Issue link: https://beckershealthcare.uberflip.com/i/961245
162 THOUGHT LEADERSHIP If I had not known who to call to have it sent to the hospi- tal, it would have been repeated. Fortunately, the hospi- talist and nurses were focused on avoiding duplication, but I'm confident that if I had been a patient that didn't know how to navigate the system, the result would have been different. There were also many opportunities for important information to be overlooked. We've come a long way in patient safety, but we still have a long way to go until information flow is better coordinated and waste is eliminated. One of my most cherished patient letters was written by a new father who had to leave his wife and newborn due to a family emergency. He wrote that he was not concerned about leaving her alone at Woman's because of the care he had observed during her delivery. Patients should not feel they need loved ones with them to guard against pre- ventable harm. Q: What change in reimbursement is your organization feeling most acutely, and how is it affecting your 2-5- year strategic plan? TF: Woman's is the largest Medicaid provider in Louisiana; over 70 percent of the births in the state are covered by Medicaid, and we receive high-risk perinatal and neona- tal patients from many underserved areas. Medicaid is our largest payer, and the program has been underfund- ed for years. Hospitals are currently paid a per diem that is unadjusted for severity for inpatient care. The payment methodology is expected to transition to diagnosis-related groups next year, which has providers very concerned due to the shift in risk and the inadequate post-acute care net- works that the five Medicaid managed care organizations currently have in place, which will exacerbate the problem. Recognizing the increased financial risk and fulfilling our commitment to improve the health of women and infants, our board just approved substantial and sustained fund- ing for comprehensive perinatal care coordination. This population health initiative elevates our current offerings through enhanced screening, treatment and support, es- pecially for patients with behavioral health issues and sub- stance misuse during the pre- and postnatal periods. Our goal is to achieve the March of Dimes 'A' score by 2020. n