MHA Today | March 16, 2016

March 16, 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. Connect with us on LinkedIn.

In This Issue
Committee Defeats Bill To Restrict Covenants Not To Compete
House Advances Hospital Construction Regulatory Relief Bill
Committee Reviews Bills On Deceased Patients
House Releases Budget Plan
CMS Announces DMEPOS Competitive Bidding
HIDI Releases Fourth Quarter 2015 VBP Payments Model
Trajectories — Opioids: A Population Health Dilemma
MHA HEN Participants Convene
AHRQ Releases TeamSTEPPS® Training
General Leonard Wood Army Community Hospital Names New Commander

Advocate
state and federal health policy developments


Committee Defeats Bill To Restrict Covenants Not To Compete

Staff Contact: Daniel Landon

The state House Health and Mental Health Policy Committee voted to defeat House Bill 1660. The measure would restrict the use of covenants not to compete in employment contracts between not-for-profit hospitals and physicians. The committee chair and bill sponsor Rep. Keith Frederick (R-Rolla), a physician, offered an amendment to modify the scope of the bill, but the committee defeated both the amendment and bill by a vote of 4-8. The committee previously revised and endorsed the bill, which subsequently was reviewed by a second committee and returned for further consideration.

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House Advances Hospital Construction Regulatory Relief Bill

Staff Contact: Daniel Landon

The state House of Representatives has given first-round approval to House Bill 2402. The legislation would revise hospital licensure standards to reflect updated life safety and construction codes and reduce the burden of complying with differing state and federal regulations. It was developed in consultation with the Missouri Society of Hospital Engineers. In debating the bill, the House added an amendment specifying that state-owned health facilities other than Department of Mental Health state psychiatric hospitals will be subject to certificate of need review.

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Committee Reviews Bills On Deceased Patients

Staff Contact: Daniel Landon

The state House Health and Mental Health Policy Committee held a hearing on two bills related to deceased patients. House Bill 2482 would clarify standards regarding access to medical records of deceased patients. House Bill 2617 would change standards for notifying coroners or medical examiners when a hospice patient dies, as well as post-mortem investigations by law enforcement.

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House Releases Budget Plan

Staff Contact: Andrew Wheeler

The U.S. House of Representative’s House Budget Committee released the committee’s budget plan for fiscal year 2017. The budget includes a reduction to Medicare spending of $449 billion throughout a 10-year period. In addition, the budget reduces Medicaid and other health care spending by $1.03 trillion throughout a 10-year period. Major changes include the following.

Medicare

  • repeal the Affordable Care Act, including the Independent Payment Advisory Board
  • create and implement a premium support for Medicare beginning in 2024
  • combine Medicare Parts A and B so that there is a single deductible
  • Medicare would transition to means-tested for high-income seniors
  • medical liability law reforms

Medicaid
  • repeal the Medicaid expansion under the ACA and create a block grant program


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Regulatory News
the latest actions of agencies monitoring health care


CMS Announces DMEPOS Competitive Bidding

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced the new single payment amounts and began sending contract offers to successful bidders for Medicare’s Round 2 Recompete and the national mail-order recompete Durable Medical Equipment, Prosthetics, Orthotics And Supplies Competitive Bidding Program. The new contracts will go into effect Friday, July 1. According to Medicare, $3.6 billion has been saved because of the program.

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HIDI Tech Connect


HIDI Releases Fourth Quarter 2015 VBP Payments Model

Staff Contact: Shane VanOverschelde

The Value-Based Purchasing Payments Model is a companion utility to the VBP Analysis that was produced for hospitals on March 1. The VBP Payments Model is an interactive tool that provides hospitals with the ability to manipulate their hospital-specific quality scores to evaluate the associated change to estimated VBP payments. The VBP Payments Model is provided to subscribers of the 2016 Premier Reporting Package. The modeling utility is located on HIDI Analytic Advantage® in the “Finance and Policy/Premier Reports” or “Quality/Premier Reports” folders, with the following file name: MOxxxx_VBP FFY2017 Payments Model_2015_Q4_(2016.03.16).xls. Hospitals interested in subscribing to the HIDI Premier Report Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Quality and Population Health


Trajectories — Opioids: A Population Health Dilemma

Staff Contact: Alison Williams

TrajectoriesThe March issue of Trajectories discusses how opioids are a population health dilemma not only in Missouri, but also nationwide. In the 1980s and 90s, physicians were encouraged to liberalize the use of opioids to treat noncancer-related pain issues, partly because of the success in using those medications to manage cancer-related pain. The logic was that if opioids worked well for one type of pain, they should be effective for other types of pain and provide improved quality of life. However, increased opioid prescriptions have not necessarily led to improved chronic pain control. In fact, the ongoing effects of long-term opioid use are extremely detrimental with potentially catastrophic effects. In 2014, the Agency for Healthcare Research and Quality released a statistical brief, and in 2016, the Centers for Disease Control and Prevention released a draft Guideline for Prescribing Opioids for Chronic Pain, both highlighting several research questions challenging the widespread use of opioids as the treatment of choice for chronic pain management.

Opioid medications are regularly prescribed for all types of acute and chronic pain conditions despite evidence that they do not outperform non-narcotic pharmacologic options or alternative therapy options, such as cognitive behavioral therapy and exercise therapy. In fact, a combination of acetaminophen and nonsteroidal anti-inflammatory drugs, along with CBT and physical therapy, has been shown to be more effective than opioids in treating both acute and chronic pain. A metric, known as “number needed to treat,” has been used in studies to note the effectiveness of using acetaminophen and NSAIDs versus opioid medications. The National Safety Council has an infographic that compares common pain medications.

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MHA HEN Participants Convene

Staff Contact: Jessica Rowden

Last week, MHA’s Hospital Engagement Network participants convened to discuss creating and sustaining best practice environments in health care. The topics of discussion were safety culture, TeamSTEPPS®, data analysis and addressing failure to rescue. Participants also toured the Sheldon Clinical Simulation Center MobileSim and conducted a sepsis simulation drill to learn new methods of quality improvement. More than 60 attendees left with concepts, ideas and tangible support that will aid with quality improvement efforts, foster teamwork and communication, and help cultivate a culture focused on safety and harm prevention.

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AHRQ Releases TeamSTEPPS® Training

Staff Contact: Jessica Rowden

Today, the Agency for Healthcare Research and Quality released TeamSTEPPS® for Office-Based Care, a version of the evidence-based program aimed at optimizing the use of evidence, information, people and resources to achieve the best outcomes for patients. The American Hospital Association’s Health Research & Educational Trust affiliate coordinates TeamSTEPPS training centers and an annual national conference. They also develop free TeamSTEPPS materials for provider use, including this version for office-based care through a contract with AHRQ.

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CEO Announcements


General Leonard Wood Army Community Hospital Names New Commander

Staff Contact: Carol Boessen

COL Peter E. Nielsen, Hospital Commander of General Leonard Wood Army Community Hospital in Fort Leonard Wood, announced he will retire in June. He has served as Hospital Commander since July 2014. COL Christian Meko has been named his successor, effective June 24. A list of CEO changes is available online.

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Consider This ...

The week is Patient Safety Awareness Week. Missouri’s overall health care quality ranking remains average, with only slight improvement in patient indicators, ranking 20th in the nation.

Source: Center for Patient Safety