The Level of State Involvement in the Reconstruction of the Municipal Healthcare System

by Andrew W. Dick, Soeren Mattke

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Key Findings:

  • The State of Louisiana needs to rebuild its healthcare system but will have limited historical experience and applicable evidence on which to draw.
  • Basic considerations in the design process include efficient use of resources, meeting needs of diverse stakeholders, meeting preparedness standards for natural disasters and bioterrorism, and reflecting important trends in care delivery.
  • In governing the decision process, the State can rely on market forces, determine the structure of the system itself, or use a consensus process. Each option has advantages and disadvantages.
  • Policy levers available to the State include Certificate of Need regulation, licensure, control of conversions and mergers, redesigning Medicaid reimbursement schedules, and financial incentives such as pay-for-performance.
  • The State may wish to consider incorporating certain accepted best practices into the reconstruction process, including electronic medical records, centers of excellence, the Chronic Care model, and magnet hospitals.
  • Potential funding sources for the reconstruction include dedicated disaster relief funds, existing federal programs, and the charitable organizations and foundations. Matching funding sources with projects will require reviewing the conditions for each program on a case-by-case basis.

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