Health Reform Implementation: When Sausage-Making Moves Downtown Alliance for Health Reform Briefing Linda E.
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Health Reform Implementation: When Sausage-Making Moves Downtown Alliance for Health Reform Briefing Linda E. Fishman, Senior Vice President, Public Policy Analysis and Development July 9, 2010 Health Reform Implementation… This is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning. Winston Churchill, November 10, 1942 at the Lord Mayor's Luncheon at Mansion House in London, in response to the Allied victory at the Second Battle of El Alamein. “There will be bumps along the way. There will be twists and turns. It will not be easy. But, after decades of standing still, we are finally moving forward.” National Press Club April 6, 2010 Strategies for Regulatory Advocacy • Develop member resources/tools • Identify key issue areas for AHA involvement; chart timelines • Identify need for advisory groups, networks, taskforces • Solicit input/gather information from members, allied associations • Lead hospitals in rulemaking activities • Identify and pursue legislative fixes 31 Key Implementation Areas for Hospitals Delivery System Reforms • Integrated care models of delivery system reform (ACOs, bundling, medical home, CMS Center for Innovation) • Major hospital payment changes (update reductions, VBP, readmissions, hospitalacquired conditions (HACs), variation) • National Quality Strategy • Reducing health disparities Key Implementation Areas for Hospitals Other Health Reforms • Insurance reforms and exchanges StateBased • Medicaid expansion and payment adequacy • Program integrity and recovery audit contractor (RAC) expansion to Medicaid • Tax-exempt hospital requirements • Administrative simplification • Workforce Fitting It All Together Readmissions ACOs Medical Homes VBP Center for Innovation Models of Care Service Delivery Accountable Organizations Readmissions VBP HAC Post Acute Care Episode Bundling Acute Care Episode with Post Acute Care Bundling Primary Care Physicians Specialty Care Physicians Outpatient Hospital Care and ASCs Inpatient Hospital Acute Care Acute Care Bundling Medical Home Long Term Acute Hospital Care Inpatient Rehab Hospital Care Skilled Nursing Facility Care Home Health Care Health Reform Implementation: When Sausage-Making Moves Downtown Alliance for Health Reform Briefing Linda E. Fishman, Senior Vice President, Public Policy Analysis and Development July 9, 2010