MHA Today | February 17, 2017

February 17, 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

Details of U.S. House Speaker Paul Ryan’s Affordable Care Act “repeal and replace” plan began to emerge this week. The House’s blueprint signals a fundamental change in the way Washington views, and may ultimately administer, our nation’s health care system. As with all significant policy shifts, the devil will be in the details. And, those details may emerge as early as the last week of February when Congress returns from recess.

On my desk, I keep a three-ring binder with the general descriptions of the titles and various subtitles of the ACA. It isn’t the full 906-page law; just the toplines. Keeping the full-text ACA and subsequent regulations in binders in my office would require moving my desk to the hallway.

Leading up to this week’s release, much of the conversation about the repeal and replace plan has focused on the law’s coverage provisions and its revenue sections. The health insurance provisions, including the marketplace design, are in Title I, while the Medicaid provisions are in Title II. Controversial revenue increases, like the “Cadillac Tax” and medical device tax, are in Title IX.

I’m concerned about Title III. This is where the ACA traded marketbasket updates, disproportionate share hospital payments and pay-for-performance risk, as revenue for new coverage. A lack of focus on repeal or transition of this title could cost Missouri hospitals more than $9.1 billion between 2017 and 2026.

The plan released by the House mentions addressing Medicaid DSH cuts, which is a promising sign. However, throughout a decade, Missouri’s DSH cuts amount to $3.4 billion, while marketbasket cuts and risk-sharing models cost $5.7 billion. Fixing DSH doesn’t address the cost of the cuts — in fact, it’s less than half back on our investment.

On Monday, MHA will send a set of resources to help hospitals engage lawmakers. The kit includes a breakdown of hospital cuts statewide and regionally, and a document explaining how the payment reductions under Title III are projected to affect your hospital or health system. The resources also include a congressional district breakdown on Title III cuts.

MHA has been briefing Missouri’s Congressional Delegation on the implications of changes to the ACA since the election. It’s time to redouble our efforts and broaden our voices.

I encourage all hospital employees to reach out to Missouri’s U.S. senators and the House of Representatives member that represents your hospital — or the multiple members for several hospital systems.

In addition, this is an important opportunity for board engagement. The resources we’re sending include a sample board resolution that can be customized to represent a board statement on the need for balance in repeal and replace — especially as it relates to Title III. Leaving these cuts in place — absent continuation of coverage — will have very real implications for hospitals throughout the state. A strong, local statement about the damage they could inflict will enhance the impact of our message.

The House’s blueprint is 19 pages — it’s three-ring binder worthy. It also represents where we are in the process. There isn’t a bill, consensus on a policy direction or agreement between the two chambers. That’s why it is so critically important to act now.

We need to reinforce with lawmakers that the Title III problem must be a parallel priority with repeal — if there is a repeal, Title III must be included. The ability of Missouri’s hospitals to serve their communities is at stake.

Thanks for your ongoing engagement. Send me a note to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
U.S. House GOP Summarizes ACA Plan
MO HealthNet Schedules Managed Care Webinars
MO HealthNet Updates Medicaid Provider Manuals
MLN Connects Provider eNews Available
Organizations Host Opioid Overdose Conference

state and federal health policy developments

U.S. House GOP Summarizes ACA Plan

Staff Contacts: Daniel Landon or Brian Kinkade

Republicans in the U.S. House of Representatives have published an overview of their plan to repeal and replace the Affordable Care Act. Its components include repeal of the individual and employer mandate, tax credits for health insurance coverage, health savings accounts, renewed emphasis on high-risk pools, per-capita funding caps for Medicaid with states choosing between a block grant or global waiver, and repeal of the ACA’s pending Medicaid disproportionate share hospital payment reductions.

Back To Top

MO HealthNet Schedules Managed Care Webinars

Staff Contact: Brian Kinkade

The MO HealthNet Provider Education Unit has scheduled four, two-hour webinar training conferences for health care providers on the planned expansion of Medicaid managed care for Missouri beneficiaries.

Back To Top

MO HealthNet Updates Medicaid Provider Manuals

Staff Contact: Brian Kinkade

MO HealthNet has updated the Medicaid provider manuals for behavioral health adult targeted case management and community psychiatric rehabilitation.

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.

  • understanding and promoting the value of chronic care management services call
  • looking ahead: the Improving Medicare Post-Acute Care Transformation Act in 2017 call
  • Medicare costs at a glance: 2017 educational tool revisions

Back To Top


Quality and Population Health

Organizations Host Opioid Overdose Conference

Staff Contact: Leslie Porth

On Friday, April 28, the Department of Mental Health, the Missouri Institute of Mental Health, and the National Council on Alcohol and Drug Abuse are hosting a one-day conference on the opioid crisis. The program is geared toward a diverse audience of medical and mental health care practitioners, emergency responders, researchers, policymakers, educators and the general public. The conference will feature national speakers and highlight successful and innovative approaches to preventing opioid overdose fatalities through overdose education and naloxone distribution efforts.

Back To Top

Did You Miss An Issue Of MHA Today?

February 16, 2017
Senate Approves Tort Reform Legislation
MO HealthNet Begins Reimbursement For HBAI Services
CMS Delays Medicare Bundled Payments Rule
HHS Issues Market Stabilization Proposed Rule
DHSS Issues Health Update On Mumps Outbreak In Missouri
HIDI Releases Fourth Quarter FFY 2016 Inpatient, Outpatient, Missouri Databases
Kindred Hospital St. Louis Names Interim CEO

February 15, 2017
Governor Appoints Chief Insurance Regulator
Legislators Consider Sexual Assault Kit Tracking System
CMS Proposes Rule To Stabilize Individual And Small Group Markets
Anthem/Cigna Squabbles Intensify
USDA Accepts Grant Applications For Broadband Services
SSM Health Names New President And CEO

February 14, 2017
Senate Gives First-Round Approval To Tort Reform Measure
House Advances Newborn Screening Bill
Uninsured Rate Drops To Record Low
MHA Distributes Wage Index, Occupational Mix Data For Review
Aetna/Humana Calls Off Merger

February 13, 2017
House Committee Approves Liability Reform Bill
MHA Announces Aim For Excellence Award Call For Applications
COCA Hosts Influenza Activity And Recommendations Call
CMS Announces QRDA Education Session
New Report Grades States On Telemedicine

Consider This ...

The number of U.S. Latinos with Alzheimer’s is expected to rise by more than eight times by 2060, to 3.5 million.

Source: USC Edward R. Roybal Institute on Aging and the Latinos Against Alzheimer’s network