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Urban health - big cities, big challenges

by Lisa Chamoff, Contributing Reporter | December 16, 2014
From the December 2014 issue of HealthCare Business News magazine


Residency program cuts
For academic medical centers located in urban areas, there are threats to graduate medical education payments, says Priya Bathija, senior director of health policy at the American Hospital Association. CMS has a fixed number of residency slots that it funds, but the number of slots were frozen several years ago. Future cuts are included in President Barack Obama’s budget for the 2015 fiscal year. “Hospitals continue to fund residents above that cap without receiving payments,” Bathija says.

Reaching out
While contending with funding issues, many urban hospitals have been trying out some innovative things to help address the challenges. The Henry Ford Health System has developed formal partnerships and the creation of community health programs, Nerenz says.

Laypeople get a certain level of healthcare training. These community health workers, paid by local social service agencies, make sure discharged patients have access to rides, and get meals delivered if they’re homebound.

The health system has also developed and maintained a formally designated primary care medical home program, with services that include making sure that when people leave the hospital, the medications they’re taking don’t conflict. “It’s just now these more daily life challenges — as a patient and a family member, how do you get done the things you need to do to manage?” Nerenz says. In an urban area, “it is just harder.”

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