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DOH: Guidelines to Help Hospitals Increase Patient Access through Innovative Delivery Models

Mar 03, 2022

Harrisburg, PA – Acting Secretary of Health Keara Klinepeter Wednesday outlined guidelines to allow hospitals to implement three innovative care delivery models designed to increase patient access to care.

“The primary purpose of these innovative delivery models is to provide options that will preserve and increase access to high quality care in areas that may be medically underserved,” Klinepeter said. “These innovative models will give rural hospitals flexibility to address historic challenges so they can maintain emergency care in local communities. Additionally, hospitals across the state will have the flexibility to minimize financial burdens, while still meeting the needs of the community.”

The optional delivery models include establishing micro-hospitals, tele-emergency departments and outpatient emergency departments, which all will be subject to eligibility criteria including patient volume, geographic location, minimum staffing and services.

Rural hospitals will be the focus of tele-emergency and outpatient emergency department expansion; any hospital that is eligible and follows specific guidelines could take advantage of the micro-hospital model.

“Rural hospitals in Pennsylvania have a hard time recruiting and maintaining staff and supporting inpatient services due to their location and patient population,” Klinepeter said. “In some instances, the options are for a hospital to close or to transform. While these care delivery models may not be what the community is used to, they are a safe and cost-effective way to maintain essential services in the community.”

Provided below is a brief description of each delivery model option:

  • An Outpatient Emergency Department (OED) is an outpatient location of a hospital that offers only emergency services and is not located on the grounds of the main licensed hospital.
  • A Micro-Hospital is an acute care hospital that offers emergency services and maintains facilities for at least 10 inpatient beds with a narrow scope of inpatient acute care services, such as no surgical services.
  • A Tele-Emergency Department (Tele-ED) is an emergency department in an acute care or critical access hospital that is staffed by Advanced Practice Providers (APP) 24 hours per day/7 days per week with a physician available at all times through telecommunications but not physically present in the emergency department.

“The Wolf Administration is committed to supporting innovative solutions and ideas to help provide quality patient care in our changing health care environment,” Klinepeter said. “Residents in northeastern Pennsylvania are already seeing the benefits of this approach.”

Last year, when Tyler Memorial Hospital in Tunkhannock, Wyoming County, announced plans to close the hospital, the Commonwealth Health healthcare network wanted to offer emergency room, outpatient diagnostics, imaging and primary care services and worked with the Department of Health and local leaders to maintain access to health care services for residents.

“Because the Department of Health and local leaders were willing to work with us last year, we found a way to maintain important services for the people in Tunkhannock,” Tom Bisignani, CFO and Interim CEO of Regional Hospital of Scranton, said. “Health care delivery is constantly evolving, and hospitals need flexibility so we can continue providing high quality care where patients need it.”

For more information about the innovative care models for hospitals, visit DOH hospitals innovative care models.

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