MHA Today | October 13, 2017

October 13, 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
Since open enrollment in the federal marketplace is only weeks away, I intended to use this week’s column as a pitch for engagement in enrollment efforts. I still will. However, several developments late this week deserve exploration since they could have implications for the marketplace in the short- and long-term.

Yesterday, President Trump signed an executive order taking a jab at the Affordable Care Act’s product and marketplace provisions. Today, he threw a second punch at and state marketplace insurers and participants, by directing his administration to cease cost-sharing subsidies, noting that they were illegal because they were specifically denied by Congress, but implemented by President Obama anyway. This legal wrangling may continue for months to come.

Meanwhile, open enrollment begins Nov. 1. The items included in Trump’s executive order will require regulatory action that generally precludes immediate implementation. The cut to subsidies — if it holds — would have implications for current individual marketplace insurers, and could affect enrollment and insurer participation in the 2018 plan year.

To some extent, the announcements aren’t surprising. In August, the Trump administration slashed funding for marketplace product advertisement during open enrollment by 90 percent. Funding for navigators to assist consumers in purchasing coverage in the marketplace was reduced as well. And, the subsidy issue was being litigated in court.

We can’t know yet whether association health plans will be successful. Theoretically, they could boost small employer options for coverage. However,  there have been questions about whether individuals — especially self-employed individuals — could participate. Another question is related to the quality of health plans that individuals would purchase under the order’s short-term insurance component. Although association health plans are likely to include most or all of the ACA’s essential benefits, the short-term plan components are not. It may very well be the middle of next year when we see actual regulations implementing this program. That’s when we will really understand the impact of this action.

The announcement most likely to challenge the 2018 Marketplace is today’s announcement related to cost-sharing. Although the months of uncertainty has led most insurers to hedge against the subsidies and risk pool imbalance, it can’t be known in advance what effect this week’s announcements, coupled with the earlier assaults on advertising and advising, will have on consumers. What we do know is that for some health plan offerings, premiums may increase. But for those who receive subsidies for their insurance, the change may be invisible since the federal government  with its other hand  will be picking up much of the premium increase. Those who will be significantly impacted are consumers who buy insurance on the federal marketplace and don’t receive a federal tax subsidy.

The background noise of the past two days tends to drown out the key issue for hospitals  that we have a tremendous stake in the outcome of open enrollment. This week’s one-two punch shouldn’t deter our efforts to reach out to current enrollees and eligible Missourians who are not currently participating. We must remain focused on that mission and continue to prepare to help those who need insurance coverage.

The Missouri Foundation for Health continues to lead efforts to educate Missourians through the Cover Missouri program. MHA is partnering with MFH, and adding resources to our Enroll Missouri page.

With all of the uncertainty, open enrollment will require all hands on deck. We’ll be sharing additional resources as they emerge.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
President Trump Ends Health Insurance Marketplace Cost-Sharing Subsidies
ISMP Launches High-Alert Medication Safety Self Assessment Tool

state and federal health policy developments

President Trump Ends Health Insurance Marketplace Cost-Sharing Subsidies

Staff Contact: Andrew Wheeler

President Trump announced that he immediately will halt payments to insurers under the Affordable Care Act. The White House stated that the government cannot legally continue to pay for cost-sharing subsidies without the formal authorization of Congress. The subsidies support payments of copays and deductibles.

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Quality and Population Health

ISMP Launches High-Alert Medication Safety Self Assessment Tool

Staff Contact: Alison Williams

The Institute for Safe Medication Practices has launched a new tool to help hospitals and other health care organizations evaluate compliance with high-alert medication best practices. The system can help organizations identify opportunities for improvement and evaluate compliance over time. The ISMP Medication Safety Self Assessment® for High-Alert Medications focuses on general high-alert medications and 11 specific medication categories, including opioids, insulin, neuromuscular blocking agents, chemotherapy, and moderate and minimal sedation. Participating organizations that submit assessment findings to ISMP  anonymously via a secure internet portal  will be eligible to obtain their weighted scores to compare themselves to demographically similar organizations. Participation also can help organizations meet requirements for managing high-alert medications from regulatory and accrediting agencies, such as the Centers for Medicare & Medicaid Services and The Joint Commission. Additional information is available on the ISMP website.

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Did You Miss An Issue Of MHA Today?

October 12, 2017
President Trump Signs Executive Order Allowing Greater Access To Association Health Plans
Medicare Advantage And Part D Star Ratings Available
MLN Connects Provider eNews Available
CMS Announces OQR Education Session

October 11, 2017
CHIP Extension Pauses For Bipartisan Negotiations
Eric Hargan Named As Acting HHS Secretary
MO HealthNet Issues Hot Tips On Retail Pharmacy Billing, Vaccine Claims For Dual Eligibles
MHA Supports End To Mandatory Participation in Medicare Bundled Payment Models
CMS Streamlining Meaningful Use Attestation For Eligible Hospitals
CoxHealth To Acquire Barton County Memorial Hospital

October 10, 2017
340B Payment Cut Decision Appears Imminent
FFY 2018 Medicare VBP Projection, HAC Projection And Pay-For-Performance Measure Trends Available
Baxter Announces Saline Shipments Disrupted
CMS Updates EHR Known Issues Documents
QRDA Reference And Implementation Guides Available At eCQI Resource Center
Landmark Hospital Of Cape Girardeau Names New CEO

October 9, 2017
Health Care Security And Safety Week Encourages Resiliency Focus
CMS Releases Hospital Quality Reporting 12.0
CMS Updates CART Tools

Consider This ...

It is National Cybersecurity Awareness Month. The U.S. Department of Homeland Security has tips individuals and businesses as part of its Stop.Think.Connect. Toolkit campaign.

Source: U.S. Department of Homeland Security