MHA Today | September 8, 2017

September 8, 2017

MHA Today: News for Healthcare Leaders

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Herb Kuhn, MHA President & CEO
The official unemployment rate in the U.S. is 4.9 percent. In Missouri, the rate is 4.2 percent, and in Kansas it is 4.6 percent. However, the official rate does not account for individuals who are unemployed and not actively seeking employment — individuals who have dropped out of the workforce altogether. That rate, known by the federal Bureau of Labor Statistics as the U-6 rate, is nearly twice as high as the official rate. In Missouri, the ratio of official to U-6 is 1.70, and in Kansas it is 1.95.

Earlier this week, MHA released a new report on the intersection of the opioid crisis and unemployment. We collaborated with the Kansas Hospital Association and the Full Employment Council in Kansas City on the release.

Using federal and state datasets, the researchers examined the combined data for unemployment, drug-related mortality, opioids prescribed per capita and opioid-related hospital utilization. The researchers found a strong correlation between unemployment and opioid use, and abuse exists in many Missouri and Kansas counties. Moreover, some large and geographically contiguous areas of both states are high risk — including rural, suburban and urban areas.

Although the correlation between opioid dependence and unemployment is strong, there also seems to be a circular aspect. Unemployment can lead to drug use and the “deaths of despair” that have been articulated in other research. And, drug use can lead to an inability to find employment — especially where drug screenings are used — and keep a job. This can have a pronounced influence on the labor pool and unemployment in rural areas where fewer jobs, workers and community resources are available to tackle the challenge.

Since the research affirms that unemployment is a strong indicator of drug use, policymakers can use the risk analysis to further inform decisions on resource allocation and proposed interventions to the opioid crisis. The research can help expand our understanding of the opioid crisis and broaden the view that the crisis is purely a public health problem.

The new research makes clear that stronger partnerships between health care providers and payers, business leaders and policymakers, and patients and caregivers, will be necessary to address the opioid crisis. Better targeting will allow limited resources to be spent wisely.

As we work to better manage population health, hospitals are looking upstream to identify the causes of poor health. As it turns out, unemployment is an upstream indicator of risk for drug use.

A 2016 survey of unemployed men between the ages of 25 and 54 — prime age for the workforce — found that 47 percent had taken a pain medication on the previous day. Among those, nearly two-thirds had taken a prescription pain medication.

Unemployment is a public health problem in Missouri and Kansas. We just don’t recognize it as such.

Let me know what you think.

P.S. — Hurricane Harvey displayed the destructive power of nature. And, hospitals in Missouri and elsewhere have been working to support our hospital family, and the citizens of Texas and along the Gulf Coast. As Hurricane Irma moves toward Florida, we’ll stay in touch about opportunities to help hospitals and communities in need. Keep the people of Florida and the southern U.S. in your thoughts and prayers as this massive system advances.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MHA Opposes Proposed 340B Payment Reductions
CDC Awards $28.6 Million To Help States Fight Opioid Overdose Epidemic
CMS Seeks Public Comment On Revised Medication Reconciliation On Admission Measure

Hurricane Harvey

Hurricane Irma

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Regulatory News
the latest actions of agencies monitoring health care

MHA Opposes Proposed 340B Payment Reductions

Staff Contacts: Daniel Landon or Andrew Wheeler

MHA has submitted a comment letter to the Centers for Medicare & Medicaid Services regarding its proposed regulatory change to reduce Medicare payments for drugs delivered to Medicare patients through the federal 340B drug discount program. The proposal is included in the Medicare outpatient PPS rule. Comments are due by 4 p.m. Monday, Sept. 11.

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Quality and Population Health

CDC Awards $28.6 Million To Help States Fight Opioid Overdose Epidemic

Staff Contacts: Leslie Porth or Alison Williams

The Centers for Disease Control and Prevention is awarding more than $28.6 million in additional funding to 44 states and the District of Columbia to support their responses to the opioid overdose epidemic. Missouri is a recipient of a portion of these funds. The funds will be used to strengthen prevention efforts and better track opioid-related overdoses. This builds upon the July 2017 announcement that the CDC was providing $12 million to states to support overdose prevention activities.

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CMS Seeks Public Comment On Revised Medication Reconciliation On Admission Measure

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services invites interested health care professionals to provide comments on the proposed medication reconciliation on admission quality measure that is proposed for adoption into the Inpatient Psychiatric Facility Quality Reporting Program. Additional information about the proposed measure is available. Comments must be submitted by 11 a.m. Friday, Sept. 29.

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Did You Miss An Issue Of MHA Today?

September 7, 2017
MHA Releases CHIP Fact Sheet
U.S. Senate Appropriations Subcommittee Approves Budget Bill
CMS Issues Revisions To SOM Appendix A For Hospitals
MLN Connects Provider eNews Available
Beterra Health, Inc., Offers Safety Culture Webinars
CMS Extends Chemotherapy Measure Dry Run
HRSA Announces Delay In 340B Recertifications

September 6, 2017
MO HealthNet To Include G Codes In Outpatient Lab Fee Schedule
MHA Distributes Analysis Of CMS’ Update Notice To The Medicare FFY 2018 IPF PPS
CMS Announces State Surveyors EP Training Online
Deadline Approaches For Second Quarter 2017 HCAHPS Data Submission
CMS Seeks Feedback For Changes To QualityNet Secure Portal
July MUR Available On HIDI Analytic Advantage®
September Marks Sepsis Awareness Month

September 5, 2017
Study Evaluates Opioid Misuse And Unemployment In Missouri And Kansas
Senate Parliamentarian Sets Deadline For Enacting ACA Reform By Majority Vote
MHA Seeks Hospital Experiences With Medicaid Managed Care
Conflicting Issues Exist Under Missouri’s Blood Draw Statutes

Consider This ...

Death rates from unintentional falls for adults ages 65 and older in the U.S. have increased an average of nearly 5 percent per year since 2000.

Source: Centers for Disease Control and Prevention