Posts Tagged ‘academic health centers’

June 9, 2010

Academic health center-community health center partnerships vital to health reform

89 percent of respondents to a recent survey (Academic Health Centers and Community Health Centers: The Landscape of Current Partnerships) by the Association of Academic Health Centers reported that the academic health centerution had an established partnerhsip with one or more community health centers.  These partnerships range from providing primary and preventive care to managing centers, training students, and conducting research. More than 60 percent of the partnerships are with federally qualified health centers (FQHCs).  The FQHC label is part of a designation category designed by the Health Resources and Services Administration and the Centers for Medicare & Medicaid Services indicating that the facility serves a medically underserved or health profession shortage area.

In this era of health reform, such partnerships are vital not only to expand access to care but also to address the nation’s health workforce needs.    Because community health centers provide care to more than 20 million people, of which a vast majority live in poverty, it is important to ensure that the policies and practices associated with the establishment,  operations, and collaborations of the community health center not only facilitiate effective care but also  promote innovation in care delivery.

The academic health center-community health center partnership is one that should be encouraged but improvement in federal policy is also needed so that the partnerships can adapt to changing needs.  Policymakers will need to examine regulatory, financing, management, and governance barriers that may be preventing collaborative models of care to flourish.

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Posted in Health Reform, Uncategorized, arra, health care delivery models, health professions education, health workforce | 3 Comments »

January 14, 2010

Haitian Relief Efforts Underway at Academic Health Centers Nationwide

The impressive, timely, and often unrecognized response of academic health centers to disasters and health emergencies was reported today by Dr. Steven A. Wartman, president of the Association of Academic Health Centers (AAHC).  In the wake of the tragic and disasterous earthquake on the island nation of Haiti,  academic health centers nationwide are mobilizing to provide health professionals and services as well as medical equipment and  supplies and public health support.  Dr. Pascal J. Goldschmidt, Senior Vice President, Dean and CEO at the University of Miami, one of the first academic health centers to get people on the ground,  “In light of this enormous catastrophe that Haiti experienced, all of us at the Miller School and UHealth are committed to doing whatever we can to bring relief during this time of immense need.” 

Academic health center activities noted by  Dr. Wartman include:

  • The University of Miami has already placed a team on the ground, led by Chairman of Neurological Surgery Dr. Barth Green, and has been working with the South Florida Hospital Association to collect medical supplies that are urgently needed as well as to provide a mechanism for faculty and staff to be able to volunteer.
  • Dr. John Williams, provost and vice president for Health Affairs at The George Washington University, reports that GW emergency medicine physicians have deployed with the Fairfax Urban Search and Rescue Team, and others will follow as needed.
  • The University of Nebraska Medical Center, led by Dr. Harold Maurer, has indicated that UNMC Vice Chancellor for Academic Affairs Dr. Rubens Pamies, a native of Haiti, and Dr. Ayman El-Mohandes, dean of the College of Public Health, are in the midst of developing a centralized plan for relief efforts.
  • Dr. Ora Pescovitz, executive vice president for health affairs and CEO of the University of Michigan Health System, indicates that the University of Michigan Health System is mobilizing for a swift response.
  • Dr. David Ramsay, President of the University of Maryland, Baltimore, notes that a shock trauma team has been assembled and is working with the US Air Force and is either en route or on the ground at present.  He also points out that they have a PEPFAR project in Haiti, involving teams of physicians, nurses, and public health educators in HIV/AIDS, but they have not yet been successful in contacting them.
  • The University of Alabama at Birmingham’s Clinical Care Transport program is on the national stand-by list and is awaiting orders, according to Dr. Robert Rich, Senior VP and Dean.  
  • Dr. Robert Grossman, Dean and CEO of New York University Langone Medical Center, reports that NYU’s medical center community  is volunteering  to help with the emotional aspects of the disaster, including rallies to organize food, clothing drives, and donations.  They have also distributed information about how faculty, staff, and students can find information on the status of friends and loved ones in Haiti, along with a list of charitable organizations and agencies that are providing aid to earthquake victims.
  • SUNY Downstate Medical Center is home to the largest Haitian population outside of Haiti, according to Dr. John LaRosa, President.  As a result, they have responded by offering expanded counseling for students, faculty, and staff on a 24/7 basis in two locations as well as an open forum in the Alumni Auditorium.  They are also working in the larger community in Brooklyn with team members who are fluent in Kreyol and French, and working with other New York area agencies to coordinate and develop relief responses.
  • Dr. James Thompson, President of the Medical College of Georgia, reported that its Disaster Medical Assistance Team is ready to deploy as necessary, and that two faculty members are on the ground treating earthquake victims.  A hygiene supply drive is underway on campus as well.
  • SUNY Upstate Medical University in Syracuse has initiated a relief drive through the Office of Community Outreach and Global Health education and the University’s Council for Employee Volunteerism, according toSUNY Upstate Medical University in Syracuse has initiated a relief drive through the Office of Community Outreach and Global Health education and the University’s Council for Employee Volunteerism, according to President Dr. David Smith.  A group of Upstate students who recently returned from Haiti are spearheading this effort.

This is only a sampling of the efforts underway from institutions where people work every day to help and care for those in need.

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Posted in Events, News, disaster and emergency response | 2 Comments »

October 2, 2009

Congress: Listen to the Academic Health Center Leaders on Health Reform

I heard today that congressional staffers are “punch drunk” from logging in so many hours working on health reform.  I am not comforted by that thought given they are trying to  write one of the most significant pieces of legislation in decades.  I am  wary of the urgent rush to produce something—good or bad—to show that Congress is not twiddling its thumbs.  Does the Congress really have all the facts?  Or are they also developing legislation based on minimal or biased information, evidence, experience, or truth?

 I would point to an opinion piece in the LA Times by Dr. Philip Pizzo, dean of the school of medicine of Stanford University and chairman of the board of the Association of Academic Health Centers, where he wrote, “Undertaking such an important shift in how we deliver healthcare requires a robust national debate.” With the members of Congress getting ready to say yea or nay on health reform,  we still have not had sufficient debate from all sides.  The nation has heard too much from those leaders who, as Dr. Pizzo says, “choose to rely on fear instead of facts to make their case.”

 Before the votes get counted, we need to hear from the patients who really use and have experience with the health care system as it exists today.  We need to hear more from the leaders of the nation’s academic health centers–some of the most experienced experts on health care in the nation.  Most are physicians who not only have practiced medicine for decades but also have had distinguished careers in academe (and sometimes government).  Most of all, they know what it means to lead and operate an institution, without which our communities–and the health system–cannot function. 

These leaders, who also include nonphysicians, can tell us about patient care, the impact of health on communities, the health and economic consequences of  having no insurance,  and the problems with the current reimbursement system.  They can tell us what it is like to run health professions schools–from medicine to allied health,   major departments at a children’s or other teaching hospital, or an entire teaching hospital or  health system–and what facilitates or impedes care delivery.  

Academic health center leaders are the people at ground zero, making sure that the nation can provide health professions education, biomedical research, and patient care.  They are sustaining the infrastructure that may determine the nation’s future.  Congress should be listening to these voices of experience and reason.

Academic health center leaders know what it takes to provide patient care and sustain a health system in challenging economic times. They not only know the problems but also how to resolve them.  Academic health center  leaders for example, will tell the Congress why we need to establish a permanent workforce planning entity or board so we can resolve primary care shortages and rural health problems–and  ensure the nation has a health workforce for the future.  

Congressional staffers—stop running on empty and get MORE input, advice, and recommendations from the academic health center community.

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Posted in Health Reform, Uncategorized | No Comments »

August 18, 2009

A Real Health Reform Issue to Address: Medicare’s Clinical Trial Policy

Let’s get some real issues on the table in the health reform debate—like Medicare’s clinical trial policy.  The Medicare program is not only the key to current and future health care delivery in this nation but also the most critical link to all clinical research occurring throughout the nation. 

Good science—and new cures and treatments for a host of diseases and illnesses–require that Medicare beneficiaries participate in clinical trials.  That was the vision and purpose of the clinical trial policy, laid out in an executive memorandum signed by President Clinton in 2000.  The goal was to provide increased access for Medicare beneficiaries to clinical trials—and that is not happening. During the Bush Administration, the policy was not fulfilling its intent and, in fact, was quite dismantled, creating a situation that discouraged participation of seniors in trials.

It’s not only seniors. The President had better check his health plan because many of the government plans do not cover clinical trials—as they should. 

Health and Human Services Secretary Sebelius should be spending more time addressing this issue.  She can provide the leadership to reform Medicare’s clinical trial policy, which currently:

  • Compromises the quality and credibility of many research studies by discouraging enrollment of elderly patients
  • Limits coverage for the elderly to potentially life-saving therapies and treatments
  • Undermines the financial viability of the nation’s academic health centers where the majority of clinical trials take place
  • Increases the likelihood of an adverse impact on the nation’s economy and job market as clinical trials continue to move overseas.

The Association of Academic Health Centers (AAHC) has been at the forefront in calling for reform of the policy.  One of AAHC’s most important recommendations is for the HHS Secretary to establish the position of research coordinator at the Centers for Medicare & Medicaid Services (CMS) to oversee clinical research coverage policy.  This position would ensure that an expert with knowledge of clinical research and trials processes and operations is providing needed leadership and making the issue a national priority.

President Obama and Secretary Sebelius need to signal that they recognize the significance of Medicare’s clinical trial policy.  Appointing a permanent administrator for CMS would also be a good start.  If the Administration can’t address clinical  trial policy, there are  many on Capitol Hill who will check their health plans, suddenly wake up and take notice, and address Medicare’s clinical trial policy so they can claim some real progress on health care reform.

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Posted in Health Reform, clinical trial policy | No Comments »

August 6, 2009

Will employer-based health insurance rescue you?

For all those Americans worrying about health reform and fearing they will lose their current insurance, think about this.  Sixty percent of all U.S. bankruptcies are attributable to medical problems, according to a study by Dr. David Himmelstein and his colleagues at Harvard and Ohio University, published this month in The American Journal of Medicine. The share of bankruptcies attributable to medical problems rose by 49.6 % between 2001 and 2007.  “Medical” was based on debtors’ stated reasons for filing, income loss due to illness and the magnitues of their medical debts.

Here’s the kicker–Many families with continuous coverage found themselves under-insured and responsible for thousands of dollars of out-of-pocket costs (averaging almost $18K for all medically bankrupt families).  Because almost all insurance is linked to employment, a medical event can trigger loss of coverage, say the authors.  Nationally,  25% of firms cancel coverage immediately when an employee suffers a disabling illness (so much for your employer taking care of you); another 25% cancel coverage within a year.  

The fear mongering currently underway to make Americans believe they will be losing the security of their current insurance coverage  if the government steps into the act is truly intended to cover up the real threat.  It seems to me that a real fear is the potential actions of  employers (look at GM over the  years–or how about the steel or airline industries) vis-a-vis health insurance.  There’s no security there–and often they too are the victims of economic decline.

Finally, where do those people without insurance go? Answer: to the emergency rooms at academic health center hospitals throughout the country.  How do policymakers think these institutions can survive? The Association of Academic Health Centers found in 2008 that AAHC institutions, on average, provided almost $44 million in uncompensated patient care each year, with one in seven institutions providing more than $100 million. It is not clear how the reform packages will help these institutions.

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Posted in Health Reform, Policy | 1 Comment »