MHA Today | April 3, 2018

April 3, 2018

MHA Today: News for Healthcare Leaders

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

In This Issue
Missouri Providers Write U.S. Cabinet Secretaries On Anthem ED Coverage Restrictions
Medicare Value-Based Purchasing Program And Hospital Readmissions Reduction Program Analysis Available
Committee Approves Helmet Law Repeal
CMS Finalizes Updates For Medicare Advantage And Prescription Drug Program For 2019
CMS Offers Hospitals Who Contract With MA Plans A Reprieve From 340B Cuts
MHA Award Reminders: Aim for Excellence, Visionary Leadership
MHA Hosts Boot Camps To Increase Workers’ Safety
St. Anthony’s Medical Center Announces New Name



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Wednesday, June 6, and Thursday, June 7
Columbia Courtyard by Marriott
Columbia, Mo.

Register on or before Wednesday, May 23.


Advocate
state and federal health policy developments


Missouri Providers Write U.S. Cabinet Secretaries On Anthem ED Coverage Restrictions

Staff Contact: Daniel Landon

MHA and three Missouri physician organizations sent a joint letter to the U.S. Secretary of Health and Human Services and Secretary of Labor regarding Anthem’s restrictions on coverage of emergency department services. It follows up on a letter to the cabinet officials from U.S. Senators Claire McCaskill and Benjamin Cardin. The physician organizations are the Missouri State Medical Association, the Missouri Association of Osteopathic Physicians & Surgeons, and the Missouri College of Emergency Physicians.

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Medicare Value-Based Purchasing Program And Hospital Readmissions Reduction Program Analysis Available

Staff Contact: Andrew Wheeler

MHA released an analysis of value-based purchasing and hospital readmissions reduction Medicare pay-for-performance programs for federal fiscal years 2017 to 2019. The VBP analysis includes dimension and domain projected scores. It also includes actual 2017 and 2018 performance, as well as projected 2019 performances. The HRRP analysis illustrates readmission performance of AMI, heart failure, pneumonia, total hip/total knee replacement, COPD and CABG patients. MHA also has released this year’s free, on-demand webinar series about the Medicare pay-for-performance programs. 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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Committee Approves Helmet Law Repeal

Staff Contacts: Rob Monsees or Daniel Landon

A House committee approved legislation that would allow adult motorcyclists to forego wearing helmets. House Bill 2158 requires the motorcycle operator who does so to have health insurance offering at least $1 million in coverage. MHA opposes the bill.

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Regulatory News
the latest actions of agencies monitoring health care


CMS Finalizes Updates For Medicare Advantage And Prescription Drug Program For 2019

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services finalized policy updates for the Medicare Advantage and the Prescription Drug Benefit program for the 2019 contract year. The final changes include giving MA plans a 3.4 percent increase in payments, excluding the effect of coding trends on risk scores. The final rule also includes the following.

  • additional transparency for STAR ratings for MA and Part D plans
  • flexibility in the MA uniformity requirements
  • maximum out-of-pocket and cost-sharing limits
  • default enrollment
  • restoration of the MA open enrollment period
  • allowing generic drugs to be substituted onto plan formularies at any point during the plan year
  • increasing competition among pharmacies

MHA published an issue brief with additional details.

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CMS Offers Hospitals Who Contract With MA Plans A Reprieve From 340B Cuts

Staff Contacts: Andrew Wheeler or Daniel Landon

The Centers for Medicare & Medicaid Services released FAQs about billing 340B-acquired drugs under the outpatient prospective payment system for calendar year 2018. CMS states that Medicare Advantage plans that contract directly with hospitals can negotiate a separate payment rate for 340B drugs. This would provide some relief from the Medicare Fee-for-Service 340B payment cut of 28.5 percent. Hospitals that don't contract through MA plans are still subject to the cuts CMS outlined, which put covered drugs more in line with hospitals' cost to buy the treatments.

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Quality and Population Health


MHA Award Reminders: Aim for Excellence, Visionary Leadership

Staff Contact: Leslie Porth

MHA is offering two prestigious awards to recognize the sustained improvements of its member hospitals — the Aim for Excellence Award and the Visionary Leadership Award. Both awards will be presented at MHA’s Annual Convention & Trade Show in November.

The Aim for Excellence Award identifies and honors organization- or team-based projects that address at least two of the three Triple Aim principles — better health, better care and lower costs. Applications must be received by 5 p.m. Monday, May 7.

The Visionary Leadership Award recognizes outstanding achievements in clinical and health outcomes by a hospital or health system chief executive. Nominations must be received by 5 p.m. Friday, May 4. As you complete the application, please consider the nominee’s role and accomplishments that extend beyond the hospital.

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MHA Hosts Boot Camps To Increase Workers’ Safety

Staff Contact: Jessica Stultz

MHA will host Regional Boot Camps to Increase Workers’ Safety. Participants will learn de-escalation management and will have the opportunity to demonstrate the learned skills. Crisis intervention training will supplement the de-escalation techniques with a focus on mental health populations, and components of rape aggression defense training will be taught to offer the participants realistic, self-defense tactics and techniques. This free, day-long training is an excellent supplement to existing safety programs already in place at your organizations. Attendance is encouraged from front-line staff in all care units, especially the emergency department, critical care units and medical-surgical units, as well as safety and security personnel.


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Noteworthy


St. Anthony’s Medical Center Announces New Name

Staff Contact: Carol Boessen

Mercy acquired St. Anthony’s Medical Center in South St. Louis County in June 2017. On Wednesday, March 28, Mercy announced the facility’s name will change from St. Anthony’s | Mercy to Mercy Hospital South, effective Oct. 1.

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Consider This ...

This week is National Public Health Week. It is estimated that washing hands with soap and water could reduce diarrheal disease-associated deaths by up to 50 percent and can reduce the risk of respiratory infections by 16 percent.

Source: Centers for Disease Control and Prevention