MHA Today | January 26, 2016

January 26, 2016
MHA Today: News for Healthcare Leaders


MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

In This Issue
HMO Legislation Encounters Vigorous Opposition In Senate Hearing
MHA Distributes CAH Databook
CBO Releases 2016-2026 Budget And Economic Outlook
MHD Revises Outpatient Codes
MHD Posts Rate Update For Home And Community-Based Services
CMS Releases Guide To Prevent Readmissions Among Diverse Medicare Beneficiaries
TJC Awards First Integrated Care Certification
CMS Updates The Submission Engine Validation Tool
CDC Launches Prediabetes Awareness Campaign

Advocate
state and federal health policy developments


HMO Legislation Encounters Vigorous Opposition In Senate Hearing

Staff Contact: Rob Monsees

Today, Senate Bill 911, sponsored by Sen. Paul Wieland (R-Jefferson County), received a hearing by the Senate Small Business, Insurance and Industry Committee. It is an expanded version of House Bill 1592, heard last week by the House Health Insurance Committee, that includes provisions to add more options for insurers to sell products with “gatekeeper” provisions and exclusive provider organizations products. Speaking for the bill were Blue Cross Blue Shield of Kansas City, the Missouri Pharmacy Association, UnitedHealthcare, Anthem and the Missouri Insurance Coalition. Testifying against the bill were the Missouri Hospital Association, Mosaic Healthcare, BJC, HCA, Saint Luke’s Health System, the Missouri State Medical Association, SSM Health, ambulatory surgical centers and Signature Medical group.

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MHA Distributes CAH Databook

Staff Contact: Andrew Wheeler

MHA has made available the 2015 Critical Access Hospital Databook, which includes quality performance, financial indicators and Medicare inpatient and outpatient utilization. In addition, assorted state and national indicators are listed to serve as benchmarks. This analysis will be available online for authorized users of HIDI Analytic Advantage®.

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CBO Releases 2016-2026 Budget And Economic Outlook

Staff Contact: Andrew Wheeler

The Congressional Budget Office released its budget and economic outlook for 2016-2026. The CBO is estimating that the federal budget deficit will be $544 billion in 2016. This would raise the debt to 76 percent of gross domestic product. Medicare, Medicaid and Children’s Health Insurance Program spending is expected to be 11 percent higher than in 2015, amounting to $104 billion. MHA has published an issue brief with additional information.

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MHD Revises Outpatient Codes

Staff Contact: Steve Renne

Effective Jan. 1, the MO HealthNet Division added a new Place of Service Code 19 for “Off-Campus-Outpatient Hospital” and revised POS Code 22 to “On-Campus-Outpatient Hospital.” The reimbursement methodology will remain unchanged for outpatient claims. Claims processed with POS 19 will be treated the same as POS 22.

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MHD Posts Rate Update For Home And Community-Based Services

Staff Contact: Steve Renne

The MO HealthNet fee-for-service program maximum allowable rate increased 1 percent for select procedure codes. The increased rates are effective for services on or after Jan. 1 for the adult day care waiver, aged and disabled waiver, AIDS waiver, independent living waiver, medically fragile adult waiver and personal care.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Guide To Prevent Readmissions Among Diverse Medicare Beneficiaries

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid services released a new guide to preventing readmissions among racially and ethnically diverse Medicare beneficiaries. The guide provides action-oriented guidance for addressing avoidable readmissions in this population, a set of seven key recommendations that hospital leaders can take to prevent avoidable readmissions and concrete examples of initiatives and strategies that may be applied to reduce readmissions in diverse populations.

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TJC Awards First Integrated Care Certification

Staff Contact: Sarah Willson

The Joint Commission has awarded Parish Medical Center, a public not-for-profit facility in Titusville, Fla., with the first Integrated Care Certification award in the U.S. The new certification began in July 2015. The purpose of the award is to recognize hospital and ambulatory centers that excel at integrating information-sharing, transitions of care, hand-off communications and other vital activities which help ensure continuity of care as the patient moves between various settings.

Hospitals and ambulatory care settings that would like to pursue Integrated Care Certification can find additional information by visiting TJC’s website or emailing integratedcare@jointcommission.org.

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Quality and Population Health


CMS Updates The Submission Engine Validation Tool

Staff Contacts: Dana Downing or Steven Njenga

The Centers for Medicare & Medicaid Services updated the submission engine validation tool located on the Physician and Other Health Care Professionals Quality Reporting Portal. Updates include changes to the quality reporting document architecture and electronic health record QRDA requirements for 2015 submission.

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Noteworthy


CDC Launches Prediabetes Awareness Campaign

Staff Contact: Sarah Willson

The Centers for Disease Control and Prevention has launched its prediabetes awareness campaign nationwide. Because the CDC considers prediabetes one of the biggest public health crises in the U.S., it has teamed up with the American Diabetes Association and the American Medical Association to launch the new campaign for National Heart Month in February.

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Consider This ...

Anxiety disorders cost the U.S. more than $42 billion a year, almost one-third of the country's $148 billion total mental health bill.

Source: Anxiety and Depression Association of America



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