MHA Today | February 8, 2016

February 8, 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
CMS Issues Change Request, Adjusting IPPS Rates
CMS Announces QualityNet Data Center Migration
HIDI HealthStats — Sociodemographic Factors In Risk-Adjusted Readmission Measures
CDC Updates Zika Virus Guidelines
CMS Hosts Medicare Quality Reporting Webinars

Upcoming WEBINAR
Hospital and Health System Board Self Evaluation
February 25
12:30 to 2 p.m.

Regulatory News
the latest actions of agencies monitoring health care

CMS Issues Change Request, Adjusting IPPS Rates

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services has issued another change request to the inpatient PPS fiscal year 2016 Pricer. Updates include adjustments to the national operating rates and several other factors, such as the fixed loss outlier threshold, national operating outlier factor, reclassification budget neutrality factor and more. The revisions were needed because of Section 601 of the Consolidated Appropriations Act of 2016, which modifies the payment calculation with respect to operating costs of inpatient hospital services in Puerto Rico. The revisions are applicable to all IPPS discharges occurring on or after Jan. 1, 2016. MHA has published an issue brief with additional details.

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CMS Announces QualityNet Data Center Migration

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has announced a relocation of the information system data center that supports the hospital quality reporting programs. The new data center is a state-of-the-art facility offering increased stability and security. Although the HQR programs will ultimately benefit from this change, the relocation will result in a delay in the anticipated CMS system release applicable to fourth quarter 2015 discharges/encounters (including sepsis data and ICD-10 codes). The following applications for inpatient quality reporting and outpatient quality reporting will be impacted.

  • hospital inpatient population and sampling
  • hospital inpatient measure designation
  • CMS Abstraction Reporting Tool
  • CMS clinical warehouse
  • vendor authorization

CMS anticipates that fourth quarter 2015 applications will be made available early- to mid-March and will provide updates through listservs and on QualityNet. No disruptions in service that would adversely impact February 2016 submission deadlines for hospital IQR, OQR and PPS-exempt cancer hospital quality reporting third quarter 2015 discharges/encounters are anticipated. The current IQR, OQR and PCHQR May 2016 submission deadlines will remain in place.

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HIDI Tech Connect

HIDI HealthStats — Sociodemographic Factors In Risk-Adjusted Readmission Measures

Staff Contact: Mat Reidhead

TrajectoriesThe February issue of HIDI HealthStats highlights the importance of including sociodemographic factors in risk-adjusted readmission measures. Numerous sociodemographic status factors have been shown to influence patients’ risk of readmission following an inpatient hospitalization. In light of the growing body of evidence, beginning in April 2015, the National Quality Forum enacted a two-year trial period to further evaluate risk adjustment for SDS factors in national quality reporting and incentive programs. Measure developers now are required to test the effects of SDS factors in statistical models and provide a conceptual and empirical justification for the inclusion or exclusion of individual or contextual SDS factors. Conceptual evidence refers to the rationale and associated theory between the health outcome being measured and the patient’s sociodemographic status or context. Empirical evidence refers to a known, observed and quantified statistical relationship between the measured outcome and SDS factor. Table 1 in this edition of HIDI HealthStats includes the conceptual and empirical bases for the individual and contextual SDS factors included in the MHA/Hospital Industry Data Institute SDS-enriched readmission methods.

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Quality and Population Health

CDC Updates Zika Virus Guidelines

Staff Contacts: Jackie Gatz or Alison Williams

The Centers for Disease Control and Prevention issued updated guidelines for testing pregnant women who live in or travel to areas with ongoing Zika virus transmission, and new guidelines for preventing sexual transmission of the virus. Thirty-five travel-associated cases of Zika have been detected in 11 states and the District of Columbia since 2015. Another 10 cases have been reported in Puerto Rico and the U.S. Virgin Islands; all but one of them locally acquired. Recent evidence suggests a possible association between maternal Zika infection and adverse fetal outcomes, such as microcephaly. Until more is known, the CDC strongly advises pregnant women to consider postponing travel to Zika-affected areas, or talk to their health care provider before they do and strictly follow steps to avoid mosquito bites. Only about 1 in 5 people infected with the mosquito-borne virus will get sick, and their illness is usually mild. There currently are no vaccines or medications to prevent or treat Zika infections. For more information, visit and

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CMS Hosts Medicare Quality Reporting Webinars

Staff Contact: Jim Mikes

The Centers for Medicare & Medicaid Services is hosting a webinar, titled “The Medicare Quality Reporting Programs: What Eligible Providers Need to Know in 2016,” at 10:30 a.m. Wednesday, Feb. 10. Registration is required. The following topics affecting providers’ current and future reimbursement will be covered.

  • Medicare access and CHIP Reauthorization Act preview
  • 2016 incentive payments and 2018 payment adjustments
  • 2016 physician quality reporting system updates
  • 2018 value-based payment modifier policies
  • physician compare updates for 2016
  • meaningful use of certified electronic health record technology in 2016

The webinar also will be offered at 10:30 a.m. Wednesday, Feb. 17. Participants are required to register separately for this webinar.

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Consider This ...

This week is Burn Awareness Week. Fires and burns are the third leading cause of deaths that occur in the home and the third-leading cause of injury-related fatalities among children ages 1 to 9 in the U.S.

Source: Shriners Hospitals for Children