the nation’s least well-served communities may seriously deteriorate,” said Bruce Vladeck, former CMS Administrator and senior advisor, Nexera Inc.

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.

The nine emerging strategies are:

• Addressing the Social Determinants of Health
• Global budgets
• Inpatient/Outpatient Transformation Strategy
• Emergency Medical Center
• Urgent Care Center
• Virtual Care Strategies
• Frontier Health System
• Rural Hospital-Health Clinic Strategy
• Indian Health Services Strategies

The AHA will work with Congress and CMS to create new payment models to support the successful implementation of the strategies. The AHA will also provide assistance and tools to communities and hospitals and health systems looking to adopt the task force-recommended strategies.

"Patients in vulnerable communities face formidable barriers to accessing quality health care and we laud AHA for exploring ways to overcome those barriers,” said Debra L. Ness, president of the National Partnership for Women & Families. “We look forward to working with AHA on these and other strategies, including partnering with patients in vulnerable communities and helping ensure that payment reform is implemented in ways that enhance patients’ access to care, so everyone will have the quality, affordable health care they need and deserve.”

“I commend the AHA for its recognition of the specific characteristics of vulnerable communities,” said Ronnie Musgrove, former Mississippi governor and chairman of the National Advisory Committee on Rural Health and Human Services. “This is an issue of particular importance in rural communities that the committee focused on last spring. We are concerned about how a rural community could maintain timely access to emergency and other core healthcare services in communities too small to support a full-service hospital but needing more services than offered by a typical primary care clinic.”

The report, with more detailed information on each strategy, case studies and a complete advocacy agenda and assistance strategy, is available at www.aha.org/ensuringaccess.

About the AHA

The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks, other providers of care and 43,000 individual members. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at www.aha.org.