Frontiers of Health Services Management - Summer 2014 - (Page 13)

Resources there is no doubt that new or realigned resources will be required if our population health improvement efforts are to be accelerated. Where can such resources come from in these times when both public and private sectors are facing economic pressure? We suggest five major opportunities for identifying new or reallocating existing resources to bring community health business models alive. 2. Better Return on Investment from Policies and Programs Outside of Healthcare Savings from healthcare alone will not be adequate to improve population health outcomes. increased attention is being paid to "health in all" policies in non-medical care sectors such as housing, agriculture, and education, which are defined as those policies that have a primary impact in a nonhealthcare sector but often have secondary health-promoting features. for example, a new US Department of Housing and Urban Development demonstration project awards rental assistance subsidies to state housing agencies or other nonprofits that partner with state health and human services and Medicaid agencies (Bostic et al. 2012). the David A. K indig a nd Ge org e Is ha m * 13 f e a t u r e 1. Capture Funding from Reduction of Ineffective Healthcare Spending it is now widely accepted that the United States delivers less health for the dollars invested in healthcare than any other developed nation (ioM 2013). governmental and business leaders are calling for significant efficiencies to keep public programs healthy and improve corporate competitiveness. Many experts assert that as much as 25 percent of all healthcare expenditures are for services considered to be ineffective. another recent estimate of such a "health dividend" available from improved effectiveness is $750 billion annually (Mccullough et al. 2012). While challenging, capturing these dollars for reinvestment in more effective programs and policies within and outside of healthcare should be a high priority for both public- and private-sector leaders. consideration should be given to setting aside a community share from savings anticipated under the implementation of accountable care organizations, which are designed to provide higher-quality care in an efficient manner (Shortell 2013). the center for Medicare & Medicaid innovation, part of the centers for Medicare & Medicaid Services, is devoting resources to population health; its Health care innovation awards program includes promising population health initiatives in asthma and diabetes treatment and in efforts to integrate community-based resources, public health, and clinical services (center for Medicare & Medicaid innovation 2012). in addition, the State innovation Models initiative includes a major focus on community-based population health initiatives in both its design and testing phases. these demonstrations could lead to policy approaches that result in additional investment from within healthcare into community health. in addition, as uncompensated care burdens are minimized under healthcare reform, community benefit resources required by the internal revenue Service for nonprofit hospital tax-exempt status might be redirected from charity care and unreimbursed Medicaid to broad healthpromoting investments (Young et al. 2013; cBo 2006; Bakken and Kindig 2012). this amount is considerable; as of 2002, the only year ever examined, the national value of this tax exemption was $12.2 billion, and current estimates project a much higher amount (Bostic et al. 2012).

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2014

Table of Contents

Frontiers of Health Services Management - Summer 2014