Brief calls for stronger federal policy on safety net providers

In order to continue the implementation of efficient, integrated health care across the nation, federal policy regarding safety net providers must be strengthened, according to a brief recently released by UC Berkeley School of Law researchers.

Fellows at the school’s Warren Institute’s Health, Economic and Family Security Program released the first part of a three-part study Thursday that recommends changes to the current health care system through the creation of accountable care organizations — a model of health care that financially rewards both patients and doctors for speedy and full recoveries, according to the brief.

The brief states that the implementation of these organizations could help curb health care costs for and, more specifically, bring better health care to low-income and disabled patients.

“New models of providing health care, like the ACO, are desperately needed to improve health care and bend the cost curve,” said Matthew Chayt, a fellow at the institute and a co-author of the brief. “People in the (low-income) safety net need these reforms even more than most.”

The study — the product of a joint effort between the institute and the campus’s School of Public Health — was funded through a $150,000 grant awarded to the university by the Blue Shield of California Foundation. The grant, awarded to the researchers in December, funds a year-long analysis of health care reform through research and fieldwork.

The brief proposes policy changes regarding several issues — such as the confusion regarding current fraud and abuse laws as well as what the incentivization system organizations would employ — that prevent the organizations from operating under current legislation.

The brief also addresses the need to amend federal regulations to allow nonprofit organizations that partner with for-profit institutions to retain their tax status.

According to Chayt, one of the primary concerns regarding the implementation process is the large start-up cost — normally incurred from expenditures for medical equipment, data systems and staffing — associated with creating the organizations.

“Many providers across the country just aren’t equipped to do this because they are very small and don’t have the capital to implement these systems,” said Stephen Shortell, dean of the campus’s School of Public Health.

As part of the study, Shortell has developed a “readiness assessment” survey that he hopes will address concerns about providers’ ability to convert to the new system. He said results from trial runs in Alameda and Orange counties, which should be produced by September, will help determine the viability of large-scale implementation of the organizations.

“I’m also optimistic that if we get enough ACOs running across the country, in the next few years after that we will see definite improvements,” Shortell said.