MHA Today | December 30, 2016

December 30, 2016

MHA Today: News for Healthcare Leaders

twitter linkedin MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

Editor’s Note: MHA Today will not be published Monday, Jan. 2. Publication will resume Tuesday, Jan. 3.


Herb Kuhn, MHA President & CEO

As I was thinking about what to share in my last column of the year, it occurred to me that three recent reports — when taken together — underscore the need to continue our advance toward the Triple Aim and signal the challenges ahead. Next year, new leaders will emerge with their own solutions to improving health and health care. We don’t yet fully understand their vision for a better system. However, the opportunities to continue improving in some areas and targets for improvement in others are abundantly clear.

The most recent report from the Trust for America’s Health reviewed states’ preparedness to protect the public from diseases, disasters and bioterrorism. Overall, Missouri scored in the bottom 10 states. Much of Missouri’s funding for public health and protection comes from federal sources, where Missouri fares slightly better. However, on the state level, Missouri ranks 50 of 51 among the states and the District of Columbia for public health spending at $5.90 per capita.

Low state public health spending has resulted in Missouri underfunding programs like vaccination efforts, smoking cessation and chronic disease management that can have a significant impact on individual health and save health system expenditures. However, public health investments from the federal level have supported Missouri’s hospital preparedness programs and ability to respond to emerging health threats.

This year’s America’s Health Rankings report from the UnitedHealth Foundation again placed Missouri in the lower bottom half of states, at 37 overall. It should surprise no one that Missouri’s score of 41st for cancer and cardiovascular deaths, and 39th for diabetes, are linked to Missouri’s poor health behavior scores. Missouri is 46th in smoking, 40th in obesity, 33rd in physical activity and 36th in drug deaths.

Both of these reports point to a state public health system that is under resourced. And, local officials have little wherewithal to make up the difference. Hospitals are working to expand their community health improvement efforts disadvantaged by low public health investment.

There was a positive signal among the public health noise. This fall, the U.S. Department of Health & Human Services’ Assistant Secretary for Health issued a report on the future of public health, “Public Health 3.0: A Call To Create A 21st Century Public Health Infrastructure.” The report focuses on emerging opportunities, including “upstreamist” approaches to health problems that are targeted, community asset-centered and data driven. In addition, it specifically identifies the social determinants of health as a driver of variation in outcomes, and recognizes the overlap of the health care system and public health — where clinical interventions and prevention, care outside the clinical environment, and population health strategies meet. This call to action from public health aligns with the health care industry shift to population-based health care. The alignment of public health and health care services will strengthen our citizens and communities.

Spending more, without building a better system for the delivery of care and public health, doesn’t make sense. Of course, spending less for the sake of savings in health expenditures without changes, likely will deliver poorer results as well.

This year, MHA and member hospitals helped shape the discussion about the drivers of disparities and outcomes that are attributed to sociodemographic differences at the community level. We also published, along with the Kansas Hospital Association, new research on acute childhood experiences and how they can be used as a population health indicator. Policymakers will have to choose whether investments in much more targeted interventions, with health care and the community, will continue. Addressing social determinants is a critical upstream focus.

The Triple Aim — better health, better care and lower costs — remains the best vehicle for improving health and the health care system. Nipping around the corners, cutting investments in improvement and failing to recognize that much of the path to a better system requires building healthier, stronger communities, would be a mistake.

We need a holistic approach. Hospitals can’t be expected to build stronger communities in areas where access to care, healthy food and other essentials of health don’t exist.

Policies that support stronger community and public health, are policies that recognize interdependencies. Our best partners will continue to be those that understand the value of a healthy Missouri.

Have a great New Year’s holiday, and thank you for all you do to make Missouri better.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Greitens To Separate State Of The State Address And Proposed Budget
CMS Announces IQR Webinar

state and federal health policy developments

Greitens To Separate State Of The State Address And Proposed Budget

Staff Contact: Daniel Landon

Gov. Eric Greitens’ State of the State address to the Missouri General Assembly will occur at 7:30 p.m. on Jan. 17, 2017. In a break from long-standing tradition, his speech will not include the release of a proposed budget for the next fiscal year. The proposed budget will be unveiled at a later date. The state constitution requires the governor to submit a proposed budget to the General Assembly within 30 days of the legislature’s convening, which is Feb. 3, 2017. Yesterday, the head of Greitens’ transition team discussed legislative priorities and transition activities. Greitens will take office Jan. 9, 2017.

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Quality and Population Health

CMS Announces IQR Webinar

Staff Contact: Sherry Buschjost

An outreach and education webinar for participants in the Hospital Inpatient Quality Reporting Program is scheduled at 1 p.m. Wednesday, Jan. 11, 2017. The webinar, titled “SEP-1 Early Management Bundle, Severe Sepsis/Septic Shock: v5.2a Measure Updates,” will discuss the impact on abstraction as a result of changes in version 5.2a of the specifications manual. Registration is required.

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Did You Miss An Issue Of MHA Today?

December 29, 2016
CMS Releases Inpatient Quality Reporting Checklist
CMS Releases OQR Specifications Manual Version 10.0a
Nance Retires From Excelsior Springs Hospital

December 28, 2016
TJC Aligns Leadership Standards With CMS
CMS Issues Additional Guidance For VTE eCQM 2016 Reporting
CMS Updates Hospital Compare

December 27, 2016
GAO Assesses Medicaid Personal Care Oversight
MO HealthNet Publishes Medicaid Fee-For-Service Report
CMS Seeks Comments On Expanding PACE Model
MHA Publishes Issue Brief On Episode Payment Model Rule
CMS Issues Preliminary Guidance On Off-Site Outpatient Payment Changes

Consider This ...

The American Cancer Society estimates that when 2016 cases are tallied, more than 76,000 Americans will have been diagnosed with melanoma during the year.

Source: STAT