As of June 22, 2023, New York state hospitals and ambulatory surgery centers are among the New York Article 28 facilities that must file Health Equity Impact Assessment documentation when submitting a Certificate of Need application. The goal of this change is to “provide information on whether a proposed project impacts the delivery of or access to services for the service area, particularly medically underserved groups,” according to the New York State Department of Health . To help you better understand the CON HEIA requirement and its impact, we put together five fast facts to get you up to speed and ready to tackle the new requirement. Multiple facilities are subject to the new requirement Under the new requirement, the following New York state Article 28 facilities must complete an HEIA requirement criteria form to determine whether they are subject to the new equity assessment: hospitals; ambulatory surgery centers; nursing homes; select diagnostic and treatment centers; and mi...

The Making Care Primary model presents a unique new opportunity for practices to deliver advanced primary care over 10.5 years. As a primary care provider, you may be wondering whether you should take on the risk and how you’ll manage the program requirements, especially if you’ve never participated in a value-based care model before. In this blog, we’ll cover four noteworthy model benefits you may not have considered. These model design elements aim to reduce historic participation barriers and provide an on-ramp for primary care practices to transition to value-based care.   Benefit #1: New structure that encourages participation Unlike other alternative payment models, MCP aims to reduce financial exposure and some of the upfront infrastructure challenges for primary care practices with no or limited value-based care experience. CMS created these flexibilities to encourage more primary care clinicians to participate, especially small, independent, rural and safety net organizat...

In the last three years, market disrupters in healthcare have increased their activity and deepened their presence. Although they bring about change, not all market disrupters are negative. Using the strategies discussed in Market Disruption: Threat or Opportunity , we’ll walk you through nine tactics to help you leverage disrupters. What are market disrupters? Market disrupters are defined as any person, product or idea that radically and permanently changes the way an industry operates, according to Western Governors University . Healthcare market disrupters use multiple strategies to address challenges like physician burnout, patient satisfaction and electronic health record shortcomings. While not all disrupter solutions succeed, new care models and technology-enabled value-based care platforms have gained traction. Currently, hospitals and health systems are tailoring their strategies to reflect: disrupters’ prime targets; current service strength and diversity; and local market d...

Multiple organizations have prioritized provider health equity requirements — from new CMS priorities in their Framework for Health Equity to accreditation standards from The Joint Commission. NCQA’s Health Equity Accreditation is one of its newest programs . Introduced in 2021, HEA expands accreditation from payers to multiple stakeholders including medical practices and health systems. A second NCQA accreditation, Health Equity Accreditation Plus, takes practices further into the social drivers of health and community partnerships. With so many existing demands, it’s natural for a medical practice to ask: Why should we pursue HEA or HEA+, and what are the benefits for our patients and practice? In this blog, we’ll cover three ways NCQA accreditation helps medical practices improve health equity and achieve full practice transformation under this new model of care. How NCQA Health Equity Accreditation can reduce health disparities 1. Increase patient awareness NCQA’s HEA standards hel...

In August, CMS published the final Medicare Inpatient Prospective Payment rule for the federal fiscal year 2024. Most changes announced in the proposed rule were adopted and several are significant, including: Disproportionate Share Hospitals payment cuts; and a Rural Wage Index recalculation with diverse impacts. In this blog, we’ll cover these updates, the IPPS rule's total payment increase and how CMS continues to prioritize health equity in its rulemaking. The most significant IPPS final rule impacts 1. DSH UCC pool payment cuts For FFY 2024, DSH uncompensated care pool payments will decrease by $595 million due to decreased funding projections and a big adjustment to Factor 2 (see below), even though the DSH methodology is the same. This means DSH hospitals will need to find a way to recoup these losses, a challenge given the disadvantaged areas where they operate. If Affordable Care Act Marketplace plan enrollment continues to increase, Factor 2 cuts will continue. DSH UCC...

Data is at the heart of a Community Health Assessment . CHAs exist to collect community input, use that feedback to identify unmet needs and intervene effectively. A CHA cannot be fully effective without accurate, community-focused data. But these data are not easy for public health departments to locate, acquire, format or interpret — even if it comes from a single, reliable source. CHA data must be high-volume, high-quality and diverse. That takes time, staff and expertise which are often in short supply at public health departments. Faced with this daunting effort, health departments may rush past data to intervention, which could be a costly mistake. They may lose sight of the CHA's purpose beyond accreditation, make incorrect assumptions about community needs and ignore better resources. While data may be the most difficult CHA step, there are three ways you can help minimize the complexity. Overcome CHA data collection challenges 1. Remember why it matters Improved community ...

Assessing the needs of a community — through preparation, coordination and implementation — does more than check a box. It provides hospitals with insight into where time, money and resources should be dedicated to improve population health. This is the purpose of the Community Health Needs Assessment. Per the American Hospital Association’s guide , the CHNA includes multiple moving parts and contributors who: interview community leaders; hold stakeholder meetings; conduct patient surveys and query results; establish and participate in community focus groups; and analyze population health metadata. These steps can be time-consuming and unclear, leaving many to question whether they’re accurately evaluating their community’s needs — or just trying to meet compliance requirements. But, what if there’s a better way? In this blog, we’ll break down three steps you can use to simplify your CHNA, so you can drive the best outcomes for patients and providers. Three ways to simplify the CHNA 1....