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Health Affairs Piece Shows California OSHPD Data a Part of National Trend from Inpatient to Outpatient Care

The OSHPD data for 2008-2011 that we reported last week showed California’s hospital inpatient days and visits declining by 11 and 2.5% respectively while California’s community clinic visits increased by 20%, particularly for managed care patients. According to a recent Health Affairs blog[1], this is part of a national trend. It could augur well for states that most effectively implement the coverage expansions and payment and delivery system reforms of the Affordable Care Act.

 

The authors identified five factors at play: 1) coordinated, collaborative care, 2) standardized, evidence based care, 3) care redesign, 4) optimal service distribution and 5) value based payments. They pointed to effective models in Chicago, Southern California, Seattle and the Maryland, Virginia DC region. Minnesota was the biggest decline, reporting a decline of more than 13%. The Minnesota State Legislature and state health systems have pioneered new care and delivery system models, leading to a state ranking of # 4 in the nation for access, prevention, lower costs of care and avoidance of hospital use.[2]



[1] Grube, Kaufman and York, Decline in Utilization rates Signals a Change in the Inpatient Business Model, (Health Affairs, March 8, 2013) at http://healthaffairs.org/blog/2014/03/08

[2] The Commonwealth Fund, Aiming Higher for Health System Performance: A Profile of Seven States That Perform Well on the Commonwealth Fund’s 2009 State Scorecard: Minnesota (October 2009) by Greg Moddy and Sharon Silow-Carroll