MHA Today | December 21, 2016

December 21, 2016
MHA Today: News for Healthcare Leaders

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

In This Issue
HHS Releases Report On Impact Of Social Determinants Of Health
CMS Finalizes New Medicare Episode Payment Models
MHA Releases CAH Reports And P4P Reference Guide
MHA Releases IPPS Reports And P4P Reference Guide
TJC Releases State Hospital Association Regulatory Update
MHA Distributes CY 2017 Medicare Outpatient PPS Final Rule
Wasden To Leave MU Health Care

Advocate
state and federal health policy developments


HHS Releases Report On Impact Of Social Determinants Of Health

Staff Contacts: Mat Reidhead or Andrew Wheeler

A new report to Congress from the U.S. Department of Health & Human Services’ Assistant Secretary for Planning and Evaluation explores the causal role of patient sociodemographic status on provider quality assessments used in CMS value-based payment programs. The first of a two-part study mandated by the Improving Medicare Post-Acute Care Transformation Act found that patients with high social risk experience poorer outcomes for most VBP measures evaluated, regardless of the provider they visited. In a corresponding blog post, Patrick Conway, CMS’ Acting Principal Deputy Administrator and Chief Medical Officer, discusses how CMS will consider the ASPE’s findings when setting future policy. While no direct mention was made of risk-adjustment for social determinants in programs such as the readmission reduction program, the post does mention plans to capture new data to better account for social risk factors in quality performance measurement.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Finalizes New Medicare Episode Payment Models

Staff Contact: Andrew Wheeler

The U.S. Department of Health & Human Services announced that the Centers for Medicare & Medicaid Services has finalized a rule which would implement the episode payment models. The EPMs would add surgical hip and femur fracture, acute myocardial infarction, coronary artery bypass graft, and cardiac rehabilitation cases to the already finalized comprehensive care for joint replacement cases. The EPM will reward or penalize hospitals within certain metropolitan statistical areas for the quality of services and cost to treat each episode. Hospitals located in all eight of the MSAs in Missouri will participate in at least one of the CJR or EPM models. It is unclear if the finalized rule will survive the new Trump administration. In September, 179 members of Congress signed a letter stating their belief that the Centers for Medicare & Medicaid Innovation has “exceeded its authority, failed to engage stakeholders, and has upset the balance of power between the legislative and executive branches.” Congressman Tom Price was one of the members who signed the letter. Since Price is the presumed new Secretary of HHS, the rule may be blocked or revised after the Trump administration takes office.

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MHA Releases CAH Reports And P4P Reference Guide

Staff Contact: Andrew Wheeler

Although critical access hospitals are excluded from the Medicare value-based purchasing pay-for-performance program, MHA is making available a simulation which illustrates the effect such a program would have on CAHs. The report includes the fiscal implications and scoring for each VBP domain, including clinical care process, patient experience of care, clinical care outcomes and safety of care. In addition, a reference guide also is available that includes summarized details about the measures, weights, and baseline and performance periods used within each of the Medicare pay-for-performance programs affecting prospective payment hospitals.

MHA also is releasing a quality program measure trending report that includes measures for each of the pay-for-performance programs. The report includes trending data through the third quarter 2016 data release of the Centers for Medicare & Medicaid Services’ Hospital Compare data. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are made available for download to authorized users of HIDI Analytic Advantage.® If you need a user ID and password or have questions about accessing these reports, contact HIDI.

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MHA Releases IPPS Reports And P4P Reference Guide

Staff Contact: Andrew Wheeler

MHA is releasing a series of Medicare pay-for-performance reports for inpatient prospective payment system facilities, including value-based purchasing, hospital readmissions reductions program and hospital acquired conditions. In addition, a reference guide is available that includes summarized details about the measures, weights, and baseline and performance periods for each of the pay-for-performance programs. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are made available for download to authorized users of HIDI Analytic Advantage.® If you need a user ID and password or have questions about accessing these reports, contact HIDI.

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TJC Releases State Hospital Association Regulatory Update

Staff Contacts: Sarah Willson or Jim Mikes

Yesterday, The Joint Commission released a state hospital association update that outlines major announcements and initiatives for 2017. It covers TJC’s launch of a medication compounding certification program, a reminder about the Jan. 1 implementation of the SAFER matrix for all programs, and changes to the clarification request process that takes effect Jan. 1.

As a reminder, MHA notified hospitals about emergency sterile compounding rules developed and approved by the State Board of Pharmacy. The Board of Pharmacy has numerous resources available for pharmacies regarding the rules, which went into effect Aug. 4. Among the resources are an implementation guide and two prerecorded webinars and handouts.

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MHA Distributes CY 2017 Medicare Outpatient PPS Final Rule

Staff Contact: Andrew Wheeler

MHA has made available an analysis illustrating the financial effect of the calendar year 2017 outpatient PPS final rule. The analysis, which is available online for authorized users of HIDI Analytic Advantage,® includes a summary for the nation, state and individual hospitals. Nationally, hospitals will experience an estimated 1.8 percent increase in payments. Missouri hospital payments are projected to increase by an estimated 1.47 percent. Even though the effects of the Medicare sequestration are not factored into the projected payment increases for 2017, the overall estimated sequestration cuts are footnoted.

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CEO Announcements


Wasden To Leave MU Health Care

Staff Contact: Carol Boessen

Mitch Wasden, University of Missouri Heath Care Chief Executive Officer, announced that he will be leaving Feb. 24, 2017, to become the Executive Vice President of Oregon Health & Science University in Portland, Ore. Wasden joined MU Health Care as Chief Operating Officer in June 2012 and has served as CEO since January 2013. A list of CEO changes is available online.

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Consider This ...

Air pollution is a major contributing factor in the deaths of around 600,000 children 5 years and younger around the world every year.

Source: Unicef