MHA Today | January 16, 2017

January 16, 2017

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
Greitens Announces Spending Withholding Choices
HHS Finalizes New Medicare Appeals Procedures
FDA Regulation Bans Powdered Gloves
New Missouri RAC Contractor Hosts Webinar
HIDI HealthStats — Medicaid Utilization
CMS Announces Upcoming Education Sessions
RUPRI Releases Marketplace Rural Enrollment Brief
Henze Announces Retirement From Lake Regional Health System

What You Need To Know This Week

  • Today, you received a legislative alert asking for your quick action on medical liability legislation. The legislation will be reviewed by a Senate committee on Wednesday.
  • Tomorrow, Gov. Greitens will deliver his State of the State address. MHA will provide a follow-up analysis on Wednesday.
  • MHA will publicly release its annual community investment report tomorrow. MHA members received the report and talking points earlier today.

Advocate
state and federal health policy developments


Greitens Announces Spending Withholding Choices

Staff Contact: Daniel Landon

Gov. Greitens has announced his budget withholdings for the current state fiscal year. The spending reductions have been made necessary by a downturn in revenue collections.

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Regulatory News
the latest actions of agencies monitoring health care


HHS Finalizes New Medicare Appeals Procedures

Staff Contacts: Andrew Wheeler

In an attempt to address the significant backlog of Medicare appeals, the U.S. Department of Health & Human Services finalized regulations which would change the procedures used to process denials. The final rule allows, in some cases, attorney adjudicators to hear appeals in lieu of an administrative law judge. The rule also allows the HHS Departmental Appeals Board to designate certain decisions as precedential.

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FDA Regulation Bans Powdered Gloves

Staff Contacts: Daniel Landon or Sarah Willson

The Food and Drug Administration has issued a final regulation banning powdered surgery and patient examination gloves, as well as absorbable powder for lubricating medical gloves. The agency has determined that the products “present an unreasonable and substantial risk of injury or illness.”

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New Missouri RAC Contractor Hosts Webinar

Staff Contacts: Andrew Wheeler

Cotiviti was recently selected to be the recovery audit contractor for Missouri. WPS Government Health Administrators is hosting a webinar at 10 a.m. Thursday, Feb. 9, to introduce Cotiviti and explain some notable differences between the new RAC contract and the prior contract. The webinar will highlight some of the key timeframes with the auditing process, and review the resources Cotiviti supplies for providers. Registration is required.

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HIDI Tech Connect


HIDI HealthStats — Medicaid Utilization

Feb HIDI HealthStats

Staff Contact: Mat Reidhead

The February edition of HIDI HealthStats highlights opportunities to generate better value in Missouri’s Medicaid program. MO HealthNet, Missouri’s Medicaid program, provides health insurance coverage to more than 800,000 low-income Missourians, including 38 percent of all children and 9 percent of all senior citizens in the state. The program accounts for nearly one-third of the total Missouri budget, and features pronounced cost centers. Individuals in the aged, blind and disabled eligibility category account for just over one-quarter of all beneficiaries, but two out of every three dollars spent on the program.

Additionally, both Medicaid delivery models in Missouri feature highly concentrated groups of high-cost patients and hospital superutilizers, yet significantly different populations. Managed care beneficiaries consist largely of children and mothers while fee-for-service covers large groups of medically and socially complex aged, blind and disabled beneficiaries. The disproportionate concentration of health care consumption and expenditures among a small portion of the population is a well-documented facet of the health care system in the U.S. The top 1 percent of the population consistently consumes more than one-fifth of health care resources, the top 5 percent account for half of all spending, while the bottom 50 percent of the population accounts for just 3 percent of health care utilization and expenditures. This differential is more pronounced among patients with low socioeconomic status.

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Quality and Population Health


CMS Announces Upcoming Education Sessions

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has announced the following upcoming webinars. Registration is available at the links provided.

  • Hospital Outpatient Quality Reporting Program — “Help, I’m New: What Do I Do”
    9 a.m. and 1 p.m. Wednesday, Jan. 18
  • Inpatient Psychiatric Facility Quality Reporting Program — “IPFQR Program: Collecting and Entering Healthcare Personnel Influenza Vaccination Data”
    1 p.m. Thursday, Jan. 26
  • Inpatient Quality Reporting Program — “Question and Answer Session I – CY 2016 eCQM Reporting”
    1 p.m. Monday, Jan. 30
    The first of two sessions devoted to addressing submitter questions related to the mandatory electronic clinical quality measure submission process for calendar year 2016. The session will include insight for troubleshooting common CMS Quality Reporting Document Architecture Category I file submission errors.


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Noteworthy


RUPRI Releases Marketplace Rural Enrollment Brief

Staff Contact: Jim Mikes

The Rural Policy Research Institute has released its 2016 Rural Enrollment in Health Insurance Marketplaces, by State brief, which presents cumulative, county-level enrollment in the health insurance marketplaces. Results show that estimated enrollment rates varied considerably across the U.S. About half of all states, evenly distributed by Medicaid expansion status, had higher enrollment growth in nonmetropolitan areas from 2015 to 2016, and aggregated nonmetropolitan growth was greater than metropolitan growth in both expansion categories.

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CEO Announcements


Henze Announces Retirement From Lake Regional Health System

Staff Contact: Carol Boessen

Michael E. Henze, CEO of Lake Regional Health System in Osage Beach, has announced his plans to retire, effective Nov. 1. He has served as CEO at Lake Regional for 27 years, and as chair of the MHA Board of Trustees in 2007. He also served on a number of MHA committees during his tenure. A search is underway for Henze’s successor. A list of CEO changes is available online.

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Consider This ...

Last year, 1 percent of Medicaid patients in Missouri accounted for 20.8 percent of total hospital charges.

Source: February 2017 edition of HIDI HealthStats