MHA Today | August 11, 2017

August 11, 2017

MHA Today: News for Healthcare Leaders

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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
The Eclipse of 2017, which will occur on Monday, August 21, is a big deal for Missouri. Both Kansas City and St. Louis are partially in the path. It’s been projected that more people in our state will, by default, see the eclipse – full and partial – because the path will come so close to these major metropolitan areas. Imagine what this astronomical phenomena would look like from the St. Louis Arch.

For those not fortunate enough to be in the path, it means travel. And it is estimated that millions of Americans will travel to be within the optimal viewing areas, which includes a path from Northwest to the Southeast Missouri

Dark Side of the Moon album cover

The total event will last just over two hours, but for several minutes — if you’re in the right spot — the moon will obscure the sun fully. It’s not actually the Dark Side of the Moon, but it will briefly look that way.

On Wednesday, I was at a meeting in Kansas City. Also attending were several hospital members who made time to Speak to Me about what they were doing to prepare for the eclipse. When hundreds of thousands of visitors arrive in towns across the state for a few days, there are a lot of things that can go wrong. What I know from this meeting and others is that hospital emergency preparedness staff — and incident command leads throughout the state’s hospitals — have barely had time to Breathe, sorting through scenarios, and planning and coordinating for just about every contingency.

Missouri path of the eclipseThe optimal viewing path runs diagonally across Missouri, with St. Joseph on one end and Perryville on the other. On Monday Aug. 21, millions of Americans will be On the Run to get to these communities and others along the path. Transportation officials are expecting epic traffic jams throughout the state. They’re fearful that during the height of the eclipse drivers will pull off the roads — including interstate highways — to view the event. If you’re saying to yourself, “who would do that,” take Time to reflect on humanity.

It’s a tourism bonanza, with many communities planning three days of activities — it’s a once-in-a-lifetime astronomical event. And, for communities within the path it’s The Great Gig In the Sky.

For hospitals, there are a lot of challenges that come with the event. It’s August and millions of folks will be outside. Dehydration, or even heat exhaustion, are very real considerations. In much of the state, there will be a transition from a normal mid-day sun, to black as night and back — all within two hours. It’s impossible to know what type of mischief that could cause.

And, of course there is the possibility that some individuals will simply not realize that gazing at the sun during an eclipse without eye protection is harmful.

Viewing glasses are available nearly everywhere. However, there are concerns because some folks, seeing all the Money being spent on the event, are selling eclipse glasses that don’t offer adequate protection. Hospitals and physicians have been building awareness about unsafe glasses, and the public conversation is good. In this Us and Them discussion, we’re winning. A great example is Perry County Memorial Hospital. Perryville is expecting its population to quadruple, since they’re in the viewing sweet-spot in eastern Missouri. The hospital is providing safe eyewear to the community and visitors.

Hospitals invest in all-hazards planning for a reason. The resources and systems needed to react to natural disasters like tornados and earthquakes, and other crises like civil unrest or terror attacks, are the same — planning and a structured incident command system. On the 21st, you can wear Any Color You Like. Staff at hospitals throughout Missouri will don incident command vests with colors and titles specific to their roles and responsibilities. Their efforts will sychronize with partners in public health, law enforcement and other emergency management organizations and agencies.

Like any significant event, there are funny stories as well. According to the Kansas City folks, they’ve had inquiries about whether pets need eye protection. Not sure if the caller had Brain Damage, but humans are about the only animal that would consider staring at the sun for an extended period.

The Eclipse of 2017 is a once-in-a-lifetime event. Next week, we’ll be checking weather forecasts and thinking about how nothing will stand in our way to see this incredible show. It should be an unbelievable sight. But as we enjoy the view, remember that it’s also an opportunity for hospitals to flex their emergency preparedness muscle while connecting with communities throughout the state.

Let me know what you think and what you’re doing on the 21st.

P.S. — In Jefferson City, event planners have scheduled a Sunday night concert on the Capitol steps featuring a Pink Floyd tribute band. What are they playing? What else – Dark Side of the Moon.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Marketplace Insurers Get More Time To Submit Premium Rates
DHSS Files Time Critical Diagnosis Emergency Rule
MHA Releases Issue Briefs On Federal Regulations
CMS Releases QRDA Guidance
RWJF Announces Application Period For Culture Of Health Prize

state and federal health policy developments

Marketplace Insurers Get More Time To Submit Premium Rates

Staff Contact: Andrew Wheeler

The U.S. Department of Health and Human Services announced that health insurers offering plans on the health insurance marketplace will have three more weeks to submit premium rate requests, which will now be due Tuesday, Sept. 5. The announcement also included a timeline for rate filing changes, with a target date for the Centers for Medicare & Medicaid Services to post all final rate information on Wednesday, Nov. 1. Open enrollment for calendar year 2018 will also begin on Nov. 1.

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Regulatory News
the latest actions of agencies monitoring health care

DHSS Files Time Critical Diagnosis Emergency Rule

Staff Contacts: Sarah Willson or Daniel Landon

The Missouri Department of Health and Senior Services notified hospitals on Aug. 10, about the emergency rule and proposed amendment filed Aug. 7 relating to hospitals’ stroke center application process. The emergency rule could impact hospitals that have a current stroke center certification with The Joint Commission, DNV-GL Healthcare and Healthcare Facilities Accreditation Program. The new application process is in accordance with the changes made to Section 190.241 RSMo, during the 2016 legislative session. The new law recognizes designations by TJC, or other certifying organization designated by DHSS, as DHSS designated stroke centers. DHSS released a copy of the new application indicating the changes. The emergency rule will go into effect on Thursday, Aug. 17. Hospitals that wish to be recognized as a stroke center by the state through a national designation must complete the application. Additional information will follow when the emergency rule is published.

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MHA Releases Issue Briefs On Federal Regulations

Staff Contact: Andrew Wheeler

MHA has released issue briefs on numerous proposed and final federal rules throughout the past two weeks. The following are available on MHAnet.

  • CMS Publishes Final FY 2018 Medicare IPPS and LTCH Update (8/8/17)
  • CMS Announces Inpatient Psychiatric Facilities PPS Update Notice for FY 2018 (8/7/17)
  • CMS Finalizes FY 2018 Hospice Wage Index, Payment Rate and Quality Reporting Requirements (8/2/17)
  • CMS Finalizes Inpatient Rehabilitation Facility FY 2018 PPS Update (8/1/17)
  • CMS Finalizes Skilled Nursing Facility FY 2018 Update (8/1/17)
  • State Disproportionate Share Hospital Allotment Reductions (7/27/17)
  • CMS Publishes Proposed Home Health Update for CY 2018 (7/26/17)

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Quality and Population Health

CMS Releases QRDA Guidance

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has published updated sample files for the 2017 CMS Quality Reporting Document Architecture Category I Implementation Guide for Hospital Quality Reporting. The sample files now address newly released guidance on proper submission of QRDA Category I files using wrappers (referred to as “Act Wrappers”) to ensure correct measure calculation of specific data types. Detailed descriptions of the issue and guidance, and examples on how to properly submit Act Wrapper templates, are available on the eCQI Resource Center QRDA Space. This guidance is for electronic clinical quality measure submissions for calendar year 2017 and QRDA Category I files only.

CMS also has issued technical guidance regarding electronic submission of hospital custodian IDs or CMS certification numbers in the QRDA Category I files. Vendors can avoid errors by only submitting CCNs for the custodian/assignedCustodian/representedCustodianOrganization/id. Identifiers with numerical values that do not meet the length requirement will return an error. This affects critical access hospitals, and hospitals participating in the inpatient quality reporting and Medicare electronic health record incentive programs in the 2017 reporting period only. Additional information is available on the eCQI Resource Center QRDA Space.

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RWJF Announces Application Period For Culture Of Health Prize

Staff Contact: Peter Rao

The Robert Wood Johnson Foundation has announced the opening of the Culture of Health Prize application period. The prize honors communities that prioritize health, build strong health-related partnerships and have a deep commitment to improving quality of life communitywide. Winners receive $25,000 and have the opportunity to share their story and lessons learned with the country. The application is available online and must be submitted by 2 p.m., Friday, Nov. 3.

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Did You Miss An Issue Of MHA Today?

August 10, 2017
MLN Connects Provider eNews Available
President Trump Elevates Opioid Crisis To A National Emergency
TJC Releases Specifications Manual Version 2017B

August 9, 2017
MO HealthNet Updates Behavioral Health Provider Manual
Board Of Pharmacy Issues Class J Emergency Rule Guidance
CMS Announces Dry Run Of Hospital Visits After Outpatient Surgery Measure
Lake Regional Health System Names New CEO

August 8, 2017
MHA Distributes Analysis For Proposed CY 2018 Medicare Outpatient PPS
MHA Publishes Issue Brief On IPPS/LTCH Final Rules
June MUR Available On HIDI Analytic Advantage®

August 7, 2017
CMS Issues Psychiatric PPS Updates For FY 2018
Emergency Rule Takes Effect For Class J Pharmacies
CMS Removes Pain Questions In Final IPPS Rule
HIDI HealthStats — Population Health
HealthCurve Analytics Announces Partnership With SpectraMedix
Jennifer Tidball Named Acting MO HealthNet Director

Consider This ...

The eclipse totality is safe to look at. During the time the Moon’s disk covers that of the Sun, it’s safe to look at the eclipse. In fact, to experience the awesomeness of the event, you must look at the Sun without a filter during totality.

Source: Astronomy Magazine