MHA Today | September 23, 2016

September 23, 2016

MHA Today: News for Healthcare Leaders

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Information about the Nov. 8 election is available on the Your Vote Matters page of Hospitals can help educate their communities about the election using the resources on MHAnet.


Herb Kuhn, MHA President & CEO September is Sepsis Awareness Month. For hospitals, awareness is essential.

Patients with septic shock have a mortality rate that increases 7.6 percent for every hour effective treatment is delayed. The slower the recognition — by the patient or family, and among the caregiving team — the less likely the chance for a positive outcome.

The August edition of HIDI HealthStats exposed the shocking increase in sepsis diagnosis — especially community-acquired sepsis. Although the full extent of the increase is unclear because of the influence of surveillance bias, it was gratifying to see that mortality rates are declining. Because the condition is costly to treat, fast moving and potentially lethal, sepsis has garnered attention as a high-priority and high-value target for quality improvement interventions.

The most recent edition of Trajectories includes analysis of MHA’s statewide sepsis immersion pilot project, two Missouri hospitals’ stories about their sepsis recognition and intervention journeys, and resources to help hospitals understand the processes to improve sepsis care. In addition, the research includes stories about Kansas Healthcare Collaborative participants’ successes. Both HIDI HealthStats and Trajectories were produced in partnership with the Kansas Hospital Association.

There are several threads that run through the projects, case studies and recommendations.

Sepsis may be a condition that’s treated in the inpatient and intensive care setting, but it largely presents through the doors of the emergency department. Since the majority of sepsis begins outside of the hospital environment, EMS personnel and ED staff recognition is essential.

These same staff need to be prepared to perform early intervention and treatment, since sooner is better with sepsis. One effective solution is to have trained sepsis recognition and response champions on the front line, combined with an evidence-based model of care, to expedite diagnosis and treatment.

As with other evidence-based care models, processes are only as good as their implementation. Tools and prompts are essential to keeping sepsis top of mind. During the nine-month MHA sepsis immersion pilot project, tools and processes implemented at participating hospitals led to a 7.6 percent increase in initiating Surviving Sepsis Campaign sepsis bundles.

Finally, a data-driven feedback loop is essential to identify gaps in processes. Identifying systems’ failures allows new opportunities for training and better system design reflective of hospitals’ organization and culture.

The stories in Trajectories explain how and why Freeman Health System and Mercy Hospital Cassville advanced through their sepsis journeys. Their experience, the experience of the Kansas Healthcare Collaborative and the rich data available from a structured intervention campaign with a strong feedback loop, can inform each hospital’s path. And, it’s through this path — not regulation — that we’ll see progress.

In 2013, sepsis was the most costly inpatient hospital treatment, accounted for 3.6 percent of inpatient stays and cost $23.7 billion — 6.2 percent of all costs. Each year there are nearly 1 million sepsis patients; one quarter will die of the condition.

The August report identifies sepsis care progress in the two-state region. This month’s report outlines — from a hospital and clinician intervention perspective in Kansas and Missouri — why we are seeing that improvement.

There’s a lot of work to do. The first step is awareness.

I want to know what you think. Send me a note.

P.S. — The National Rural Health Association’s annual Critical Access Hospital Conference was held in Kansas City this week. Three Missouri hospitals were recognized during the conference.

  • Perry County Memorial Hospital in Perryville was named one of the nation’s Top 20 Critical Access Hospitals
  • Pike County Memorial Hospital in Louisiana was recognized as a Best Practice Recipient — Quality
  • Mercy Hospital Cassville was celebrated as a Best Practice Recipient — Patient Satisfaction

Please join me in congratulating these great Missouri hospitals.


Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Medicare Advantage Premiums Expected To Decrease For 2017
MLN Connects Provider eNews Available
U.N. Leaders Take Action To Combat Antimicrobial Resistance
HEN 2.0 Concludes Today
Barnes-Jewish St. Peters Hospital And Progress West Hospital Name New President

Regulatory News
the latest actions of agencies monitoring health care

Medicare Advantage Premiums Expected To Decrease For 2017

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced that the 2017 Medicare Advantage premiums are estimated to decrease about 4 percent, or $1.19 per month, in 2017. According to CMS, this represents a 13 percent reduction in premiums since the passage of the Affordable Care Act. Medicare Advantage enrollment is expected to increase to an all-time high of 18.5 million Medicare beneficiaries, which represent approximately 32 percent of all Medicare beneficiaries. Medicare Part D prescription drug premiums also are expected to remain stable. Medicare beneficiaries will have received $23.5 billion in savings and discounts in the coverage gap because of the ACA. CMS Acting Administrator Andy Slavitt stated, “Medicare Advantage and the prescription drug benefit continue to be a great option for seniors and people living with disabilities. Medicare enrollees will continue to have access to predictable premiums and high quality of care.”

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issues updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • dual eligible beneficiaries under the Medicare and Medicaid program fact sheet revisions
  • critical access hospital booklet revisions
  • provider compliance — reporting changes in ownership
  • electronic clinical quality improvement resource center news and resources
  • inpatient rehabilitation facility and long-term care hospital quality reporting program provider review reports — review data by Friday, Sept. 30

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Quality and Population Health

U.N. Leaders Take Action To Combat Antimicrobial Resistance

Staff Contact: Alison Williams

Yesterday, members of the United Nations committed to concerted action to address antimicrobial resistance. In a draft political declaration to be transmitted to the U.N. General Assembly for adoption, the U.N. agreed to develop national action plans on antimicrobial resistance in line with the World Health Organization global action plan and mobilize resources to implement those programs. Participants at the meeting stressed that antimicrobial resistance poses a number of grave threats, including a possible resurgence in tuberculosis, malaria, HIV/AIDS deaths and food insecurity.

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HEN 2.0 Concludes Today

Staff Contact: Jessica Rowden

For the last 12 months, 63 Missouri hospitals participated in the American Hospital Association/Healthcare Research and Education Trust cohort for the Hospital Engagement Network 2.0. As previously reported, total harms prevented during the HEN 2.0 project evaluation period of October 2015 through May 2016 totaled 622, bringing the cost savings to $4,426,467. Nationally, within the AHA/HRET cohort of 1,500+ hospitals, the number of harms prevented totals 34,422, bringing the cost savings to $288,171,052. MHA congratulates all participating hospitals.

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CEO Announcements

Barnes-Jewish St. Peters Hospital And Progress West Hospital Name New President

Staff Contact: Carol Boessen Chris Watts

Chris Watts has been named President of Barnes-Jewish St. Peters Hospital and Progress West Hospital in O’Fallon, effective early November. Watts has served more than 10 years in leadership roles at BJC HealthCare and currently is Vice President of Planning and Construction. He succeeds Larry Tracy, who resigned in July. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

September 22, 2016
HHS Partners With Drug Companies To Develop New Antibiotics
HEN 2.0 Project Results Reveal Impressive Improvements
MHA Recruits For Antibiotic Stewardship Program Immersion Project
Registration Opens For MHA’s Immersion Pilot Project Showcase
HIDI Hosts Monthly Focus Session Highlighting PPS Reports

September 21, 2016
State Courts Rule On Ballot Measures
Trajectories — Sepsis
CMS Releases Outpatient Quality Reporting Checklist
Hospitals Present Harm And Readmission Reduction Stories At HEN 2.0 Summit

September 20, 2016
MHA Releases Guide For Nonprofit Hospitals
CMS Issues Proposed Rule On Medicaid Fraud Control
CMS Announces IQR Webinar
NQF Revises Measure Endorsement Procedures
IHI Posts Helpful Definitions On Health Equity

September 19, 2016
Your Vote Matters
Trajectories — Sepsis
CMS To Update PSVA Tool
This Week Marks Prescription Opioid And Heroin Epidemic Awareness Week
CDC Releases Influenza Season Update

Consider This ...

September is Thyroid Cancer Awareness Month. The American Cancer Society estimates that there will be about 64,300 new cases of thyroid cancer in the U.S. in 2016. Of these new cases, about 49,350 will occur in women and about 14,950 will occur in men.

Source: Thyroid Cancer Survivors’ Association, Inc.