Tuesday, January 21, 2014

Assignment Blog 2 for my students









  1. Safety net hospitals treat all patients regardless if they insurance or not. I read one article where a patient that was suffering from heart failure refused to go to the hospital because it was a safety net hospital. His argument was of the environment he felt that the quality of care was poor. According a study in this article they found that hospitals that were not safety net had more problems with malpractice than that of non-safety net hospital. What I took out of that article was that perhaps may be due to lack of patients with insurance some safety net hospitals may be closing because some of the paying patients refuse to get treated there. On the other hand in another article I read suggested that due to Obama care , safety net hospitals are in danger of closing because funding that they would receive from federal grants would not be available because they are helping with insurance. The article states the affordable care act creates a gap that leaves safety-net hospitals without any funding.
    My understanding of Accountable Care Organizations is that they focus on keeping patients healthy and out of the hospitals. Georgia has two locations one in Athens and the other in Savannah. ACO’s are said to “improve care for Medicare beneficiaries and slow rising costs by changing the incentives that influence how doctors and hospitals operate. Participation is voluntary for both providers and patients” (Andy MillerPublished: Apr 11, 2012).
    See more at: http://www.georgiahealthnews.com/2012/04/georgia-role-medicare%E2%80%99s-accountable-care/#sthash.zTfeVouk.dpuf

    1. Thank you, Angela. As I read your comment I though about the fact that many homeless people prefer to be on the street at night than in shelters, apparently because they feel safer on the streets. It is sad if some safey net hospitals have a poor reputation. I am thankful that I have been able to avoid emergency departments and that the couple of times long ago I went to an emergency department years ago, the facility was clean and service was good. I did not realize that there are already two ACOs in Georgia. Thank you for that information!

  2. A safety net hospital or health system provides a significant level of care to low-income, uninsured, and vulnerable populations. Safety net hospitals are not necessarily distinguished from other providers by ownership – some are publicly owned and operated by local or state governments and some are nonprofit. Currently, Medicaid DSH [Disproportionate Share Hospital program] disburses $11.5 billion annually to the states, which have considerable latitude in allocating these funds. Some states carefully target their DSH payments to hospitals providing large volumes of uncompensated care, but others, such as Ohio and Georgia, spread their payments broadly, transforming the program into a de facto subsidy of their hospital industry. If properly enforced, the proposed rule will help sustain the safety net. But if the state governments that refused to expand Medicaid also refuse to rethink their approach to allocating DSH funds, there will be little money left to sustain their safety-net hospitals when the cuts deepen in 2017. The cascade of service reductions and facility closures that this could trigger would have sweeping consequences. The proposed DSH rule is a good start, but much remains to be done.


  3. Despite the criticism that Safety Net Hospitals receive, in low income communities such as i grew up in, they can be considered as a life saver especially for those who are not insured. Although the quality of service may not be grade A, most patients would rather have someone look at them than for no one at all. When i was 17 i was in a car wreck and broke my femur and had to go to the hospital with no insurance. At first my parents were skeptical about which one i should get go to but without insurance, a hospital in Brunswick politely admitted me and treated me with the best care they could produce. Yes, there were a few things i felt they could have did better but I couldnt complain due to the fact that i did not have insurance and they still took care of me.


    1. Thank you, Joe, for sharing both your insights and your experience.

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  5. Safety net hospitals are quite commonly used by most of Americans and it has been this way for many years. Safety net hospitals have been the pipeline for efficient healthcare services provided for the less fortunate Americans in highly populated cities. I read in a few articles that the medicare budget provided federally to safety net hospitals has a small responsibility in keeping the bills paid. Safety net hospitals are frowned upon by some consumers whom have insurance solely upon their disbelief of the quality of services. I predict that Obama care will possibly save some of the remaining safety net hospitals if there is a clear understanding of the most efficient way to compensate the consumer as well as the institution. The ACO from what i read is the best thing for elderly patients since the invention of slice bread! It provides a continuum of the patients health history as well as a system that the respective billing department can follow. I also read that the consumer will be notified by the physician if they are a member and can opt out if they desire. http://www.youtube.com/watch?v=zQIf2ggEp6s&feature=player_detailpage