Publications

Quality

Tue, 13 Apr 2010 09:31:49 GMT

June 2010: Research Brief: NAPH Members Continue to Improve on Key Quality Measures

Thu, 29 Jul 2010 11:33:06 GMT

NAPH continuously tracks member performance on publicly reported quality measures. This Research Brief looks at the latest data release on CMS's Hospital Compare website and analyzes longitudinal trends between the averaged NAPH member scores and the averaged U.S. hospital scores. It concludes that NAPH members continue to outperform non-members on most core measures.

June 2007: NAPH Members Perform Well on CMS Core Measures

Wed, 28 Jul 2010 17:41:02 GMT

As part of its ongoing commitment to quality improvement, NAPH has been analyzing member-versus-national hospital performance on the 21 key measures that the federal Centers for Medicare and Medicaid Services (CMS) is using in its Medicare "pay-for-reporting" effort. These measures cover four clinical conditions: heart attack, heart failure, pneumonia, and surgical care infection prevention. NAPH's analysis concludes that its members score well across the board, particularly on CMS's cardiovascular measures.

October 2006: Quality Measures: A Major Focus for NAPH

Wed, 28 Jul 2010 17:45:51 GMT

This Research Brief summarizes the hospital quality measurement development process. It also reviews recommended measures by the Centers for Medicare & Medicaid Services (CMS) and describes current NAPH activities around quality improvement.

October 2008: HCAHPS Survey: Patients' Perspective of Care

Wed, 28 Jul 2010 17:25:31 GMT

Patient satisfaction is an increasingly critical piece of how hospitals and the Centers for Medicare and Medicaid Services (CMS) measure quality of care. Indeed, CMS has recently begun publicly reporting results of a patient satisfaction survey, called the "Hospital Consumer Assessment of Healthcare Providers and Systems" (or "HCAHPS"). This Research Brief explores factors leading to HCAHPS development and its fiscal implications, as well as performance of NAPH member hospitals in the initial data reporting periods.

December 2009: NAPH Members Embrace Transparency in Quality Performance

Thu, 29 Jul 2010 11:23:47 GMT

The brief provides an overview of members' efforts to share their quality data both internally (with hospital staff, board members, and executives), as well as externally (with patients and community members). The report provides information on the trend of external transparency in public hospitals, the practices that they have implemented to be more transparent, and the impact that transparency has had on five member hospitals that are leaders in this area.

June 2009: NAPH Influence and Involvement in the National Quality Forum

Thu, 29 Jul 2010 11:24:37 GMT

This Research Brief describes NAPH's involvement with National Quality Forum(NQF) activities and provides information to increase member involvement in the NQF consensus development process.

June 2009: Kaiser Scholarships Help NAPH Members Reach Quality Goals

Thu, 29 Jul 2010 11:28:43 GMT

NAPH and its research affiliate, the National Public Health and Hospital Institute (NPHHI), publish a series of Research Briefs that inform NAPH members and share innovative and important practices among NAPH members. This Research Brief describes a special member benefit that has made a significant contribution to NAPH's quality improvement agenda.

September 2009: CMS Releases Latest Quality Data: NAPH Members Outperform on Most Core Measures

Thu, 29 Jul 2010 11:29:35 GMT

This research brief analyses CMS's July 2009 release of hospital performance scores on Hospital Compare. Specifically, the analysis compares aggregated NAPH members' scores with those of hospitals nationally and discusses data trends over time.

February 2010: Safety Net Hospitals Establish "Medical Homes"

Thu, 29 Jul 2010 11:27:27 GMT

This Research Brief on safety net hospital and health system implementation of the medical home model of care provides an overview of NAPH member medical home programs and identifies common characteristics of such programs. It also shares evidence from the literature about the efficacy of medical homes in improving quality of care and reducing both costs and emergency department visits.

Emergency Preparedness

Tue, 13 Apr 2010 09:33:46 GMT

October 2007: Research Brief: Designated Coordinators Boost Preparedness Efforts at Public Hospitals

Thu, 29 Jul 2010 11:31:57 GMT

Most public hospital facilities assign disaster preparedness functions to existing staff, who take on this role in addition to their other responsibilities. However, to stay atop the ever-growing demand for disaster readiness activities, a new trend is emerging in public hospitals: the creation of a full-time, dedicated staff position with the sole responsibility of coordinating, integrating, and assessing preparedness activities for the hospital. To gain insight into this emerging trend, NPHHI conducted a telephone survey of dedicated disaster planners at NAPH facilities. This Research Brief presents findings from that survey.

Summer 2007: The Safety Net Magazine: Emergency Preparedness - Safety Net Hospitals Ready When Disaster Strikes

Thu, 29 Jul 2010 11:31:11 GMT

Safety net hospitals and health systems are the essential foundation of the nations emergency health system. This magazine showcases NAPH members across the nation who stand ready when disaster strikes.

June 2007: Emergency Preparedness in Public Hospitals: Complete Findings of the 2006-2007 Emergency Preparedness Study

Thu, 29 Jul 2010 11:29:57 GMT

Summer 2007

NAPH's comprehensive emergency preparedness (EP) research study to, conducted in 2006-2007, sought to: (1) determine the role of public hospitals during an emergency, and (2) identify emergency related concerns and activities at member hospitals. The study covered a broad range of topics-from communications systems to worried-well management, and is the most comprehensive work to date on safety net hospital preparedness. This monograph presents the full set of findings from this study.

May 2008: Recent Changes to Emergency Preparedness Mandates and Funding

Wed, 28 Jul 2010 17:47:33 GMT

This Research Brief provides an update on upcoming and recent changes in hospital preparedness regulations, as well as changes in federal grant administration. Specifically, it outlines upcoming federal mandates for National Incident Management System compliance, new Joint Commission emergency management standards, and changes in federal preparedness funding.

May 2007: Hospital Staffing and Surge Capacity During a Disaster Event

Wed, 28 Jul 2010 17:26:27 GMT

Recent disasters like the Northeast Blackout of 2003 and Hurricane Katrina have given NAPH members firsthand experience activating complex surge capacity plans. This Research Brief describes key findings from NAPH's 2007-2008 emergency preparedness study, particularly focusing upon NAPH members' structural surge capacity plans, provisions for staff and their families, identifying and credentialing additional health care professionals, and emergency preparedness training strategies for hospital personnel.

September 2006: Findings from the NPHHI Preliminary Emergency Preparedness Survey

Wed, 28 Jul 2010 17:23:42 GMT

This Research Brief describes the key findings from the intial phase of NAPH's emergency preparedness research study, which was a preliminary survey to gather data on preparedness efforts in public hosptials. It provides information about the special role of safety net hospitals during emergencies and explores issues around hospital staffing, preparedness equipment, staff training, and additional financial needs and priorities for member hospitals to increase planning efforts.

Chronic Conditions

Tue, 13 Apr 2010 09:36:13 GMT

May 2005: Innovative Chronic Care Programs in Public Hospitals and Health Systems

Wed, 28 Jul 2010 17:04:44 GMT

This Monograph provides a brief overview of the challenges that public hospitals and health systems face in attempting to improve chronic care. It offers case studies of chronic care improvement efforts in six public hospitals and health systems, and reviews the three models that have become the foundation for chronic care improvement. Finally, the report concludes by exploring common themes and offering recommendations for hospitals to consider in managing chronic care patients.

June 2005: Caring for Patients with Diabetes in Safety Net Hospitals and Health Systems: What Patients Say About Their Care

Wed, 28 Jul 2010 17:14:59 GMT

With support from The Commonwealth Fund, NPHHI conducted a survey of diabetes patients who received care from four hospital systems: Cambridge Health Alliance, Community Health Network of San Francisco/San Francisco General Hospital, Cook County Health & Hospitals Systems, and LSU/Medical Center of Louisiana at New Orleans. This report summarizes survey results, including information on overall patient satisfaction with diabetes care, access to important diabetes-related services, individual diabetes management, health status, and communication with health care providers.

November 2007: Research Brief: Obesity Treatment Programs in Public Hospitals and Health Systems

Wed, 28 Jul 2010 17:45:00 GMT

With guidance from an advisory board of experts at NAPH facilities, NPHHI conducted a study of NAPH members to better understand the scope of public hospital obesity-related interventions. This Research Brief provides a summary of the study results. For more detailed findings, please see the related monograph, published in April 2008.

April 2008: Obesity Treatment Programs in Public Hospitals and Health Systems: Complete Findings of the NPHHI Study

Wed, 28 Jul 2010 17:42:44 GMT

This monograph presents findings from the 2007 NPHHI study on obesity treatment in public hospitals. Funded by Morrison Healthcare Food Services, the study included a survey of NAPH members to ascertain the range and characteristics of public hospital obesity treatment programs. This monograph offers analyses of collected data (sample size: 69 obesity programs at 41 NAPH member facilities), as well as in-depth case studies of quantitatively successful programs at five safety-net hospitals.

Disparities

Tue, 13 Apr 2010 09:37:35 GMT

April 2007: Medicaid and SCHIP Funding for Language Services

Wed, 28 Jul 2010 17:35:30 GMT

All public hospitals - as recipients of federal financial assistance - must ensure that individuals receive all necessary and appropriate care, regardless of language spoken, yet there is often little or no reimbursement available for supporting language programs or encouraging innovation in culturally and linguistically appropriate care. This Research Brief summarizes state reimbursement policies for language services, and profiles several states that assist hospitals directly by paying for language services in either inpatient or outpatient settings.

December 2008: Public Hospitals Focus on Reducing Health Care Disparities

Wed, 28 Jul 2010 17:19:02 GMT

This Research Brief offers findings from a May 2008 NAPH study of promising, replicable public hospital practices that are successfully reducing health care disparities in member institutions. NAPH's study identifies organizational models to address health care equity, as well as characteristics and common themes of disparities-reducing activities. This Brief also outlines the six domains of public hospital efforts to reduce disparities, providing specific examples of programs at eight safety-net hospitals.

September 2008: Assuring Healthcare Equity: A Healthcare Equity Blueprint

Wed, 28 Jul 2010 17:13:42 GMT

This monograph provides a list of strategies to address disparities through interventions that can be tailored to an individual hospital's setting. These strategies, developed with input from disparities experts, are grouped into five categories. Included in the document are a guide for its use, appendices addressing data collection and measurement, practical tools and resources for initiating change, and an extensive reference list.

January 2007: Addressing Disparities and Serving Diverse Patient Populations

Wed, 28 Jul 2010 17:07:01 GMT

Because NAPH members care for an extremely diverse patient population, they have ample opportunities to become laboratories for efforts to reduce racial and ethnic health care disparities. This Research Brief describes NAPH members' efforts related to cultural competency, language access, and health care quality that focus upon eliminating racial and ethnic disparities in care.

2009: Safety Net Health Systems: An Essential Partner in Reducing Health Care Disparities

Thu, 29 Jul 2010 10:57:40 GMT

Safety net health systems are committed to eliminating health care disparities by providing access to high-quality health care to all patients regardless of income, race, culture, or ethnicity-a cornerstone of health reform.

December 2008: Research Brief: Public Hospitals Focus on Reducing Health Care Disparities

Thu, 29 Jul 2010 11:19:47 GMT

NAPH conducted a study in 2008 on promising, replicable public hospital practices that are successfully reducing health care disparites in member hospitals. This Research Brief identifies organizational models to address health care equity, as well as characteristcs and common themes of disparities-reducing activities.

September 2008: Assuring Healthcare Equity: A Healthcare Equity Blueprint

Thu, 29 Jul 2010 11:23:26 GMT

Through a generous grant provided by the U.S. Department of Health and Human Services' Office of Minority Health, the National Public Health and Hospital Institute (NPHHI) - NAPH's research affiliate - released "Assuring Healthcare Equity: A Healthcare Equity Blueprint" in September 2008. In developing the Blueprint, NPHHI combined the expertise of national health care disparities leaders, experience of NAPH members, strategies for quality improvement designed by the Institute for Healthcare Improvement, and the research knowledge of The Disparities Solutions Center at Massachusetts General Hospital. The Blueprint serves as a guide for all hospitals and providers, and offers strategies to address disparities through interventions that can be tailored to the individual hospital setting.

Safety Net Financing

Tue, 13 Apr 2010 09:40:03 GMT

Key Features of State 1115 Demonstration Projects

Wed, 20 May 2009 16:41:24 GMT

This chart outlines key features of select demonstration projects approved by CMS between January 2001 and December 2005.

March 2006: Medicaid Section 1115 Demonstration Projects: Emerging Trends in Safety Net Financing

Wed, 28 Jul 2010 17:37:35 GMT

Section 1115 of the Medicaid statute enables the Centers for Medicare and Medicaid Services (CMS) to waive compliance with certain Medicaid requirements. This paper focuses on an emerging trend among states to use Section 1115 demonstrations to restructure Medicaid payments supporting safety net providers (i.e. "safety net financing").

March 2006: Medicaid Section 1115 Demonstration Projects: Financing Opportunities and Considerations for Public Hospitals and Health Systems

Wed, 28 Jul 2010 17:38:41 GMT

In 2005, four states - Massachusetts, California, Iowa, and Florida - received approval for Section 1115 demonstration projects that restructure Medicaid safety net hospital financing. In part, this trend is an outgrowth of the Centers for Medicare and Medicaid Services' (CMS) enhanced scrutiny of Medicaid reimbursement and financing mechanisms. Section 1115 may present opportunities for states and public hospitals to preserve funding for the safety net in the face of CMS efforts to restrict or eliminate intergovermental transfers and supplemental upper payment limit (UPL) payments.

Comparison of Safety Net Financing Provisions in Recent 1115 Demonstration Programs

Wed, 28 Jul 2010 17:17:30 GMT

December 2009: Research Brief: 2008 Annual Survey Underscores Key Role of Nation's Safety Net Hospitals and Health Systems

Thu, 29 Jul 2010 11:26:28 GMT

Results from the NAPH 2008 annual Characteristics Survey indicate safety net hospitals continued to fulfill critical roles in their communities amid the initial effects of a national economic downturn. Read more about the what the survey findings mean for the future of the safety net.

February 2010: America's Safety Net Hospitals and Health Systems, 2008: Results of the NAPH Annual Hospital Characteristics Survey

Thu, 29 Jul 2010 11:25:36 GMT

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2008. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

2007 Annual Survey Results Highlight the Importance of the Nation's Safety Net Hospitals and Health Systems

Mon, 19 Jul 2010 15:08:08 GMT

Results from the National Association of Public Hospitals and Health Systems (NAPH) annual membership characteristics survey indicate that safety net hospitals continue to fulfill critical roles in their communities.

May 2009: America's Safety Net Hospitals and Health Systems, 2007: Results of the NAPH Annual Hospital Characteristics Survey

Thu, 29 Jul 2010 11:01:20 GMT

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2007. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

October 2006: America's Safety Net Hospitals and Health Systems, 2004: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:21:58 GMT

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2004. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

October 2005: America's Safety Net Hospitals and Health Systems, 2003: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:21:10 GMT

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2003. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

September 2003: America's Safety Net Hospitals and Health Systems, 2001: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:18:41 GMT

Results of the Annual NAPH Characteristics Survey: This Monograph examines the utilization and financial characteristics of NAPH members in 2001. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

September 2004: America's Safety Net Hospitals and Health Systems, 2002: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:19:15 GMT

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 2002. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

October 2001: America's Safety Net Hospitals and Health Systems, 1999: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:16:32 GMT

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 1999. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals.

October 2000: America's Safety Net Hospitals and Health Systems, 1998: Results of the NAPH Annual Hospital Characteristics Survey

Wed, 28 Jul 2010 18:17:56 GMT

Results of the Annual NAPH Characteristics Survey: This report examines the utilization and financial characteristics of NAPH members in 1998. Key findings include: financial challenges faced, clinical and community services provided, and profiles of patients served by member hospitals. This report also outlines NAPH member trends, including the increasing burden of treating the uninsured, the shift from inpatient to outpatient care, increased competition for Medicaid and commercially insured patients, and reduced federal/state funding.

June 2010: Issue Brief: Safety Net Providers Transform the Health System & Prepare for Medicaid Expansion

Thu, 29 Jul 2010 11:32:39 GMT

This brief highlights NAPH members' innovative efforts to coordinate and integrate care for vulnerable patients and to contain costs. Many of these innovations can be expanded through opportunities afforded by the new health reform law to prepare for the Medicaid expansion in fiscal year 2014.

June 2010: Research Brief: NAPH Members Continue to Improve on Key Quality Measures

Thu, 29 Jul 2010 11:33:06 GMT

February 2010: Safety Net Hospitals Establish "Medical Homes"

Thu, 29 Jul 2010 11:27:27 GMT

Safety Net Health Systems: An Essential Resource During the Economic Recession - February 2010

Mon, 01 Mar 2010 10:49:29 GMT

Since the start of the current economic recession, safety net health systems have treated more patients overall and provided even more uncompensated care to low-income populations. This research brief explores how safety net organizations remain critical to the nation's health care system.