MHA Today | August 5, 2016

August 5, 2016

MHA Today: News for Healthcare Leaders

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Herb Kuhn, MHA President & CEO

Predicting the outcome of an election is like predicting the path of a hurricane. All the fancy tools that are available to build a solid guess generally result in a product that is just that — a guess. And, that’s in the best of years. One day, one media cycle or one tweet can fundamentally alter the course.

It’s an interesting political season nationally and in Missouri. Perhaps more interesting than any most of us have, or will, live through. There’s passion this year. Unfortunately, much of it is of the torch and pitchfork variety. And, for many, there’s a palpable sense that something has gone terribly wrong.

Although it is absolutely essential to hospitals and health care in our nation, our national conversation about the future isn’t what I want to discuss this week. State elections will have a significant influence on our ability to continue to serve communities while transforming health care delivery.

This week’s primary delivered results underscoring that the reshaping of our politics isn’t just occurring in distant, disconnected Washington, D.C.

For governor, Missouri Democrats overwhelmingly nominated Attorney General Chris Koster, who — a decade ago — was one of the brightest lights in the Missouri Republican Party. Not to be outdone, Missouri Republicans nominated author and former Navy SEAL Eric Greitens, formerly a Democrat. The contentious, four-way Republican primary was by far the most costly in the history of Missouri elections. Moreover, it proved that given the political malaise, even deep-pocketed donors couldn’t elect candidates in the gubernatorial contest or down the statewide ticket.

This is important for a variety of reasons. Nationally, and in Missouri, the future of the Affordable Care Act’s implementation will be influenced by candidates that emerge from the November elections. Certainly, policy lines have been drawn in the presidential and gubernatorial races. However, the Republicans nominated a standard-bearer with few details in his plan for health policy and a vice presidential candidate who, as governor, implemented Medicaid expansion, albeit one of the nation’s most conservative Medicaid expansion plans. The Democrats nominated a candidate with a long history of advocacy for health care coverage, and a senator from a state that has not adopted Medicaid expansion.

In Missouri, our nominees for governor have articulated their health care policies. The Koster campaign seems to have Medicaid expansion on the front burner — hopefully that will continue in his general election rhetoric. Greitens has opposed the Affordable Care Act. However, he strongly supports our veterans and as noted throughout the last few years, Medicaid expansion in Missouri would greatly benefit veterans and their families. Also, as a political outsider, he has never voted on the topic and has no record to defend or which to adhere.

These elections matter. However, the real work will occur in the Missouri General Assembly. The next three months will be essential to shaping the composition of that body and their attitude about the future of our efforts to improve health care in Missouri.

There are some fundamental questions I urge all members of the hospital community to ask lawmakers as we embark on the last leg of the 2016 election cycle.

  1. What is your position on access to health insurance in Missouri?
  2. Will you partner with hospitals to improve care through new and innovative delivery models?
  3. Will you support providers by making sure health care dollars are retained locally?
  4. Are you committed to building the health care workforce that will be necessary to deliver care?
  5. What will you do to ensure that rural Missourians have access to the care they need?


Lawmakers will be reaching out to voters and opinion leaders as the general election unfolds. These questions should be on the lips of all 150,000 hospital employees as they interact with lawmakers who are interviewing for governor or a seat in the Missouri General Assembly. In addition, members of the communities we serve must understand that they have a stake in the answers.

Labor Day is the unofficial kickoff of the general election. Although MHA is engaged with lawmakers and candidates all year around, the public’s attention generally focuses in September. Before Labor Day, we will be delivering additional resources to hospitals and expanding our public outreach. However, the questions listed above will continue to form the core of the hospital community agenda for 2016.

The storm that is this election season will pass. What the nation, Missouri and the state’s hospitals do to prepare for the event and its aftermath will determine what recovery looks like.

Some might suggest hunkering down and waiting. That only makes sense when you’ve prepared.

It’s going to be an interesting summer and fall.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Announces FCHIP Demonstration Participants
MHA Releases Issue Brief On Final Payment And Policy Updates
CMS Releases CY 2016 eCQM Reporting FAQs
CMS Uploads October 2016 Overall Star Rating HSRs

state and federal health policy developments

CMS Announces FCHIP Demonstration Participants

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced the participants in the Frontier Community Health Integration Project Demonstration. The demonstration was established to increase access to care for Medicare beneficiaries in areas where access to health services can be limited. Ten critical access hospitals located in Montana, Nevada and North Dakota have been chosen to participate. The demonstration project began Aug. 1 and will continue for three years.

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Regulatory News
the latest actions of agencies monitoring health care

MHA Releases Issue Brief On Final Payment And Policy Updates

Staff Contact: Andrew Wheeler

Earlier this week, the Centers for Medicare & Medicaid Services released the final payment and policy updates for federal fiscal year 2017 for the inpatient and long-term care hospital prospective payment systems. MHA has published an issue brief with additional details about the final rule. Major provisions include the following.


  • payment increase of 0.95 percent for those that are meaningful electronic health record users and participate in the Hospital Quality Reporting Program
  • CMS finalized reversing previous years’ payment cuts associated with the two-midnight policy
  • Nantucket Cottage Hospital’s request to revise wage data was rejected
  • pushed back the use of S-10 to distribute Factor 3 Medicare DSH payments from fiscal year 2018 to no later than FY 2021
  • final guidance on how to implement provisions form the Notice of Observation Treatment and Implication for Care Eligibility Act
  • transition to a Winsorized “z-score” methodology within the hospital-acquired conditions pay-for-performance program

  • payment reduction of 7.1 percent
  • updates to the LTCH quality reporting program

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Quality and Population Health

CMS Releases CY 2016 eCQM Reporting FAQs

Staff Contacts: Dana Dahl or Sherry Buschjost

The Centers for Medicare & Medicaid Services, in collaboration with the Hospital Inpatient Value, Incentives, and Quality Reporting Outreach and Education Support Contractor, created an FAQ tool for calendar year 2016 electronic clinical quality measures. Content includes the inpatient quality reporting program and policy requirements, electronic health record incentive program and policy requirements, and eCQM data submission and reporting.

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CMS Uploads October 2016 Overall Star Rating HSRs

Staff Contacts: Dana Dahl or Stephen Njenga

The Centers for Medicare & Medicaid Services has uploaded the October 2016 Hospital Compare overall star rating hospital-specific reports on the QualityNet Secure Portal. Reports will be available through Saturday, Sept. 3.

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Did You Miss An Issue Of MHA Today?

August 4, 2016
TJC Releases Antimicrobial Stewardship Program Update
MLN Connects Provider eNews Available
Senators Urge CMS To Rescind IMD Exclusion
CIHQ Hosts Webinar On Proposed Changes To CMS CoPs

August 3, 2016
State Releases July 2016 General Revenue Report
CMS Releases Final Payment And Policy Updates
TJC Releases Survey Update For Life Safety
New Patient Safety Primer Highlights Learning Through Debriefing

August 2, 2016
CMS Opens Application Period For Comprehensive Primary Care Plus

August 1, 2016
CMS Issues Multiple Final Rules
Organizations Release eCQM Survey Results
CDC Updates NHSN Version 8.5.4 Release Notes
CMS Releases PPSR For FY 2017 VBP Program

Consider This ...

Allergies are the sixth leading cause of chronic illness in the U.S., with an annual cost in excess of $18 billion. More than 50 million Americans suffer from allergies each year.

Source: American College of Allergy, Asthma & Immunology