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 Biweekly Marketplace Enrollment Snapshot
VA Rule Allows Full Scope Of Practice For Certain APRNs
CMS Launches IRF Compare And LTCH Compare Websites
MHA Provides Missouri ED Prescribing Guidelines Update
HIDI Releases Report On 2015 Average Hospital Charges For Medicare Patients
state and federal health policy developments
Staff Contact: Andrew Wheeler
The Centers for Medicare & Medicaid Services has issued its biweekly assessment of marketplace enrollment data for weeks five and six of the open enrollment period (Nov. 27 to Dec. 10). It includes state-specific data — 117,245 people enrolled in Missouri from Nov. 1 to Dec. 10. Nationally, more than 4 million enrollees signed up during that period. Although two more days were included, 129,536 people had enrolled in Missouri during last year’s open enrollment period.
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the latest actions of agencies monitoring health care
Staff Contact: Daniel Landon
The U.S. Department of Veterans Affairs has issued a final regulation that allows three types of advanced practice registered nurses — certified nurse practitioners, clinical nurse specialists and certified nurse midwives — to provide services in the VA system to their full scope of practice authority, as defined by the rule. State practice restrictions will not apply, other than limits on prescribing and administering controlled substances. When proposed, the rule also applied to certified registered nurse anesthetists. The final rule excludes CRNAs, citing the “VA’s lack of access problems in the area of anesthesiology.” However, the final rule solicits further comments about the CRNA exclusion, which are due Jan. 13, 2017.
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Quality and Population Health
Staff Contact: Jim Mikes
The Centers for Medicare & Medicaid Services has launched the Inpatient Rehabilitation Facilities Compare and Long-Term Care Hospitals Compare websites. The following quality measures will be reported on the new websites: rate of pressure ulcers that are new or worsened, catheter-associated urinary tract infections and rate of unplanned readmission after discharge from facility. Additionally, the LTCH Compare website includes a measure of central line-associated blood stream infections.
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Staff Contacts: Leslie Porth or Alison Williams
December marks one year since six health care associations collaborated to take steps to curb the fastest growing drug problem across the U.S. and Missouri — the misuse and abuse of opioid-based pain relievers. The Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians & Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association, Missouri Hospital Association and Missouri State Medical Association, endorsed emergency department prescribing guidelines in 2015, urging prescribers to adopt the guidelines and update their prescribing practices. In addition, educating the community on changes in prescribing practices and the risks associated with opioids was seen as a crucial step to curbing use. MHA collaborated with the Center for Health Policy and developed three patient education tools on opioid medications — proper disposal, pain management options and pre-operative pain management planning.
In June, MHA surveyed emergency departments statewide and noted, on average, that 70 percent of the guidelines had been implemented by those who responded. The main exception at that time was prescription of naloxone in the ED. Another survey will be distributed this month to all Missouri EDs to reassess the level of guideline implementation one year from publication. The goal of the survey is two-fold: to assist your organization in identifying evidence-based practice gaps relative to the guidelines and to help determine ways MHA can continue to support opioid reduction strategies in Missouri. Hospitals are encouraged to complete and return the survey by Jan. 25, 2017. Additional MHA-developed opioid resources can be found online.
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HIDI Tech Connect
Staff Contact: Shane VanOverschelde
HIDI’s Average Hospital Charges for Medicare Patients Report, based on the 2015 Medicare Provider Analysis and Review file, is now available. The MedPAR file includes 100 percent of Medicare beneficiaries using short-stay hospital inpatient services. The report features fiscal year 2015 hospital-specific detail on Medicare diagnosis related group cost components, utilization and ranks. It also includes a comprehensive set of reports and associated data files.
The report is available as an a la carte offering and also was available as part of the 2016 Premier Reporting Package. For current Premier Reporting Package subscribers, the report can be found on HIDI Analytic Advantage® in the following location, with the following file name.
Hospitals interested in subscribing to the 2017 HIDI Premier Reporting Package should review the package information. Hospitals interested in the a la carte offering of the report should contact HIDI.
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At least 43 percent of people with cell phones located in their bedrooms wake up at least once a night to respond to texts or messages. Even those who do not use their devices at night suffer from disturbed sleep because of the noise and light emitted.
Source: Hospitals & Health Networks