MHA Today | October 6, 2017

October 6, 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
Compound interest has been called a “miracle” because it can turn a small early investment into significant value over time. The Children’s Health Insurance Program is a compound interest generator.

CHIP creates access to care — well-child visits, immunizations, primary care and prevention generally — for kids from low-income families. The program is designed to set children on a path to better health in the long term. In fact, the benefits of CHIP are so clear that the program has garnered bipartisan support since it was established two decades ago.

Last weekend, the deadline for Congress to extend CHIP funding passed. This week, committees in the U.S. Senate and House approved bills to extend CHIP. Nearly everyone agrees the program should continue. The question is how to pay for it.

There’s no question CHIP is a good value for Missouri. The state’s federal CHIP grant is $175 million, and the match rate for these funds has historically been more favorable than the traditional Medicaid rate. In addition, the Affordable Care Act encouraged CHIP enrollment, temporarily raising the federal share to 97 percent. Whether at the traditional match of 74 percent or the ACA rate of 97 percent, the state gets a lot of coverage for a low-cost population for reduced state investment.

CHIP Fact Sheet

Missouri’s CHIP program maximizes the federal dollars through flexibility. Missouri covers some children who would otherwise be in traditional Medicaid through CHIP — this saves the state money and allows a part of the population to benefit from the program without the jeopardy of change in federal policy. Although the ACA added some constraints within the eligibility categories, the state continues to realize a significant benefit.

If CHIP is not reauthorized, and the federal funds are not available, the program would disappear. The state could opt to cover more children — which are generally very low cost by comparison to other Medicaid populations. However, Missouri would receive only the traditional Medicaid match, which is much less generous. Given the state’s financial outlook, keeping kids within the Medicaid system without the favorable rate, is unlikely.

The real question is about the federal spending, not the health value. Since new federal spending must be balanced by reductions elsewhere under the congressional rules, reauthorization hangs on the ability to find budget offsets. Moreover, with tax reform and tax cuts on the agenda, spending of any kind — even on a children’s’ health program — is subject to a new calculus.

The compounding health value of CHIP is clear. However, the funding debate draws another economic principle into sharper relief — opportunity-cost.

What is the cost to the health care system if children from low-income families don’t receive the services that are the central components of CHIP? It’s pretty clear. We’ll lose the compounding benefit of health and prevention when it is inexpensive, and pay at the other end of the system — where chronic disease, poor health and high costs are the norm.

There’s no “miracle” in compound interest. It’s math — the time value of money. And, there’s no real debate about whether CHIP is an opportunity or a cost.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
2018 ICD-10 Updates For MO HealthNet Billings Effective Oct. 1
August MUR Available On HIDI Analytic Advantage®
HIDI Releases Third Quarter FFY 2017 Inpatient, Outpatient, Missouri Databases
CMS Releases Addendum to IQR Manual Version 5.2a
TJC Releases Addendum To Specifications Manual For National Quality Measures

state and federal health policy developments

2018 ICD-10 Updates For MO HealthNet Billings Effective Oct. 1

Staff Contact: Brian Kinkade

MO HealthNet will implement 2018 ICD-10 updates for Clinical Modification diagnosis codes, ICD-10-CM, and Procedure Coding System surgical procedure codes, ICD-10-PCS, for services delivered on or after Oct. 1.

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HIDI Tech Connect

August MUR Available On HIDI Analytic Advantage®

Staff Contact: Cerise Seifert

Data for the August 2017 monthly utilization report have been posted on HIDI Analytic Advantage® and are available to download for distribution or placement in a network folder. HIDI Analytic Advantage PLUS has been updated to include this data. Contacts from the participating hospitals have been notified by email, and may download and save the Excel worksheet to a secure network location or PC. The data are encrypted on the site and also during the transmission from HIDI. Once the data have been transferred, it must be secured according to the hospital’s security procedures. September 2017 data are being collected now and are scheduled to be available Monday, Nov. 6.

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HIDI Releases Third Quarter FFY 2017 Inpatient, Outpatient, Missouri Databases

Staff Contact: Shane VanOverschlede

The third quarter federal fiscal year 2017 inpatient and outpatient databases, including HIDI-reporting hospitals in Missouri and Illinois are now available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage®. These databases will be updated to include the Kansas City, Kansas hospital data for the third quarter in the coming weeks. The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in “Strategic Planning/Premier Data” and are organized in the following categories.

  • Q1-Q3 FFY2017, Inpatient
  • Q1-Q3 FFY2017, Outpatient Classified
  • Q1-Q3 FFY2017, Outpatient Unclassified
Hospitals interested in subscribing to the 2017 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Quality and Population Health

CMS Releases Addendum to IQR Manual Version 5.2a

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services and The Joint Commission have determined that an addendum is required for the Specifications Manual for National Hospital Inpatient Quality Measures, version 5.2a, effective with acute inpatient discharges beginning Oct. 1. Updates have been made to Appendix A based on the ICD-10 code updates for fiscal year 2018. A complete list of changes is available in the manual’s release notes, version 5.2b. The addendum is available on QualityNet.

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TJC Releases Addendum To Specifications Manual For National Quality Measures

Staff Contact: Sherry Buschjost

The Joint Commission has released an addendum to the Specifications Manual for Joint Commission National Quality Measures. Addendum version 2017A1, effective with discharges beginning Oct. 1, reflects changes to the ICD-10 master code tables. The addendum is available on the TJC Performance Measurement System Extranet Track.

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Did You Miss An Issue Of MHA Today?

October 5, 2017
CHIP Bills Advance In Senate And House
GAO Assesses Neonatal Abstinence Syndrome
CMS Publishes Correction Notice To FY 2018 SNF PPS Rates
CY 2017 Qualifying APM Participant Determination And Status Data Available
MLN Connects Provider eNews Available
CMS Issues Addendum To May 2017 eCQM Specifications
December 2017 Hospital Compare Preview Reports Available

October 4, 2017
CMS Withdraws Medicare Part B Drug Payment Model
CMS Publishes FY 2018 IPPS Rates Correction Notice
Free Opioid Training Available
Facility-Specific OP-32 Reports Available
CMS Reminds Hospitals About Second Quarter 2017 Data Submission Deadlines

October 3, 2017
CMS Issues Revised Cost Report Instructions For Worksheet S-10
HIDI Schedules ADT Regional Meetings

October 2, 2017
Medicare Releases 2018 MA Benefit And Premium Information
Senate Finance Committee Prepares To Reauthorize CHIP
HRSA Announces Nurse Faculty Loan Program
HQR Monthly News Blast Available
CMS Announces Education Session

Consider This ...

The average American consumes more than 3,600 calories each daily — a 24 percent increase from 1961, when the average was just 2,880 calories.

Source: Business Insider