Coverage counts when it comes to meeting the AHA's vision of healthy communities, where all individuals reach their highest potential for health. Health care coverage means more than access to care when we are sick or injured; it is the passport to staying healthy and preventing the chronic illnesses that account for a high percentage of health care spending.
Conversely, lack of coverage can result in lost opportunities to improve health and longevity. Without coverage, people may not be able to go to school or work, with long-term consequences for productivity. Families and health care providers may face financial stress. America's hospitals have a long and proud history of providing people in their communities with access to needed health care services; now they also have the opportunity to connect their neighbors to necessary health care coverage.
The good news is that more than 25 million Americans who do not have health care coverage today may gain access through private options available through the new health insurance marketplace and public options through Medicaid and the Children's Health Insurance Program. This expansion of coverage is part of the implementation of the Patient Protection and Affordable Care Act. The federal and state governments launched a six-month open enrollment period Oct. 1. New coverage will take effect on Jan. 1, 2014.
The bad news? Most Americans do not feel that they have enough information to understand how expanded coverage would affect them and their families. Many are understandably confused, in fact, about whether the ACA will be implemented. Hospitals, as trusted community leaders, can play a pivotal role in answering questions and helping their neighbors with enrollment.
The marketplaces aimed at individuals who do not have health insurance from their jobs and must buy it on their own differ from state to state. They are a new concept, and people won't use them to enroll in affordable new coverage if they don't know about them. Adding to the challenge is state-to-state differences in Medicaid expansion. Getting information to those who need it about coverage options and the financial assistance that is available is a big job. Many of your neighbors are looking forward to taking advantage of this new opportunity, but some people will need to be educated about the value of coverage. That includes young people, who may not feel that they need coverage but whose participation is crucial.
There's nothing more critical than your connection to the community you serve. As a trusted health care provider and community leader, you can use that special connection to help patients get appropriate coverage and make the enrollment process easy, accessible and widely available.
To support your efforts, the AHA has created a new "Get Enrolled" page on www.aha.org. It has links to an extensive collection of AHA, national and state-specific resources and is updated frequently.
Coverage is coming — but we have to help it happen.
Rich Umbdenstock is president and CEO of the American Hospital Association.
News from the AHA
Mergers part of building care continuum, Congress told
Health care providers are transforming care delivery to improve quality and lower costs, and mergers and acquisitions are often essential to those goals, an AHA witness testified before a House subcommittee in September. "There's no question that the health care field is undergoing a period of fundamental transformation in which the very model of health care delivery is being changed in order to improve quality and lower costs," said Sharis Pozen, a partner at Skadden, Arps, Slate, Meagher & Flom. Providers often choose consolidation as one way to gain enhanced efficiencies and quality "because regulatory barriers can keep hospitals and doctors from working closely together unless they are under the same ownership umbrella." Still, only 12 percent of hospitals were involved in a merger or acquisition between 2007 and June 2013. Visit www.aha.org/research/policy/2013.shtml.
Patient safety checklists
The Hospitals in Pursuit of Excellence free guide "Checklists to Improve Patient Safety" is a compilation of checklists to prevent patient harm in 10 areas: adverse drug events, catheter-associated urinary tract infections, central line-associated blood stream infections, injuries from falls and immobility, pressure ulcers, surgical-site infections, and obstetrical adverse events and early elective deliveries. Hospitals and health care systems that use checklists can reduce mortality, complications, injuries and other patient harm. Visit www.hpoe.org/checklists-improve-patient-safety.
Spread the word
The AHA and other hospital and physician groups have joined the Health & Human Services' Champions for Coverage initiative to help get out the word about the new health insurance marketplace, otherwise known as exchanges. Participants help promote the marketplace at HealthCare.gov and CuidadoDeSalud.gov and the Consumer Call Center at 800-318-2596.