MHA Today | November 11, 2016

November 11, 2016

MHA Today: News for Healthcare Leaders
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MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.


Herb Kuhn, MHA President & CEO

There was a strong signal for change sent throughout the nation on Tuesday. It hadn’t been a signal the pollsters or professional political class had heard during the long march to the election. Bernie Sanders’ and President-elect Trump’s voices were considered part of the noise in a contentious, and sometimes ugly, fight for the nation’s highest office. Voters added their voice on Election Day, dialing in the signal.

It looks as if President Obama’s singular achievement, the Affordable Care Act, is in great peril. The likelihood of “repeal and replace” has moved much closer to a policy option, with Republicans controlling the executive and legislative branches of government, beginning in January 2017. What replace means — and what the nation’s health care system looks like afterwards — are at present, unanswerable. Much work remains on a broadly acceptable alternative.

What’s clear is that a grand negotiation for the future of the ACA, or more appropriately the ACA’s replacement, has begun. There are too many popular aspects of the law — guaranteed issue and community rating for insurance, and expanded access especially for nearly 20 million previously uninsured — to expect repeal without replace. As a result, the immediate focus has been on how to keep the best aspects, and reform or replace the troublesome, contentious parts.

With three days since the election, calmer heads are beginning to prevail — or at least the shock is wearing off. Now the focus is turning to understanding Trump’s governing style, policy rather than political agenda, and relationship with leaders in the new Congress. And, Obamacare 2.0, or Trumpcare, may create new opportunities for the health care system. Changes in the state’s political environment will provide a ripe climate for medical liability reform and advances in behavioral health. A new look at Medicaid and the health insurance marketplace could empower states, and bring new opportunities for innovation. The ACA’s provisions — many of which were originally conservative solutions to a better functioning system — may possibly remain.

Since it was adopted, the law has been like a millstone — one policy and one political wheel. Since 2010, the political bedstone wasn’t well-aligned with the policy-running stone. It wasn’t producing grist evenly. It was especially out of alignment in states like Missouri that shunned essential ACA provisions. The Trump election, and that of Governor-elect Greitens, are a new opportunity to address the design.

Retaining and expanding coverage is essential. And, not putting states like Missouri at a disadvantage that have taken a cautious, conservative approach, should be a priority for lawmakers and policymakers as they look at Medicaid block-grant options. However, coverage is only one aspect of the program that must be protected.

Our focus on the Triple Aim must be a centerpiece of a new system. Above all else, the ACA forced health care leaders to lean in and focus on safety, quality and value. Those goals and actions should not be lost during the changes that may be ushered in throughout the upcoming months.

The Trump rhetoric has been significantly pro-growth. However, often the best approach for the management of resources is conservation, rather than investment. A health care system that builds on better health, better care and lower costs can help stabilize the massive outlay of gross domestic product spent on inefficient and unnecessary care — opening resources for other priorities. Even as demand for care increases, more efficient care can offset potential increases in cost.

Many of the investments that have supported the movement toward quality and patient safety may be at risk, but they shouldn’t be. They are the path to a better system and must be retained. As we embark on the Health Improvement and Innovation Network, this has never been more evident. We’re seeing real savings and better care.

Fighting the same fights never makes sense. It’s a losing proposition for all involved. Fighting to ensure that the next major transformation of the system embraces the best of what’s working and allows space for innovation must be the focus.

Our raucous political system sometimes delivers unexpected returns. In those moments, the nimble separate the wheat from the chaff … the existing from the opportunity. Tuesday delivered Wednesday’s opportunity.

After more than a year of listening intently to identify the signal that has been buried in all the noise, the message has become clear. The status quo will not hold. As the intensity of the clarion call for change grows, and the opportunities to create harmony among the disharmonic chords present themselves, hospitals will be there.

Amid all this uncertainty, we can, and must, continue to lean in to create a better system. And, this moment can be one that shapes how we deliver better value to our patients and communities.

Send me an email to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Announces 2017 Premiums And Deductibles For Medicare Parts A And B
CMS Extends Submission Deadline For Reporting Perinatal Care Elective Delivery Data
CDC Issues Guidance On Outpatient Antibiotic Stewardship

Regulatory News
the latest actions of agencies monitoring health care

CMS Announces 2017 Premiums And Deductibles For Medicare Parts A And B

Staff Contacts: Andrew Wheeler or Daniel Landon

The Centers for Medicare & Medicaid Services has issued an overview of the 2017 premiums and deductibles for Medicare Part A and Part B coverage. It summarizes the more detailed regulatory notices for Medicare Part A deductibles and coinsurance, Medicare Part B premiums, deductibles and actuarial rates, and premiums for those ineligible for Part A coverage. The notices are slated to be published in the Federal Register on Tuesday, Nov. 15. MHA has published an issue brief with additional details.

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Quality and Population Health

CMS Extends Submission Deadline For Reporting Perinatal Care Elective Delivery Data

Staff Contact: Sherry Buschjost

Because of issues experienced with the Web-based data collection application, the Centers for Medicare & Medicaid Services has extended the deadline for submitting second quarter 2016 perinatal care elective delivery measure (PC-01) data from Tuesday, Nov. 15, to Tuesday, Nov. 22. The data submission deadline for second quarter 2016 chart-abstracted clinical measures and health care-associated infection measures remains Tuesday, Nov. 15.

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CDC Issues Guidance On Outpatient Antibiotic Stewardship

Staff Contact: Alison Williams

The Centers for Disease Control and Prevention has released a framework for improving antibiotic prescribing in outpatient settings. Its four core elements are commitment, action for policy and practice, tracking and reporting, and education and expertise.

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Did You Miss An Issue Of MHA Today?

November 10, 2016
MHA Distributes FFY 2019 Medicare SNF VBP Projection
MLN Connects Provider eNews Available
Trajectories — Missouri: Aim for Excellence
CMS Announces Unavailability Of Web-Based Data Collection Application
HRSA Opens Application Period For Rural Grant
Faircloth Announces Retirement From Twin Rivers Regional Medical Center

November 9, 2016
Election Solidifies Republican Control
CMS Publishes Details About Payment Reduction For Film X-Rays
September MUR Available On HIDI Analytic Advantage®
March of Dimes Releases 2016 Prematurity Report

November 8, 2016
CMS Releases Final CY 2017 PFS And Other Part B Services
MO HealthNet Issues Hospice Bulletin
CMS Announces VBP Webinar

November 7, 2016
Changes Proposed For Medical Residency Programs
CMS Provides Details About Hospital Appeals Settlement Process For 2016
TJC Releases Addendum To Specifications Manual
Webinars Scheduled For National Rural Health Day

Consider This ...

November is Pancreatic Cancer Awareness Month. Adenocarcinoma is the most common type of pancreatic cancer. It accounts for about 90 percent of all pancreatic cancers.

Source: Pancreatic Cancer Action Network