MHA Today | April 18, 2016

April 18, 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
MHA Distributes Analysis Of Medicare’s HAC Reduction Program
WPS Hosts New Rural Health Clinic Billing Teleconference
CMS Publishes Final Rule On Home And Community-Based Services
HIDI HealthStats — Diabetes And Health Equity
CMS Issues Guidance For Labs And Radiology

What You Need To Know This Week

  • The Centers for Medicare & Medicaid Services' Star Ratings will be released on Thursday, April 21. MHA has created talking points on the issue.
  • Watch for an issue brief on the Hospital Inpatient PPS for Acute Care Hospitals and the Long-Term Care Hospital PPS and Fiscal Year 2017 Rates.

Advocate
state and federal health policy developments


MHA Distributes Analysis Of Medicare’s HAC Reduction Program

Staff Contact: Andrew Wheeler

MHA has released a projection of the effect of Medicare’s federal fiscal year 2017 hospital-acquired conditions reduction program based on the fourth quarter 2015 data update from Hospital Compare. The analysis, which is posted on HIDI Analytic Advantage®, evaluates performance scores for hospitals included in the Centers for Medicare & Medicaid Services’ Hospital Compare database. The latest release indicates that the projected effect on hospitals’ finances is estimated to decrease operating payments to Missouri hospitals by $7.9 million. Seventeen of Missouri's 74 (23 percent) participating hospitals are projected to receive the payment reduction. As mandated by the HAC program, 25 percent of participating hospitals in the nation receive a penalty.

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Regulatory News
the latest actions of agencies monitoring health care


WPS Hosts New Rural Health Clinic Billing Teleconference

Staff Contact: Andrew Wheeler

The Wisconsin Physicians Services, a Centers for Medicare & Medicaid Services’ Medicare Administrative Contractor, is hosting a teleconference about the rural health clinic billing requirements that took effect April 1. The “Ask-the-Contractor” teleconference is scheduled at 10 a.m. Thursday, April 21. Registration is required and will be closed at 8 a.m. Wednesday, April 20.

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CMS Publishes Final Rule On Home And Community-Based Services

Staff Contacts: Sarah Willson or Jim Mikes

The Centers for Medicare & Medicaid Services published a final rule to enhance the quality of home and community-based services and provide protections for participants. The rule ensures that individuals who receive HCBS have full access to the benefits of community living and have the opportunity to receive services in the most integrated and appropriate type of setting. Missouri’s Medicaid Audit and Compliance Unit is participating in the state’s transition plan and transition activities.

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HIDI Tech Connect


HIDI HealthStats — Diabetes And Health Equity

Staff Contact: Mat Reidhead

HIDI HealthStats, April 2016 The April issue of HIDI HealthStats discusses how diabetes affects Missouri communities differently and the opportunities that arise to promote health equity. Multiple determinants from an individual’s physical and social surroundings have complex interactions that can lead to a higher risk of developing Type 2 diabetes, which accounts for 95 percent of all cases. These factors and interactions are referred to as the social determinants of health that are the most influential predictors of individual and population health outcomes. The development and consequences of diabetes is a cyclical process known as the sociobiologic cycle. Type 2 diabetes is both caused by, and results in, adverse social and health-related outcomes for individuals with the disease. Social determinants of health — such as socioeconomic status, environmental context, access to nutritious food and material deprivation — result in behavioral traits and chronic biological and psychological stress, which increase the risk of developing diabetes. In turn, individuals’ bio-psychological responses to the disease result in social consequences that exacerbate the social determinants influencing adverse outcomes, and the sociobiologic cycle repeats. Two infographics demonstrate the cycle of diabetes using two Missouri ZIP codes in both St. Louis and Kansas City.

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Noteworthy


CMS Issues Guidance For Labs And Radiology

Staff Contact: Jim Mikes

The Centers for Medicare & Medicaid Services has issued two documents clarifying requirements for computed tomography imaging services and clinical laboratory services. Survey and certification memo 16-19 ALL provides FAQs for complying with XR-29 standards and survey and certification memo 16-20 CLIA provides direction on complying with quality control standards.

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Consider This ...

According to the American Nurses Association, by 2022, there will be a need for 3.44 million nurses, of which 1.13 will need to be registered nurses.

Source: American Nurses Association