MHA Today | November 10, 2017

November 10, 2017
MHA Today: News for Healthcare Leaders

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November 10, 2017

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
Next week is National Rural Health Week, and Thursday is recognized by the National Organization of State Offices of Rural Health as National Rural Health Day. There’s much to celebrate, but also cause for concern.

Missouri’s rural hospitals are essential to the health of the communities they serve. Over two-thirds of the state is considered rural, with 81 of the state’s 114 counties receiving that designation. One-quarter of the state’s population — just over 1.5 million — lives in these 81 rural counties. During the past year, 624,000 rural Missourians, just over 40 percent of the state’s rural population, had a health care encounter in a rural hospital. Rural hospitals provide a foundation for access to care — including primary, chronic and long-term care, as well as inpatient, home health, hospice and assisted living. They serve rural patients and visitors alike in parts of the state with otherwise limited health resources. They are economic pillars in the rural communities they serve.

As important as rural hospitals and the rural health infrastructure they support are, many of these institutions are facing an ever-mounting list of challenges. There isn’t one single factor driving the difficulties. The challenges — financial, regulatory and operational — are manifold.

A large body of research suggests that rural residents are older, sicker and poorer than their urban and suburban counterparts. As a result, rural patients often are more medically complex, while rural hospitals are more dependent on Medicare, Medicaid and self-pay payers. This can result in higher rates of uncompensated care and tight or negative margins.
National Rural Health Day
The Hospital Industry Data Institute looked at changes in several factors affecting rural hospitals throughout the last 10 years. The trends are alarming.

  • Inpatient volume at independent and system-affiliated rural hospitals is down 26 percent.
  • The average operating margin is negative 5 percent for independent rural hospitals and 1 percent for system-affiliated rural hospitals.
  • Compensation costs are higher as a percent of expenses than all but urban independent hospitals, while operating revenue per-FTE has been steady or in decline.
Despite all of these challenges, rural hospitals are more relevant than ever. They are essential to maintaining the pool of health care professionals, extending services into adjoining communities through clinic systems, supporting emergency transportation and reducing time to care.

In many rural communities, the hospital is a stable and venerable institution. That’s appropriate and worth celebrating.

As health care continues to evolve, rural hospitals will transition along with others as we move toward value-based payments. Rural hospitals have embraced health care’s triple aim: better care, better health and lower costs. But, to ensure rural hospitals are both valued and viable during this time of transition, state and federal policies must continue to recognize the essential nature of these organizations. Communities must actively advocate for their institutions and recognize that without rural hospitals, their towns could become medical deserts. Finally, rural hospitals should capitalize on opportunities to engage at all levels — with policy makers, local leaders and patients — to improve care, payments and community connections.

Rural patients need their hospitals just as much as rural hospitals need patients. The model for how care is delivered may change, but the need for that care will always exist. In fact, it’s likely to grow.

Sometimes there are misconceptions about rural health care. Next week provides another opportunity to tell the story. We’ll continue to fight for a system that recognizes and celebrates these essential institutions.

Share your thoughts in an email.

P.S. — Tomorrow is Veterans Day. Thank you to all of the men and women who have sacrificed to ensure our freedom and maintain our values. And, thank you to the many caregivers who serve our veterans in our state’s veterans hospitals, military hospitals and other hospitals and clinics throughout the state.


Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Six Organizations Send Joint Letter On Drug Shortages To Oversight And Investigations Subcommittee
HIDI Releases Third Quarter FFY 2017 Inpatient, Outpatient, Missouri Databases

Quality and Population Health

Six Organizations Send Joint Letter On Drug Shortages To Oversight And Investigations Subcommittee

Staff Contact: Jaclyn Gatz

A joint letter from the American Hospital Association, American Society of Anesthesiologists, American Society of Clinical Oncology, American Society of Health-System Pharmacists, American Society for Parenteral and Enteral Nutrition, and Institute for Safe Medication Practices was sent to the Oversight and Investigations Subcommittee of the House Energy and Commerce Committee. The letter outlines concerns and potential impacts of continued critical drug shortages and lists several questions for Congress to consider as members work to investigate and address the ongoing issue.

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HIDI Tech Connect

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

Staff Contact: Shane VanOverschelde

The second quarter federal fiscal year 2017 inpatient and outpatient databases, including Hospital Industry Data Institute-reporting hospitals in Missouri, Illinois and Kansas City, Kan., are now available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage®. 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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Did You Miss An Issue Of MHA Today?

November 6, 2017
Issue Briefs Available For New 2018 CMS Rules
HIDI HealthStats — Hospital Super-Utilizers
CMS Extends Question Deadline Related To Dry Run Reports For The IPFQR Readmission Measure
CMS Announces IQR Webinar
Mercy Springfield Communities Names Interim President

November 7, 2017
GAO Assesses Medicare Oversight Of Opioids
CMS Administrator Encourages States' Use Of 1115 Medicaid Waivers, Announces Transparency Reporting Initiative
September MUR Available On HIDI Analytic Advantage®
CMS And TJC Release Addendum To Inpatient Specifications Manual Version 5.3a
CMS Announces HAC Reduction Program ListServe
CMS Reports Issue With IQR CART Application
Freeman Names Interim CEO At Nevada Regional Medical Center

November 8, 2017
CMS Updates Appendix A
CMS Announces Change In Meaningful Use Attestations
IV Fluid Shortage: Missouri’s Current Status And Mitigation Efforts
HSHS St. Joseph’s Hospital Names New President & CEO

November 9, 2017
CBO Updates Estimate Of Repealing The Individual Health Insurance Mandate
CMS Releases Results Of Week One Marketplace Enrollment
MLN Connects Provider eNews Available
MO HealthNet To Accept Electronic Signatures
MHA Reports FFY 2018 To 2020 Medicare Pay-For-Performance Reference Guide
Patient Education Resources For ED Use Available
NOSORH Schedules Keys To Successful Grant Writing Webinar

Consider This ...

An estimated one in 25 adult drivers (aged 18 or older) report having fallen asleep while driving in the previous 30 days.

Source: Centers for Disease Control and Prevention