How are the hospital based programs funded? Is there any reimbursement from health plans?
28 May 2013 - 3:49pm
Depends upon state and institution... and what all is involved. The salaries for the clinical and administrative staff,equipment ,administrative supplies and educational needs for the Asthma Action Team are provided by the Center for Pediatric Medicine and the Greenville Health System and are largely self-sustaining through the budgetary process and revenue and reimbursement from patient visits. There are many educational sites available to the public with low or no cost publications that can be ordered.
The return on investment to the program by decreased emergency room visits and hospitalizations...offsets the costs of sustaining the program.
In SC, we have had some difficulty obtaining consistent reimbursement as there seems to be difficulty nationwide. At CPM in addition to a teaching charge, we submit "statistical" charges for case management ( telephone encounters,pharmacy calls,school calls,etc. ) that our administation evaluates
28 May 2013 - 3:38pm
Hospitals are now required to show impact in identified areas based on the health assessment. They may be very responsive to community partnerships to address needs and can count the support and plan towards meeting that requirement. Our health system actually tithes a percent of net revenue to pay for community health programs.
I certainly think this is an emerging area of funding and would be well worth the conversation about partnering with them to address the needs. It is also important to note that they are to work with the community to devise action plans and having you as a partner helps meet that requirement as well.
In regards to health plans, some states have a more robust system for reimbursement. Our state is still primarily fee for service but the hope is that as we embrace accountable care this will be a standard in care as we have been able to demonstrate significant financial savings for all of the parties involved and better utilization of staff time not to mention overall patient safety