MHA Today | December 20, 2017

December 20, 2017
MHA Today: News for Healthcare Leaders

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December 20, 2017

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

In This Issue
Congress Completes Enactment Of Tax Reform Legislation
MO HealthNet Cuts Outpatient Lab Rates
Federally Facilitated Marketplace FAQs Available
CMS To Host Medicare Low Volume Appeals Settlement Call
Trajectories: ED Utilization Right Care. Right Place. Right Time.
Third Quarter 2017 HCAHPS Data Submission Deadline Approaching
Colonoscopy Measure Results Available

Advocate
state and federal health policy developments


Congress Completes Enactment Of Tax Reform Legislation

Staff Contact: Daniel Landon

As expected, the U.S. House of Representatives and Senate enacted federal tax reform legislation. However, the process required an extra step. Following House Republican celebration of its passage of the bill yesterday, it was discovered that two components of the negotiated compromise version violated Senate procedural rules and would require approval by a 60-vote majority in the Senate. Today, the House took a second vote on the bill after removing the two components, which were unrelated to health care. The legislation now moves to the president for approval, which is expected to occur early in January.

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MO HealthNet Cuts Outpatient Lab Rates

Staff Contact: Brian Kinkade

MO HealthNet rates for outpatient lab codes will be set at 80 percent of the Medicare fee schedule for dates of service on and after Monday, Jan. 1, 2018. Although some rates may increase, the overall impact will be a reduction in reimbursement for these services. MHA aggressively pressed MO HealthNet to modify this change in light of the planned Medicare reduction in the lab fees also scheduled for Jan. 1; however, the division only committed to reviewing the impact of the combined reductions after the fact.

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Federally Facilitated Marketplace FAQs Available

Staff Contact: Andrew Wheeler

A frequently asked questions document about the Federally Facilitated Marketplace in Missouri is available. This information is intended to be distributed to those who have questions about the state of the marketplace in Missouri.

The documents are available with the MHA logo or can be customized to fit your facility’s style and needs. Both documents can be found on the MHA website.

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Regulatory News
the latest actions of agencies monitoring health care


CMS To Host Medicare Low Volume Appeals Settlement Call

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services is providing an option to settle outstanding appeals for providers who have fewer than 500 pending at the Office of Medicare Hearings and Appeals and the Medicare Appeals Council at the Departmental Appeals Board. CMS is hosting a call for those interested in pursuing the settlement option and how the process will work. The call will be held 12:30 p.m. Tuesday, Jan. 9, 2018. Participant slots are limited, and registration is required.

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Quality and Population Health


Trajectories: ED Utilization Right Care. Right Place. Right Time.

Trajectories - Dec. 2017 Staff Contact: Alison Williams

The December 2017 issue of Trajectories focuses on emergency department utilization. EDs have evolved to become a major primary source of medical care in the U.S., essentially serving as the ultimate safety net for vulnerable populations.

To truly affect ED utilization, changes also need to occur across policy, regulatory and payer options. Drivers of ED overuse include lack of access to timely primary care services, referral to the ED by primary care physicians themselves, and financial and legal obligations by hospitals to treat all patients who arrive in the ED. Strategies to curb ED overuse include redesigning primary care to improve access and scheduling, providing alternative sites for non-urgent primary care, improving the case management of chronic disease patients, and using financial incentives and disincentives for visits to the ED. Hospital EDs across Missouri have implemented many successful models to improve utilization for both patients and providers.

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Third Quarter 2017 HCAHPS Data Submission Deadline Approaching

Staff Contact: Sherry Buschjost

The submission deadline for the Hospital Consumer Assessment of Healthcare Providers and Systems patient perspectives on care survey data for third quarter 2017 discharges (July 1 – Sept. 30) is Wednesday, Jan. 3, 2018. The Centers for Medicare & Medicaid Services encourages all hospitals to submit data at least two days before the deadline to allow time to address any submission issues. Inpatient PPS hospitals participating in the Hospital Inpatient Quality Reporting Program must collect and submit HCAHPS data in order to qualify to receive their full annual payment update. Non-IPPS hospitals must meet the same submission deadline for their data to be published on Hospital Compare.

The review and correction period is Jan. 4 - 10 during which participating hospitals and survey vendors have the opportunity to access and review the HCAHPS data review and correction report. The report contains a summary of the data accepted into the warehouse for the quarter. New data are not accepted into the warehouse during the review and correction period. However, errors in data accepted into the warehouse by the Jan. 3 deadline can be corrected during this period and resubmitted.

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Colonoscopy Measure Results Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services announced that measure results for “Facility Seven-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy” will be publically reported on Hospital Compare by the end of December. The results are based on colonoscopies performed during CY 2016 and will be used for payment determination for calendar year 2018. Results are calculated separately for hospital outpatient departments (OP-32 measure) and ambulatory surgical centers (ASC-12 measure). HOPD measure results can be found under “Unplanned Hospital Visits.” Measure results for ASCs will be available on the Ambulatory Surgical Center Quality Reporting Program page.

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Consider This ...

Every year, about 735,000 Americans have a heart attack. Of these, 525,000 are a first heart attack, and 210,000 happen in people who have already had a heart attack.

Source: Centers for Disease Control and Prevention