MHA Today | February 9, 2018

February 9, 2018
MHA Today: News for Healthcare Leaders

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February 9, 2018

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
I was watching sports coverage last night when a commentator said, “It looks like they have been chopping wood, and they have the calluses to prove it.” The comment was interesting and relevant to what I wanted to talk about today.

Earlier this week, MHA released the 2018 Community Investment Report. Each year, the report quantifies the value that hospitals deliver in the communities they serve — significant community benefits and economic impact.

Health care is a people-focused enterprise. That inherent intimacy creates powerful stories about compassion and connection. If you want good examples, look at the videos that are on our Hospital Heroes page at However, the Community Investment Report tells the story in a very different way. It shows how hospitals deliver a strong safety net, healthier communities and economic value — as individual organizations and as a community of hospitals.

Here are the toplines.
Community Investment
In 2016, the state’s hospitals provided $1.26 billion in uncompensated care. That’s $37 million more than in 2015 — with the growth primarily in charity care. Hospital bad debt declined by approximately $41 million in 2016. Total community benefit — including hospitals’ unpaid costs of treating Medicare and Medicaid beneficiaries, health care workforce investments, free or reduced-cost clinic services, and donations to local causes — increased by $250 million over 2015, to approximately $3 billion.

Hospitals’ economic investments are essential locally and statewide. In 2016, Missouri’s hospitals employed more than 158,000 full-time equivalent staff, with an annual payroll and benefits of $10.6 billion. Between 2015 and 2016, hospitals added more than 5,000 full-time equivalent employees and expanded payroll by $670 million. In addition, hospitals invested approximately $1.8 billion in various capital improvement projects throughout the state.

The numbers are impressive. And, the report validates that hospitals are delivering on their missions and building stronger communities.

These are challenging times for hospitals. From patient care to payment systems, the work gets more difficult every day. It’s also rewarding, and necessary.

We’re not chopping wood. For every dollar represented in the report, there is a hospital employee or patient with a story. The Community Investment Report is hospitals’ way of holding out our hands to show the calluses.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Congress Enacts Budget Legislation With Health Care Components
MHA Files Comments Opposing MO HealthNet Reductions In Lab Reimbursements
Stroke Center Designation Application Rule Is Final
AHIP Study Compares Claims Data With CDC Opioid Prescribing Guidelines
CMS Announces IPFQR And OQR Education Sessions

state and federal health policy developments

Congress Enacts Budget Legislation With Health Care Components

Staff Contact: Daniel Landon

Congress has enacted legislation to bypass a federal government shutdown and establish a two-year federal spending guideline. Congress’ next deadline is March 23, in which they must enact specific appropriations. The legislation includes many health-related issues, including a two-year delay in reductions of state Medicaid disproportionate share hospital allotments and reauthorizing payment streams for Medicare-dependent and low-volume hospitals.

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MHA Files Comments Opposing MO HealthNet Reductions In Lab Reimbursements

Staff Contacts: Kim Duggan or Brian Kinkade

MHA filed comments in opposition to MO HealthNet’s change in methodology for reimbursing outpatient lab services. The change, which went into effect Jan. 1, will reimburse hospitals and other providers billing lab services at 80 percent of the Medicare fee schedule. The change results in a net reduction in reimbursement of $13.2 million for all providers; the estimated impact to hospitals is $10.1 million. This policy change is one of several that are anticipated as MO HealthNet responds to Governor Greitens' call to achieve $40 million in savings from the Medicaid program. MHA is advocating strenuously that cuts to the hospital program be limited to no more than the proportional share of the state’s General Revenue commitment to it, which is minimal because of the Federal Reimbursement Allowance.

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Regulatory News
the latest actions of agencies monitoring health care

Stroke Center Designation Application Rule Is Final

Staff Contact: Sarah Willson

The notice of proposed rulemaking on 19 CSR 30-40.720 Stroke Center Designation Application was published in the Missouri Register on Sept. 15, 2017. After considering comments received during the public comment period, the final rule will be published in the Missouri Register on Thursday, Feb. 15. The amendment becomes effective 30 days from the publication date; however, an emergency rule has been in effect since September.

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Quality and Population Health

AHIP Study Compares Claims Data With CDC Opioid Prescribing Guidelines

Staff Contacts: Leslie Porth or Alison Williams

America's Health Insurance Plans released findings from a study assessing health insurance claims from 2009 to 2013 on six recommendations from the Centers for Disease Control and Prevention's Guideline for Prescribing Opioids for Chronic Pain. According to AHIP, the vast majority of opioid prescriptions for chronic pain were for immediate-release opioids, consistent with CDC recommendations, but certain other measures could be improved. For example, about one-quarter of opioid prescriptions were above the CDC-recommended morphine milligram equivalent dosage, the organization said. The study methodology has been shared with insurance providers nationwide who may apply it to measure their own opioid prevention and management efforts.

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CMS Announces IPFQR And OQR Education Sessions

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services announced the following outreach and education webinars for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting and Outpatient Quality Reporting programs.

  • IPFQR — 1 p.m. Thursday, Feb. 15 — “Quality Measures at CMS: A Closer Look at the Measure Development Lifecycle and CMS’ Meaningful Measures Initiative”
  • OQR — 9 a.m. and 1 p.m. Wednesday, Feb. 15 — “Measure by Measure: Data for the Hospital Outpatient Quality Reporting Program”

Registration is available at the noted links.

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Did You Miss An Issue Of MHA Today?

February 5, 2018
Report Charts Distribution Of High-Cost Enrollees In Commercial Insurance Plans
CMMI Cancels Beneficiary Engagement Model
CMS Releases Overview And Upcoming Events For BPCI Advanced
HQRx News Blast Available
HRSA Offers NURSE Corps Loan Repayment Program

February 6, 2018
2018 Community Investment Report Finds Charity Care, Community Benefit Up In 2016
U.S. House Republicans Unveil Continuing Resolution Legislation
State Senate Advances FRA Reauthorization And Safeguard Legislation
CDC COCA Hosts Call To Update On Current Influenza Season
TJC Releases Specifications Manual Version 2018A

February 7, 2018
MHA Opposes State Bill Restricting Covenants Not To Compete
Regulatory Relief For Hospitals Heard In Senate Committee
U.S. Senate Develops Its Own Budget Continuation Legislation
CMS Releases HQRP, HIS And Hospice CAHPS FY 2020 Requirements
2018 Aim For Excellence Award — Call For Applications
CMS Hosting Q&A Session Regarding CY 2017 EHR Attestation

February 8, 2018
U.S. Senate Develops Its Own Budget Continuation Legislation
Analysis Of Medicare Pay-For-Performance Programs And Projections Available
MO HealthNet Enhances Reimbursement For Certified Providers Treating Severely Abused Children
CMS Hosts Comment Period On New eCQM Measures
MLN Connects Provider eNews Available
NHSN Requires Updated Consent Forms
CMS Announces VBP Webinar

Consider This ...

Approximately 6 million children in the U.S. have asthma, and every year, one in six children with asthma visit the emergency department.

Source: Centers for Disease Control and Prevention