MHA Today | December 1, 2017

December 1, 2017
MHA Today: News for Healthcare Leaders

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December 1, 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
In Mel Brooks’ Broadway hit and two-time big screen production, “The Producers,” a theater producer and his accountant concoct a scheme to win by losing. (If you haven’t seen the film or show — spoiler alert!) The goal is to put together a show so foul that it fails immediately, allowing the producer to pocket the funds from the show’s backers without IRS scrutiny. The scheme backfires. The show becomes a hit when the audience misinterprets the repugnant storyline as satire.

There’s a similar plot twist occurring in this year’s enrollment in the marketplace. Despite significantly reduced advertising about the marketplace, fewer navigators and assisters, and a truncated enrollment period, sign-ups have exceeded last year’s totals each week.

Open enrollment in the federal marketplace began on Nov. 1 and will continue through Dec. 15. The most recent data, consisting of sign-ups through Nov. 25, includes nearly 2.8 million Americans. More than 78,000 Missourians had signed up by Nov. 25.

We don’t know what is driving the surge in enrollment, nor do we know if the early-enrollment crowd are predominantly the Americans who most need coverage — the sick. Nonetheless, with a shortened enrollment period, the early returns are very good news.

There is a chance that all of the rhetoric about the Affordable Care Act’s repeal and replacement, the ongoing battle over cost-sharing subsidies and fear that the marketplace may implode, are driving participation. Scarcity — even if just perceived — could be affecting behavior.

Of the nearly 2.8 million Americans who have selected a plan, 718,000 are new consumers. The total number of covered lives in the plans already submitted is nearly 5 million. Since open enrollment began, approximately 1 million Americans have been “window shopping,” but have not applied.
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We know that having health insurance matters. And, this year, more Americans have come to realize that the marketplace — while fragile — remains an essential source for affordable health insurance policies for individual purchasers.

Like the protagonists in "The Producers," some in Washington seem perplexed by consumers’ behavior. Purported efforts to sabotage the marketplace, or at least let it wither from benign neglect, may have backfired.

The next two weeks will be very important. Last year, approximately 244,000 Missourians participated in the marketplace. Missouri is nowhere near that level of participation yet.

There’s a lot riding on the third act of this enrollment season.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MO HealthNet Plans State Medicaid System Outages For End Of December Upgrades
HIDI Releases Annual Licensing Survey Raw Data File And User-Defined Report Generator

state and federal health policy developments

MO HealthNet Plans State Medicaid System Outages For End Of December Upgrades

Staff Contact: Brian Kinkade

MO HealthNet scheduled planned outages in December to upgrade its claims processing systems. From Dec. 29 through 6 a.m. Jan. 1, 2018, all systems supporting the submission of claims, verification of eligibility and pharmacy POS adjudication will be offline. Between Dec. 15 and 29, users of the claims submission system, eMOmed, will not be able to establish new user accounts or reset passwords online. These functions can be completed during the outage by calling the help desk at 573/635-3559.

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HIDI Tech Connect

HIDI Releases Annual Licensing Survey Raw Data File And User-Defined Report Generator

Staff Contact: Shane VanOverschelde

The raw data file for the 2016 Annual Licensing Survey is available for download by Premier Data Package subscribers on HIDI Analytic Advantage®. The file and Excel-based report generator includes all hospital-level public data elements contained on the 2016 Annual Licensing Survey.

  • File location: Finance and Policy/Premier Data
  • File name:

Hospitals interested in subscribing to the HIDI Premier Reporting 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 27, 2017
HIDI HealthStats — Hospital Super-Utilizers
Closing The Looming Health Care Talent Gap

November 28, 2017
New Federal Legislation Would Repeal Medicare Wage Index Manipulation
MO HealthNet Issues Billing Requirements For Hospital Inpatient Consultations
Missouri Register Releases Emergency Rules And Proposed Rules Related To Abortions

November 29, 2017
Trump Visits Missouri To Promote Tax Reform Legislation
CMS Releases Results Of Week Four Marketplace Enrollment
Missouri Register Issues Proposed Rules On Reporting Health Care-Associated Infection Rates

November 30, 2017
Trump Administration Scales Back Mandatory Bundled Payment Initiatives
MHA Releases Study Of The Senate Finance Committee Medicare Extenders Discussion Draft
MLN Connects Provider eNews Available

Consider This ...

December 1 is World AIDS Day. Today, an estimated 36.7 million people are living with HIV worldwide. Since the peak of the epidemic in 2005, annual AIDS-related deaths have declined by 48 percent.

Source: Centers for Disease Control and Prevention