MHA Today | December 21, 2017

 

MHA Today: News for Healthcare Leaders

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December 21, 2017

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

NOTE: MHA Today will not be published Friday, Dec. 22 or Monday, Dec. 25. Publication will resume Tuesday, Dec. 26.

Insights

Herb Kuhn, MHA President & CEO
Present.

During the holiday season, when you use or hear the word present, it likely will reference a tangible gift. However, according to most major dictionaries, this is the second definition.

The first definition of present relates to a location or state of being.

Thousands of hospital employees will sacrifice time with their families during the holiday season. It’s part of their vocation — a requirement to spend time away from loved ones to care for members of the community who need their support during an illness or emergency.

During the holidays, there will be patient dressings to change, vitals to check and medicines to deliver. The routines of care won’t change. However, there will be transformative moments — to be truly present.

No one wants to spend the holidays in the hospital. And, the delivery of a warm word, a touch or a smile will make a holiday spent in a hospital just a bit more tolerable for these patients. Being present can be the most important gift delivered this holiday season.

It is an honor to serve the state’s hospitals. At MHA, we understand how important each of your institutions is to the communities you serve and support. The greatest gift our team receives is the opportunity to be your partner in making our state a better, safer and healthier place.

This is the last Insights column of the year. Remember to stay in touch. I always want to know what you’re thinking.

Happy holidays.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO


In This Issue
Congress Considers Legislation To Avoid Government Shut-Down, Extend CHIP
OIG Asserts Loss Of $1.3 Billion To Misclassified Medicaid Drugs
MACPAC Releases Medicaid And CHIP Data Book
Third Quarter Hospital Compare Readmission Trend Report Available
Hospital Compare Star Ratings And HAC Payment Penalties Available
MLN Connects Provider eNews Available
CMS Issues Supplemental Document To OQR Specifications Manual
Hospital Quality Reporting Center Fall 2017 Newsletter Available
State Auditor Findings Analysis Available
Saint Luke’s North Hospital Names New CEO

Advocate
state and federal health policy developments


Congress Considers Legislation To Avoid Government Shut-Down, Extend CHIP

Staff Contact: Daniel Landon

Republican leaders in the U.S. House of Representatives released a proposal to avert a government shut-down ― slated for Friday, Dec. 22 ― and provide short-term funding extensions for some but not all expired federal programs. The legislation would fund the federal government through Jan. 19, 2018. Through March 31, 2018, $2.85 billion would be authorized to fund the Children’s Health Insurance Program. Funding also would be included through March 31, 2018, for the National Health Service Corps and for community health centers. On Dec. 8, Congress enacted a two-week funding extension to provide more time to develop a legislative budget accord. Congress is expected to delay decisions on several high-profile issues until 2018.

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OIG Asserts Loss Of $1.3 Billion To Misclassified Medicaid Drugs

Staff Contacts: Daniel Landon or Brian Kinkade

A report by the U.S. Department of Health and Human Services Office of Inspector General evaluates the potential implications of drug manufacturers misclassifying drugs with the Medicaid Drug Rebate Program. The OIG also released a summary. Comparing data of the Food and Drug Administration and the Centers for Medicare & Medicaid Services, the OIG found only 3 percent of the drugs were potentially misclassified. However, the misclassification of those 885 drugs would account for a loss of $1.3 billion from 2012 to 2016. CMS concurred with the OIG’s recommendations for preventing a loss of Medicaid rebate payments due to drug misclassification. Some of the lost revenue would be borne by state governments. In August 2017, a drug manufacturer agreed to a $465 million settlement to resolve a U.S. Department of Justice lawsuit over alleged misclassification of the Epi-Pen drug.

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MACPAC Releases Medicaid And CHIP Data Book

Staff Contact: Brian Kinkade

The Medicaid and CHIP Payment and Access Commission released its MAC Stats: Medicaid and CHIP Data Book and an online listing of tables and charts. MACPAC is a non-partisan federal advisory commission that makes recommendations to Congress, the executive branch and state governments regarding Medicaid and the Children’s Health Insurance Program.

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Third Quarter Hospital Compare Readmission Trend Report Available

Staff Contact: Andrew Wheeler

A readmission trending report that illustrates readmission performance of AMI, heart failure, pneumonia, total hip/knee replacement, COPD and CABG patients is available from MHA. For each condition cohort, the U.S. and state averages and rankings are displayed. Although critical access hospitals currently are exempt from the Medicare readmission reduction program, their results are available to view. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage®.

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Regulatory News
the latest actions of agencies monitoring health care


Hospital Compare Star Ratings And HAC Payment Penalties Available

Staff Contact: Peter Rao

New star ratings will be updated on the Center for Medicare & Medicaid Services’ Hospital Compare website. The list of hospitals receiving Hospital-Acquired Condition penalties for fiscal year 2018 also will be released. Please refer to the Quality Advisory from the American Hospital Association.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

Updates to MLN Connects Provider eNews were issued by the Centers for Medicare & Medicaid Services. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • 2018 Medicare EHR incentive program payment adjustment for eligible clinicians
  • Physician Compare: 2016 performance information available
  • low volume appeals settlement option call Jan. 9, 2018

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Quality and Population Health


CMS Issues Supplemental Document To OQR Specifications Manual

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services determined that a supplemental document is required to the Hospital Outpatient Quality Reporting Program specifications manual version 10.0a for encounters beginning Jan. 1 through Dec. 31, 2017. The supplement updates categories and Healthcare Common Procedure Coding System for OP-26 (Hospital Outpatient Volume on Selected Outpatient Surgical Procedures) is available on QualityNet.

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Hospital Quality Reporting Center Fall 2017 Newsletter Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released the Hospital Quality Reporting Center Fall 2017 newsletter. The issue contains information for acute care hospitals, critical access hospitals, inpatient psychiatric facilities and PPS-exempt cancer hospitals. Topics include the following.

  • Are you ready for the new NHSN agreement to participate and consent?
  • What’s new for IQR?
  • step-by-step NHSN location mapping checklist for ACHs
  • anticipated acute care HSR releases for calendar year 2018
  • new tools for quality reporting
  • important dates

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Noteworthy


State Auditor Findings Analysis Available

Staff Contact: Dana Dahl

The state auditor finalized and released a third report on a Missouri hospital. In response, MHA updated the State Auditor Findings Analysis to reflect the newest information. The document is a fillable PDF form that outlines the main findings of State Auditor Nicole Galloway's reports for the three hospitals that were audited in 2017. This resource should not be used solely as a basis for full compliance.

In September 2016, Auditor Galloway announced that her office would be conducting a series of audits of county-owned hospitals. Her announcement indicated that the goal of the reviews is to identify key factors impacting facility finances and offer solutions designed to improve business operations and bolster fiscal solvency.

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CEO Announcements


Saint Luke’s North Hospital Names New CEO

Staff Contact: Carol Boessen

Adele Ducharme has been named permanent CEO of Saint Luke’s North Hospital Barry Road and Smithville, effective Nov. 28, 2017. She served as interim CEO since May, succeeding Matt Wenzel. Prior to serving as interim CEO, Ducharme served as CEO of Saint Luke’s Cushing Hospital in Leavenworth, Kan. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?


December 18, 2017
Medicare OPPS Final Rule CY 2018 Available
Study Concludes UberX Reduces Ambulance Usage
Missouri Flu Activity Is Widespread

December 19, 2017
Congress Preparing To Enact Tax Reform Legislation
CMS Clarifies Proficiency Testing Referral
CMS Clarifies Ligature Risk Policy
MO HealthNet Ends Certificate Requirements For Certain Enteral Formula And Trachea Supplies
HIIN Lean Six Sigma Green Belt Project

December 20, 2017
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



Consider This ...

American life expectancy at birth declined for the second consecutive year in 2016, fueled by a staggering 21 percent rise in the death rate from drug overdoses. The U.S. has not seen two years of declining life expectancy since 1962 and 1963, when influenza caused an inordinate number of deaths.

Source: The Washington Post