Last week’s 30th Annual Symposium on Health Care Services: Research and Practice focused on the Medicare for All debate and bridging acute and post-acute care (PAC). The Symposium was sponsored by GNYHA and the United Hospital Fund (UHF), in collaboration with major health services organizations from the metropolitan New York region.
Drew Altman, PhD, President and CEO of the Henry J. Kaiser Family Foundation (KFF), discussed public opinions on the 2020 election and health care, including the divisiveness of the Medicare for All debate in his keynote speech. Dr. Altman noted that according to KFF polling, voters are very concerned about the increasingly unaffordable cost of health care. He said that with 90% of the US population insured, candidate messaging could benefit from focusing on “pocketbook” issues such as the rising costs of deductibles and premiums.
Dr. Altman also discussed the political dangers of the Medicare for All policy platform, confusion about the policy, and how it could potentially impact voters. He noted that despite the overall popularity of the Affordable Care Act and Medicaid expansion, the lack of deep public knowledge about these policies leaves them vulnerable to exploitation by political parties opposed to them. Dr. Altman emphasized the need to reframe the health care policy debate to be about cost rather than access and coverage.
Presenters discussed how they are bridging the gap between acute care and PAC. Harvard Medical School Health Care Policy Professor David Grabowski, PhD, discussed how alternative payment models, Medicare Advantage, and other new payment models are impacting PAC, most notably by reducing spending, with little improvement in patient outcomes.
UHF Team Leader and Quality Director Lynn Rogut discussed a UHF study on difficult PAC decisions—including how they are made and factors that can influence them—and strategies to improve communication, practices, and policies to better support more informed decision-making.
Mount Sinai Hospital Vice President of Quality Initiatives Claudia Colgan, RN, discussed Mount Sinai Health System’s efforts to implement patient-centered discharge planning by developing its high-value network of PAC providers, which includes 17 skilled nursing facilities and four certified health home agencies. She also detailed the many challenges that both hospitals and PAC providers face in the discharge planning process, including competing priorities and misaligned financial incentives that could inhibit a patient-centered process.
GNYHA Senior Vice President Tim Johnson moderated a panel discussion on various issues around acute care and PAC integration, including staffing challenges, end-of-life discussions, the for-profit nursing home industry, and the alignment of quality measures across PAC stakeholders.