MHA Today | February 10, 2017

February 10, 2017

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.


Herb Kuhn, MHA President & CEO

Last weekend I attended a relative’s birthday party. It was held at a roller rink. I roller skated occasionally as a kid, but it’s been many years since I’ve laced up skates and taken to the rink. Nonetheless, I felt like I should participate.

I started out tentatively. Relearning how to skate is like getting back on a bicycle after years without riding — you understand the mechanics, but have to find the equilibrium. Skating rink designers understand this — they put a rail around the edge of the rink to help the cautious and faltering gain a better footing.

Earlier this week, MHA held a series of member calls to walk through Gov. Greitens’ budget proposal for state fiscal year 2018. This is Greitens’ first budget. As predicted, it will be a year of belt tightening.

Among the more talked about elements of the proposal, are a 3 percent cut to most Medicaid provider payments and an eligibility change for some individuals who receive in-home or nursing home care. Hospitals won’t be subject to the 3 percent reduction. Budget officials say that the reduction reverses a past reimbursement change that did not apply to hospitals because of their FRA-based reimbursement system. Moreover, the state’s fiscal woes are largely in the general revenue column, and the state’s Medicaid reimbursements to hospitals are largely outside of general revenue.

Reducing Medicaid hospital payments by 3 percent would equate to about $93 million. However, we should avoid being too giddy in taking a victory lap around the rink. Hospitals are not subject to the 3 percent cut, but the interconnected nature of our health care system could result in hospitals feeling some effects.

For example, it may be more difficult to place a Medicaid patient in a nursing home or arrange for in-home care services upon discharge. Without the appropriate post-discharge care and placement services, some of these patients may be boarded in the hospital or readmitted. In addition, some hospitals have in-home care or nursing home affiliates that will experience the cuts. The same may hold true for hospital-employed physicians or hospital retail pharmacies. Anyone who has ever been skating knows that if the person in front of you takes a tumble, it’s easy to get mired in their fall.

Gov. Greitens’ budget suggests the long-term predictability and stability of the federal reimbursement allowance — the quarter-century partnership between hospitals and policymakers — will be sustained. That’s a very good signal. Where other states have diverted their provider taxes, or failed to maintain their integrity, they have opened the door to federal scrutiny. Missouri has billions of dollars at stake in the continuity of its Medicaid provider tax system. And, federal changes to the current system would dwarf the problems reflected in the current budget.

In difficult budget times, the FRA has provided the side rail for the state’s Medicaid stability. However, Missouri can’t stay on the rail forever.

Hospitals and the health care system get better every day. We need a system that is stable and confident enough to leave the rail. Missouri needs a Medicaid program that replaces a vicious cycle of falls and cuts with a virtuous cycle of improvement and value.

Budget-making is hard. So is roller skating.

Send me a note to let me know what you are thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Senate Confirms Price As Secretary Of HHS
MO HealthNet Corrects Asthma Services Start Date
MLN Connects Provider eNews Available
CMS Extends Feb. 15 Submission Deadline
CMS Announces IQR Education Session
AHA Offers Webinar On Strategies For Promoting A Safe Workplace

state and federal health policy developments

Senate Confirms Price As Secretary Of HHS

Staff Contact: Andrew Wheeler

Early this morning, by a vote of 52-47, the U.S. Senate confirmed Tom Price as the Secretary of Health and Human Services. Price is expected to “usher through any changes in health care policy.”

Back To Top

MO HealthNet Corrects Asthma Services Start Date

Staff Contact: Brian Kinkade

MO HealthNet has issued a corrected provider bulletin to clarify that asthma education and environmental assessment services are reimbursable for service dates on or after Feb. 1.

Back To Top

Regulatory News
the latest actions of agencies monitoring health care

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.

  • January 2017 outpatient PPS pricer file
  • clinical laboratories: easier to report lab data
  • understanding and promoting the value of chronic care management services call
  • Improving Medicare Post-Acute Care Transformation Act in 2017 call

Back To Top


Quality and Population Health

CMS Extends Feb. 15 Submission Deadline

Staff Contact: Sherry Buschjost

Because of system issues and the inaccessibility of QualityNet reports, the Centers for Medicare & Medicaid Services has extended the Wednesday, Feb. 15, quality reporting submission deadline. The extension affects submission of the following third quarter 2016 data. Details on affected programs and measures are available.

  • hospital inpatient quality reporting chart-abstracted clinical and web-based perinatal care (PC-01) measures — Friday, Feb. 24
  • PPS-exempt cancer hospital quality reporting cancer-specific treatment measures — Friday, Feb. 24
  • health care-associated infection data submitted through the Centers for Disease Control and Prevention’s National Healthcare Safety Network for the hospital IQR and PCHQR programs — Wednesday, March 15
  • inpatient rehabilitation facility and long-term care hospital quality reporting data submitted through the CDC’s NHSN — Monday, May 15

Back To Top


CMS Announces IQR Education Session

Staff Contact: Sherry Buschjost

The next education session for hospitals participating in the Hospital Inpatient Quality Reporting Program is scheduled at 1 p.m. Wednesday, Feb. 22. The webinar is titled “Hospital Inpatient Quality Reporting Program Requirements for Fiscal Year 2019 Payment Determination.” Registration is required.

Back To Top

Workforce News

AHA Offers Webinar On Strategies For Promoting A Safe Workplace

Staff Contacts: Meredith Kenyon or Jackie Gatz

The American Hospital Association and the American Society for Healthcare Risk Management are hosting a webinar at 2 p.m. Wednesday, Feb. 15, on practical strategies for promoting a safe workplace culture. The webinar is part of the Hospitals Against Violence educational series.

Back To Top

Did You Miss An Issue Of MHA Today?

February 9, 2017
Judge Rules Against Proposed Anthem/Cigna Merger
Governor Nominates Director Of Health And Senior Services
State Senate Committee Approves Prescription Drug Monitoring Bill
CMS Updates OQR Known Issues Document
HIDI Posts 2016 Annual Licensing Survey Of Missouri Hospitals
HRSA Announces Loan Repayment Programs
Federal Officials Warn Hospitals To Be On Alert For “Lone Wolf” Terror Attacks

February 8, 2017
Committee Defeats Substitute On Covenants Not To Compete
State Legislative Proposal Blurs Physician Board Certification Standards
MHA Supports Bills On Death Investigation And Physician Loan Repayment
Missouri ACHE Chapter Changes Name

February 7, 2017
House Committee Hears Liability Reform Legislation
Missouri House Committee Hears PDMP Bill
TJC Announces Pioneers In Quality Webinar
FLEX Program Releases Educational Resources For Participating CAHs
December MUR Available On HIDI Analytic Advantage®

February 6, 2017
CMS Releases Biweekly Marketplace Enrollment Snapshot
OIRA Issues Guidance On “One-In, Two-Out” Executive Order
CMS Hosts MOON Webinar
CMS Announces IPFQR Webinar

Consider This ...

Every year in the U.S., approximately 50,000 people visit the emergency department because of accidental carbon monoxide poisoning.

Source: Centers for Disease Control and Prevention