MHA Today | January 19, 2018

January 19, 2018
MHA Today: News for Healthcare Leaders

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January 19, 2018

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

Insights

Herb Kuhn, MHA President & CEO
On Tuesday, MHA released new data on the economic cost of the state’s opioid crisis. The numbers are staggering. In 2016, the cost of opioid overdose deaths in Missouri was estimated at $12.1 billion. Costs associated with nonfatal opioid use disorder totaled $519 million. That’s a grand total of $12.6 billion.

The human toll of the opioid crisis is abundantly clear. So-called “deaths of despair” that are often reflected in drug- and opioid-related overdoses represent significant human loss, and they are reversing decades of growth in life expectancy in the U.S. However, this loss also is associated with economic loss from the premature death of 921 Missourians in 2016, and the ongoing costs of individuals with opioid use disorder that year.

The research used methods from the White House Council of Economic Advisors report on the underestimated cost of the opioid crisis and mortality data released in late 2017 from the Centers for Disease Control and Prevention. Hospital Industry Data Institute researchers replicated the earlier research to establish a state-level economic burden using the updated mortality data.

The CEA tallied the national economic burden of opioid deaths and opioid use disorder, finding a cost of $504 billion nationally, or 2.8 percent of gross domestic product in 2015. The Missouri rate exceeds the national average at 4.2 percent of the state GDP. This was the 15th largest burden among 50 states and the District of Columbia.

Sadly, these numbers are moving in the wrong direction. In 2016, on average, nearly three Missourians died each day from an opioid overdose. Missouri’s one-year increase over 2015 was 35 percent — six percentage points higher than the national increase of 29 percent.

As with last week’s release of data on drug and opioid deaths compared to motor vehicle accident deaths, a comparative can provide perspective. For example, the CDC found 42,000 Americans died from opioid-related deaths in 2016 — more deaths than from breast cancer. In Missouri, 880 breast cancer deaths were reported in 2016, while 921 lives were lost to opioids.Economic Cost of Opioid Epidemic

Breaking down the numbers a bit more, an economic cost of $12.6 billion in Missouri is equivalent to $1.4 million per hour, $24,000 per minute and $399 per second. Or, to provide another perspective, Missouri’s cost from the opioid crisis exceeds the economic activity generated by the agriculture, mining and utilities sectors combined.

There will be costs associated with reducing these economic losses. In addition, it will require a real plan — investments in education, behavioral health and substance use disorder interventions, and coordination with law enforcement, among others.

Prevention and treatment of opioid use disorder are more important now than ever before. Sadly, opioid overdose deaths are growing exponentially while interventional resources are growing geometrically, if at all. That’s not a winning equation. None of this will happen quickly. However, with an average of nearly three Missourians dying each day from an opioid overdose, there’s also no time to lose. And, the value proposition is pretty clear.

Share your thoughts in an email.

Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO


In This Issue
Congress Faces Imminent Government Shutdown
Governors Make Federal Action Recommendations On Opioid Abuse
CMS Releases 2018 ACO Participants
MedPAC And MACPAC Release Dual Eligible Data Book
2018 Medicare Value Modifier Results Available
CMS Updates Known Issues Documents
NGA Selects Six States To Participate In The Rural Health Learning Collaborative
State Board Of Nursing Releases Enhanced Nurse Licensure Resources
Landmark Hospital Of Columbia Names Interim CEO
VanConia Announces Resignation With SSM Health


Advocate
state and federal health policy developments


Congress Faces Imminent Government Shutdown

Staff Contact: Daniel Landon

With the most recent short-term reauthorization of federal government funding slated to expire at midnight tonight, the prospects for averting a shutdown worsen and partisan finger-pointing abounds. The U.S. House of Representatives passed a bill creating another short-term extension, coupled with a six-year reauthorization of the politically popular Children’s Health Insurance Program and delays in ACA taxes on medical devices, “Cadillac insurance plans,” and health insurers. The House bill appears to have insufficient support to win U.S. Senate approval. In anticipation of a shutdown, the Department of Health and Human Services issued a contingency plan.

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Governors Make Federal Action Recommendations On Opioid Abuse

Staff Contacts: Daniel Landon or Leslie Porth

The National Governors Association issued recommendations and a media statement regarding federal actions to help states curtail opioid abuse.

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CMS Releases 2018 ACO Participants

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services updated the next generation accountable care organizations model webpage, including a participant listing for 2018. In 2018, 58 ACOs will be participating in the next generation ACO model. Missouri has one entity that will be participating.

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MedPAC And MACPAC Release Dual Eligible Data Book

Staff Contacts: Brian Kinkade or Andrew Wheeler

The Medicare Payment Advisory Commission and the Medicaid and CHIP Payment and Access Commission issued a joint data book regarding “dual eligibles” who are enrolled in both programs. The data is for calendar year 2013.

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Regulatory News
the latest actions of agencies monitoring health care


2018 Medicare Value Modifier Results Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a fact sheet about the 2018 Medicare value modifier results. The value modifier provides payment adjustments to clinicians paid under the Medicare physician fee schedule based on quality of care compared to the cost of care. The value modifier program ends in 2018 and will be replaced by the MIPS or APM tracks as defined by the Medicare Access and CHIP Reauthorization Act. In 2018, 20,481 clinicians will receive an upward adjustment, 834,397 will receive a neutral payment adjustment and 121,642 will receive a negative adjustment.

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Quality and Population Health


CMS Updates Known Issues Documents

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services updated the known issues documents associated with the Inpatient and Outpatient Quality Reporting programs with issue resolutions and newly identified issues. The reports are available on QualityNet.

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NGA Selects Six States To Participate In The Rural Health Learning Collaborative

Staff Contact: Stephen Njenga

The National Governors Association selected six states — Alabama, Arizona, Indiana, Louisiana, Missouri and Oregon — to participate in a project called Improving Health in Rural America: Addressing the Leading Causes of Death. Specifically, states will develop and implement specific strategies to address one of the five leading causes of death in rural areas. MHA will be represented in the Missouri team.

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Workforce News


State Board Of Nursing Releases Enhanced Nurse Licensure Resources

Staff Contacts: Sarah Willson or Jill Williams

The Enhanced Nursing Licensure Compact goes into effect today. Missouri is one of 29 states where registered nurses and licensed practical/vocational nurses will be able to apply for a multistate license with the ability to practice in person or via telehealth in both their home state and other eNLC states. With employers and nurses having questions about the implementation of the eNLC, The National Council of State Boards of Nursing is hosting upcoming employer forums. For questions or concerns, please contact the Missouri State Board of Nursing.

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CEO Announcements


Landmark Hospital Of Columbia Names Interim CEO

Staff Contact: Carol Boessen

Mark Brodeur has been named interim chief executive officer at Landmark Hospital of Columbia, effective Jan. 8. He replaces Jerry Deller who had served as CEO since November 2016. Brodeur previously served as CEO of the former Jefferson Memorial Hospital, now Mercy Hospital Jefferson, from 1997 to 2007, and also was CEO of Select Specialty Hospital in Springfield. A list of CEO changes is available online.

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VanConia Announces Resignation With SSM Health

Staff Contact: Carol Boessen

Brent VanConia, mid-Missouri regional president of operations for SSM Health and president/chief executive officer of SSM Health St. Mary’s Hospital – Jefferson City, announced his resignation, effective Friday, Feb. 9. VanConia has been with SSM for 19 years and served in his current role since July 2007. Effective Monday, Feb. 12, Philip Gustafson, former President of SSM Health’s Southern Illinois Region, will serve as interim president while a search is conducted for a permanent regional president. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?


January 15, 2018
CMS Approves Kentucky Medicaid Work Requirement
MO HealthNet Seeks Comments On Reduction In Outpatient Lab Reimbursement
CMS Updates Conditions Of Participation For Hospitals
CDC Launches New Patient And Provider Sepsis Resources

January 16, 2018
New Research Finds The Opioid Crisis Cost Missouri $12.6 Billion In 2016
HHS Updates Federal Poverty Guidelines
CMS Releases BPCI Advanced Episode Definitions
Hospital Construction Standards Still On-Hold
Study Finds Increased Rate Of Alcohol-Related ED Visits
HRSA Launches Public Health Webinar Series
Mercy Hospital Aurora And Cassville Name New Administrator

January 17, 2018
HRSA Selects Two Missouri Hospitals To Receive Technical Assistance
Influenza Activity In Missouri Continues
FDA Issues Statement On Ongoing IV Fluid Shortages
CMS Announces EHR Incentive Program Demonstration
CMS Announces IQR Webinar

January 18, 2018
Plaintiffs In 340B Challenge File Motion For Expedited Review
CMS Issues Home Health Appendix Change Memo
CMS Releases Survey Memo On Deemed Status Removal
MLN Connects Provider eNews Available
CMS Updates Inpatient CART




Consider This ...

The Centers for Disease Control and Prevention estimates that each year in the U.S., norovirus — a group of viruses that can cause gastroenteritis — causes 10 to 21 million illnesses, 56,000 to 71,000 hospitalizations and 570 to 800 deaths.

Source: Centers for Disease Control and Prevention