MHA Today | June 16, 2017

June 16, 2017

MHA Today: News for Healthcare Leaders

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Herb Kuhn, MHA President & CEO
We don’t know what the U.S. Senate is thinking about the American Health Care Act — the House’s plan to repeal and replace the Affordable Care Act. Word has it that the Senate’s lack of transparency is by design. Mounting evidence suggests that the Senate is looking at a solution similar to the House version of the AHCA. If that’s the case, there’s a good reason for keeping quiet.

New research from the Hospital Industry Data Institute finds that the AHCA significantly disadvantages states like Missouri. It’s adding insult to injury. The 19 states that didn’t expand Medicaid — largely conservative and fiscally minded — will get the short end of the stick.

In the House, this was apparent enough to lawmakers. In fact, Rep. Billy Long of Missouri worked to pad the bill at the last minute to protect access for Americans with pre-existing conditions. Sadly, those with experience in high-risk pools say it will be nowhere near enough.

The HIDI research finds that under the House-approved AHCA, nonexpansion states would forego more than $680 billion compared to Medicaid expansion states between 2014 and 2025. And that’s after accounting for a $10 billion “safety-net fund” specifically earmarked for the 19 remaining nonexpansion states. I can’t help but think Missouri wits will call the bill’s attempt at equity exactly what it is — small beer.

The ACA is funded through a variety of cuts to Medicare provider payments and new revenues. Hospitals and other providers have experienced these cuts regardless of whether they received the benefits of new Medicaid coverage through expansion. The AHCA blocks $31.2 billion in future ACA cuts to the Medicaid disproportionate share hospital program, in addition to the safety-net fund. However, Medicare DSH cuts remain, as do cuts to other Medicare payments. In addition, the continuation of Medicaid DSH funding eventually will benefit all states, not just those in nonexpansion states.

You don’t have to be a cynic to realize the glass is half empty — the AHCA fails the equity test. Throughout a decade, the lack of funding parity, not created but continued by the AHCA — after accounting for its Medicaid DSH and new safety-net fund spending — will cost Missouri an estimated $41.7 billion. This effectively means that Missouri and the other nonexpansion states will be buying round after round of coverage for other states.

When the AHCA moved from the House to the Senate, attention was given to the influence of senators from more conservative states that had adopted Medicaid expansion. Their voices continue to be heard, as reports on the Senate’s framework indicate that senators from these states may compromise on the AHCA if the Medicaid expansion phase-out is extended to a seven-year “glide path.” If this unfortunate “compromise” moves forward, the lack of equity will be compounded.

There’s room to improve the ACA. Those improvements should pull nonexpansion states up, not draw expansion states down. However, building a new national health care framework on the backs of the states that have benefited the least from the ACA, is simply unfair.

The Senate can’t keep the bill in the back room forever. The AHCA as passed by the House is a bad brew not worthy of serving to Americans. The Senate should pour it out now to save the eventual outpouring later.

What do you think?

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MHA HIIN Announces Physician Opportunities
AHA/HRET Releases Leader And Trustee Quality Modules
Mercy And St. Anthony’s Finalize Affiliation Agreement

Quality and Population Health

MHA HIIN Announces Physician Opportunities

Staff Contact: Jessica Stultz

Through its partnership with the Health Research & Educational Trust, MHA is offering scholarships to Hospital Improvement Innovation Network-participating hospitals to attend the Adaptive Leadership in Medicine training held in Chicago, Wednesday, Aug. 2, through Thursday, Aug. 3. The training provides an opportunity for a physician and administrator from the same organization to gain valuable leadership tools. HIIN-participating hospitals are eligible to receive a scholarship that covers training, hotel and airfare expenses. Non-HIIN-participating hospitals also are encouraged to apply for a scholarship that includes only the cost of the training. During registration, those interested in applying will be required to identify both individuals from their organization who will be attending. Register online by Friday, July 14.

HRET also has announced the American Board of Medical Specialties’ Maintenance of Certification Part IV, which allows physicians who are directly engaged and active in HIIN topics to maintain their certification while participating in quality improvement programs in their organizations. For each eligible HIIN topic chosen, the physician must demonstrate meaningful participation in the project.

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AHA/HRET Releases Leader And Trustee Quality Modules

Staff Contact: Jessica Stultz

The American Hospital Association and the Health Research & Educational Trust have released a video guide to illustrate the important role that leaders and trustees play in the journey to improve patient care. It serves as a tool for all trustees to use as they work toward the goal of eliminating all patient harm within their organizations. A workbook also has been released to accompany the videos.

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CEO Announcements

Mercy And St. Anthony’s Finalize Affiliation Agreement

Staff Contact: Carol Boessen

The affiliation between Mercy and St. Anthony’s Medical Center in St. Louis was finalized, effective June 1. Mike McCurry, Mercy Executive Vice President and Chief Operating Officer, also will serve as President of St. Anthony’s Medical Center. He replaces Kelly Wetzler, who served as Interim CEO since March 11. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

June 15, 2017
State Senate Approves Abortion Regulation Legislation
CMS Releases Heath Care Spending By State
MLN Connects Provider eNews Available
CMS Issues Technical Guidance Regarding CY 2017 eCQM Submissions
CMS Announces OQR Education Session
MHA Provides HIIN Update

June 14, 2017
Trajectories — Opioid Use Disorder
Health Care Foundation Releases Recommendations To Reform MO HealthNet

June 13, 2017
Nearly 502,000 Clinicians Incur Payment Reductions
Individuals Drop Out Of Health Care Marketplace

June 12, 2017
FY 2018 IPPS And LTCH Proposed Payment, Policy Update Comments Due Tomorrow
CMS Updates EP And Disaster Response Regulatory Crosswalk
Harrison County Community Hospital Names CEO

Consider This ...

According to 2013-2015 data, the percent of U.S. children ages 4 to 17 with attention deficit/hyperactivity disorder is higher among boys than girls in all metro and nonmetro areas.

Source: Centers for Disease Control and Prevention