Oklahoma Hospitals 2021-2022 A Resource Guide for Elected Offi cials The Oklahoma Hospital Association The Oklahoma Hospital Association has prepared this document to assist elected offi cials in better understanding various health care terminology and practices as they relate to the government’s impact on hospitals. Established in 1919, the Oklahoma Hospital Association (OHA) is the voice of Oklahoma’s hospital industry. The Association is a pri- vate, non-profi t trade association funded by organizations and individuals who purchase memberships in exchange for services. In addition to hospitals, the Association off ers memberships to businesses, agencies and individuals who are interested in network- ing with those in Oklahoma’s health care industry. Currently, the OHA represents more than 135 hospitals and health care entities across the state of Oklahoma. OHA’s primary objec- tive is to promote the welfare of the public by leading and assisting its members in the provision of better health care and services for all people. OHA provides a variety of membership services including legislative advocacy and representation, communications, educational programs, information and data, quality initiatives and more. OHA also partners with a number of other organizations on a variety of initiatives to lower the number of uninsured and improve the health of Oklahomans. No other industry is changing so quickly and dramatically. In order to keep up with these changes and the challenges that lie ahead, hospitals must continue to adapt. The OHA’s objective is to assist hospitals and health care professionals as they look ahead to the challenges of the future. For more information about the Oklahoma Hospital Association, contact Sandra Harrison or Scott Tohlen at (405) 427-9537, [email protected], [email protected], or go to www.okoha.com. Copyright © 2021 Oklahoma Hospital Association The information in this document is current at publication date of January 2021. Table of Contents Types of Hospitals ................................................2 Health Information ............................................23 Electronic Health Records ..........................................................................................................23 Current Health Care Environment ........................3 State Health Information Exchange .........................................................................................23 Affordable Care Act ......................................................................................................................3 HIPAA ..........................................................................................................................................23 Medicaid Expansion ....................................................................................................................3 Medicaid Managed Care .............................................................................................................4 Telemedicine .....................................................24 Regulation of Telemedicine ......................................................................................................24 Financial Information ..........................................5 Funding of Telemedicine ...........................................................................................................25 Funding Sources...........................................................................................................................5 Physician Patent Relationship in Telemedicine .......................................................................25 Hospital Payments .....................................................................................................................10 Telehealth ...................................................................................................................................25 Billing , Collections & Charity Care ............................................................................................11 Uncompensated Care ................................................................................................................12 Trauma Care .......................................................27 Community Benefit ...................................................................................................................12 Background ................................................................................................................................27 Trauma Legislation ....................................................................................................................27 Quality and Patient Safety .................................13 Trauma Fund ..............................................................................................................................28 Mandated Quality and Safety Programs .................................................................................13 Revenues and Distributions ......................................................................................................28 Voluntary Quality and Safety Programs ..................................................................................13 Pay for Performance ..................................................................................................................15 EMTALA ..............................................................28 Clinical Initiatives........................................................................................................................15 Infection Control and Prevention .............................................................................................15 Emergency Preparedness ..................................29 Quality Public Reporting and Transparency ............................................................................16 COVID-19 ....................................................................................................................................29 Rural Hospitals ...................................................17 Specialized Infectious Unit ........................................................................................................30 Oklahoma Is a Rural State .........................................................................................................17 Improving Oklahoma’s Health ...........................30 Part of a Rural Health Safety Net ..............................................................................................17 Oklahoma’s Tobacco Tax ............................................................................................................30 Economic Impact of Critical Access Hospitals ..........................................................................17 2018 Cigarette Tax Increase.......................................................................................................30 The Backbone of the Safety Net ...............................................................................................17 Tobacco Settlement Endowment Trust (TSET) ........................................................................31 Health Care Workforce .......................................18 OHA Health Improvement Initiatives .......................................................................................31 Nursing and Allied Health Recruitment...................................................................................18 Physician Recruitment ..............................................................................................................19 Appendix 1: Statutory References ............................................................................................33 TSET Funds for Workforce Shortages ........................................................................................21 Appendix 2: Snapshot of Oklahoma Hospitals .......................................................................35 Licensing and Credentialing of Health Care Professionals .....................................................21 Glossary of Terms .......................................................................................................................39 TTypesypes ofof HospitalsHospitals There are numerous terms that defi ne hospitals, their owner- diff erences in regulatory requirements. There are currently 40 ship or control, or the services that they provide. Generally, CAHs in Oklahoma. Oklahoma law defi nes hospitals under Title 63:1-701. The term “hospital” includes general medical surgical hospitals, specialty System Hospitals hospitals, critical access hospitals, and birthing centers. How- System hospitals may be managed or owned by a corporate ever, the following defi nitions provide additional clarifi cation. entity, either for-profi t or not-for-profi t. A hospital system may Oklahoma does not have a hospital Certifi cate of Need require- have a collection of any of the hospitals previously described ment (see glossary page 39). such as acute medical surgical, specialty or critical access. Non-Profi t or Not-for-Profi t Hospitals Government-Owned Hospitals A non-profi t hospital is recognized under the IRS code as a Some hospitals are owned by the state of Oklahoma. Likewise, 501(c)(3) organization. The term non-profi t does not imply that federal hospitals such as veteran’s hospitals are owned by the the hospital does not make a profi t, rather that profi ts of the federal government.