The Hospital Association of Southern California (HASC) has been a steadfast presence in health care for nearly a century. Together with the California Hospital Association (CHA), HASC has helped serve hospitals with determined advocacy, innovative initiatives and thoughtful leadership on issues that matter most. The dramatic shifts we now face are well known and present us with great opportunities to improve care quality, increase efficiency, and to better serve the needs of an increasingly diverse population.
Physician shortages and new demands on leadership mean discovering better ways to equip executives right at a time when hospital and physician integration is reaching a critical turning point. Our members must implement new, more collaborative approaches to how we care for patients and how we work with each other.
These are transformative times in health care. Members—and HASC—have successfully faced these challenges before.
Advocating for the Future of Health Care
HASC has always been a strong advocate and representative for hospitals and health systems, providing leadership and vision for members and the industry at pivotal moments.With more than 170 members, plus numerous related associate members, HASC gives voice to the one goal we all have: to improve the operating environment for hospitals and the health status of the communities we serve.
Commitment to Responsible Reform
California is an early adopter of the ACA and HASC has taken the lead in educating policymakers and the public as hospitals and health systems work to ensure patient access to care. Southern California hospitals have responded to health care reform by assessing service lines, prioritizing the organization’s focus, and developing physician leadership. Hospitals are also making bold moves to evaluate billing and payment reform, form new partnerships, leverage information technology and create a culture of continuous improvement.
As the industry stands on the verge of payment reform, HASC has been an effective part of the discussion since 1983. HASC’s support for moving from cost-based reimbursement to selective provider contracting (SPC) helped optimize hospital inpatient services. Though soon to be replaced by new discharge-based diagnosis-related groups, SPC was the first step in much needed industry change.
With an idea ahead of its time, HASC took the initiative to form new partnerships in 1995 by bringing together hospitals, physicians and integrated systems in what would ultimately lay the foundation for accountable care organizations in California. The unprecedented collaboration, called the Physicians Groups Council, now California Association of Physician Groups (CAPG), was formed at HASC under the leadership of Terry Hartshorn and Dr. David Hartenbower. Independent since 2002, CAPG is now led by Donald Crane and is viewed as the leading advocate for physician groups in the state.
Similar out-of-the-box collaborations helped bring an health information exchange (HIE) to the Inland Empire. In 2009, HASC and regional hospitals, medical centers, medical groups, clinics, IPAs, physician practices, health plans, public health and medical societies established the Inland Empire Health Information Technology Collaborative to secure funding for the project. In 2012, the region successfully launched a pilot program to improve access and information sharing for the 5 million residents of Riverside and San Bernardino.
At the heart of health care reform is expanding access to health care while reducing costs. In the 1990s, HASC was instrumental in designing and implementing Medi-Cal managed care for California’s low-income and medically indigent populations, helping to iron out the process for transferring millions of Medi-Cal consumers from fee-for-service Medi-Cal into a managed care system.
And in another move supporting responsible change in managed care, HASC and CHA fought to defeat the 1996 ballot initiatives, Propositions 214 and 216. The measures not only would have created new taxes on HMO practices, but they also would have hiked insurance fees and added unnecessary administrative burdens for hospitals.
“What people are left with are proposals that will force health care costs skyward, which, in turn, will leave more people unable to afford health insurance and not improve access or coverage,” said C. Duane Dauner, president of the California Hospital Association, in 1996.
Improving Patient Outcomes
When a 1966 report indicated a troubling rate of patient mortalities in the field, Los Angeles County Board of Supervisors’ Kenneth Hahn and the medical community looked for solutions. To reduce patient transport times and potential treatment delays, Hahn proposed a system of emergency medical services where trauma victims would be directed to designated facilities and personnel during emergencies. With HASC’s support, a commission was formed, and a plan for implementing a trauma system in Los Angeles was adopted January 25,1983.
The number of trauma centers has varied over the years. HASC’s tireless advocacy for funding alternatives, like Measure B: Trauma, Emergency and Bioterrorism Response Assessment passed in 2002, has helped stabilize the network and ensure countless lives are saved.
Trauma centers were not the only development contributing to better patient outcomes in the field. The Los Angeles medical community re-envisioned emergency care delivery by expanding the scope of practice for ambulance drivers responding to emergency calls.With specialized training, the agreement of local hospitals to provide necessary medical direction, and the passage of The Wedworth-Townsend Paramedic Act in 1970, California firefighters designated as paramedics became the first in the country to provide advanced medical life support without the presence of a physician or nurse.
Connecting these elements was a new communications system, HEAR (Hospital Emergency Administrative Radio). The two-way voice radio was developed by HASC in 1969 to provide ambulance-to-hospital and hospital-to-hospital communications on VHF. Having evolved into ReddiNet Medical Communications, the system now uses satellite technology and remains a valuable component of Southern California’s emergency response network.
Continuous Quality and Patient Safety Improvement
In 2004, HASC spearheaded the California Hospital Assessment and Reporting Taskforce (CHART). This effort brought together hospitals, insurers, consumer advocates, researchers and others to produce a statewide report card on hospital performance and quality. Supported by hospitals and regulatory agencies like the California Office of Statewide Health Planning and Development and the Joint Commission, the taskforce adopted 50 hospital performance measures that they agreed were indicative of quality and aligned with national initiatives like the Agency for Health Quality and Research and the National Quality Forum.
Implementing these performance measures was only one aspect of HASC’s quality and patient safety initiative. Through a partnership with Blue Cross in 2010, HASC and National Health Foundation formed Patient Safety First…a California Partnership for Health, helping hospitals to improve medical care, reduce costs and establish a best practice model across the state. To date, more than 170 Southern California hospitals have participated in the collaborative focusing on Sepsis Mortality, Perinatal Safety, HAI – C. Difficile and Surgical Safety, saving nearly 1,000 lives and more than $19 million.
Taking patient safety and quality to the next level, CHA, HASC and the other regional associations created the Hospital Quality Institute (HQI) in 2013. Building on the foundation of California Hospital Patient Safety Organization, Patient Safety First, and the California Hospital Engagement Network, HQI will consolidate the efforts of these programs to become the leading organization for continuous quality and patient safety improvement in the state.
HASC’s intrepid spirit is likewise demonstrated in the development of products and services that sought to meet the challenge of the Triple Aim—better care, better health and lower costs—before the idea became so prominently voiced in the industry. Anticipating what members would need in this new environment has helped the association become the go-to resource for data, education and solutions in labor, revenue benchmarking, and quality and patient safety.
Through the years, HASC’s members and staff have developed a number of industry-leading innovations. Among these are the wristband patient identification system; an Eligibility On Site program that helps private hospitals reduce the amount of uncompensated care; and the hospital emergency codes, developed by HASC and safety, security and nurse leaders, now the standard throughout California.
HASC also contributed to the creation of PDS, an online database of paid claims. Launched in 2004, PDS was developed to level the playing field for hospitals by providing the same market information that the payers have, and more. This market revenue data help hospitals support business development and long-term strategic planning with sophisticated analytics and benchmarking.
Whether supporting our hospitals at the local, state and federal levels, or spearheading groundbreaking collaborations, or launching innovative initiatives to reduce operational costs, HASC has always placed the quality and safety of patient care at the forefront. It’s not just innovation, but a dedication to a greater ideal—the best care for patients and their families, improved population health and lower overall costs.