MHA Today | May 11, 2018

May 11, 2018
MHA Today: News for Healthcare Leaders

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May 11, 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 National Nurses Week, which runs parallel with National Hospital Week, ends tomorrow.

Registered nurses are the largest occupational segment in health care. When combined with nursing assistants, licensed practical nurses and vocational nurses, the nursing profession dwarfs all other health care professions in size.

The numbers are only part of the story. Nurses are essential to making care better in hospitals and health care. They are the front-line of patient care, and leaders in quality improvement and patient satisfaction efforts, among many other priorities.

Not only are nurses the glue that holds health care organizations together, they are — and consistently have been — America’s most trusted professionals.

None of that is to say the work is easy.

When MHA surveyed hospitals about their organizations’ biggest threats, workplace violence was one of the top concerns. Given the size of the nurse workforce and their forward placement in care delivery, they are some of the most vulnerable members of the hospital team.

Throughout the past year, the MHA board has made it a priority to address workplace violence. This week marked two important milestones in that effort.

First, in partnership with the Missouri Department of Public Safety, MHA convened a series of four meetings across the state with hospitals, local law enforcement and emergency management leaders for case-based discussions and the exploration of collaborative opportunities to address hospital violence. All meetings were well attended. Thursday, we completed the fourth and final session in Cape Girardeau. The next step is to take what we heard at those meetings and create a series of action plans, including opportunities for joint training on de-escalation techniques.

Second, I was in Washington, D.C., early this week with members of the state’s hospital community sharing priority issues with members of Missouri’s congressional delegation. Among the issues on the agenda was the spike in violence against hospital staff. One of the issues we raised was the need for alignment between the two federal agencies with jurisdiction — the Centers for Medicare & Medicaid Services, which focuses on patient safety and the Occupational Health and Safety Administration, which shoulders the responsibility of ensuring safe work environments. Sadly, the two agencies don’t communicate with one another. Hospitals are stuck in the middle and deal with the result on a daily basis. We shared with Congress that we need the two to work together on a common set of standards. Our message was simple – we need to honor the health care worker in the same manner that we honor the patient. Also while in Washington, MHA staff gave a presentation at the American Hospital Association’s annual meeting on the various initiatives we are undertaking in the state to improve workplace safety. The presentation gave us a chance to share our work and to learn from others what is working in their states. This was a good opportunity to accelerate our efforts.

In a perfect world, caregivers would focus on helping patients heal, and patients and their support networks would participate in implementing the care plan. Hospitals are seldom that perfect world. Verbal and physical abuse by patients and visitors has increased, hampering care and endangering hospital staff members throughout the organization.
S.A.F.E.R Initiative
Hospital safety and resiliency have long been part of MHA’s emergency preparedness strategy. MHA has facilitated armed intruder training, and multiple cohorts of hospital employees have attended de-escalation training. The March edition of Trajectories details the current workplace violence and safety challenge and outlines MHA’s S.A.F.E.R initiative — a framework to identify and provide resources to hospital staff.

Our ability to care for and protect patients is only as good as our ability to protect and create a safe environment for care provision for our front-line caregivers. We have a good start. However, we need policymakers and community partners to help hospitals build a safer care environment.

No nurse — no caregiver of any stripe — should be faced with aggressive behavior or physical violence. If Americans truly hold nurses in the highest esteem, then we all have a stake in doing what it takes to protect them and their partners in care delivery.

On National Nurses Week, we recognize nurses for their important contributions. Every day, we have an obligation to honor them.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Trump Drug Pricing Initiative Highlights 340B, Site-Neutral Payment
Senate Approves FRA Reauthorization And Payment Safeguard Legislation
House Advances Hospital Regulatory Reform Proposal
CMS Releases Spring OQR Newsletter
Becker Announces Departure From SSM Health Saint Louis University Hospital

state and federal health policy developments

Trump Drug Pricing Initiative Highlights 340B, Site-Neutral Payment

Staff Contacts: Daniel Landon, Brian Kinkade or Andrew Wheeler

President Trump released a plan for addressing drug prices, along with a fact sheet. While specifics are few, it cites an earlier budget proposal to create new standards for participation in the 340B drug discount program. The document cites 340B expansion as a contributor to decreased pharmaceutical manufacturer revenues and cost-shifting pressure on drug prices. It also proposes changes to the Medicaid drug rebate program. The administration invites comment on a variety of questions regarding 340B, site-neutral payment between hospitals and other settings and in outpatient and inpatient settings, and other drug pricing topics.

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Senate Approves FRA Reauthorization And Payment Safeguard Legislation

Staff Contacts: Daniel Landon or Rob Monsees

The state Senate unanimously approved the conference committee substitute for Senate Bill 775, which addresses provider taxes. It returns to the House of Representatives for ratification of the changes. The bill reauthorizes the hospital Federal Reimbursement Allowance and the other state provider taxes for one year. It also upgrades a 17-year-old safeguard in current law for hospital payments funded by the FRA. The new safeguard emphasizes greater transparency and accountability, particularly for FRA-funded payments flowing through Medicaid-managed plans. The final bill does not authorize a provider tax for managed care plans, reflecting legislative concern about perpetuating and embedding the role of managed care in Medicaid.

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House Advances Hospital Regulatory Reform Proposal

Staff Contacts: Daniel Landon or Rob Monsees

The state House of Representatives approved Senate Bill 951 with a number of amendments. The underlying bill revises hospital licensure standards as enacted Wednesday, May 9. The bill also includes MHA-promoted changes regarding standards of consent for drawing blood to collect forensic evidence to prosecute impaired driving crimes and also for administering prophylactic eye drops to newborns. House amendments address the investigation of hospice deaths by coroners or medical examiners, fees for copying medical records, licensure of radiological technicians, and various opioid treatment initiatives. An MHA amendment protects hospitals’ autonomy to make employment and credentialing decisions regarding assistant physicians. The bill returns to the Senate for consideration of the House changes.

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Quality and Population Health

CMS Releases Spring OQR Newsletter

Staff Contact: Sherry Buschjost

The spring OQR Times quality reporting newsletter has been released by the Centers for Medicare & Medicaid Services. The issue includes the following topics for the Hospital Outpatient Quality Reporting Program.

  • May 2018 data submission deadlines
  • program tools and resources
  • sampling methods
  • educational events
  • availability of facility-specific reports
  • program support documents

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CEO Announcements

Becker Announces Departure From SSM Health Saint Louis University Hospital

Staff Contact: Carol Boessen

Kathleen “Kate” Becker, president of SSM Health Saint Louis University Hospital, announced she will be leaving, effective Friday, July 6. She served as president of the hospital since September 2015. Becker accepted the chief executive officer position at the University of New Mexico Hospitals in Albuquerque, effective Sunday, July 15. A list of CEO changes is available online.

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Did You Miss An Issue Of MHA Today?

May 7, 2018
MHA Celebrates National Hospital Week
CMS Seeks Comments On Proposed IPF Screening For Pregnancy Measure

May 8, 2018
Get Social For National Hospital Week
Budget Conference Committee Favors Lower Medicaid Hospital Rate Cuts
CMS Releases eCQM Information
Hospital Compare Preview Reports Available
CMS Announces Rural Health Strategy

May 9, 2018
Celebrate National Nurses Week
Congressional Committee Advances 27 Bills On Opioid Issues
General Assembly Enacts Hospital Licensure Reform Legislation
Mammography Insurance Coverage Bill Enacted
Trajectories: Advancing Population Health: Assessment And Action In Missouri Hospitals
CMS Announces IQR Education Session
Missouri State Board Of Nursing Workforce Report Available

May 10, 2018
Celebrate Missouri Hospital Heroes
State Legislators Complete Budget Work
House Advances Legislation On Telemedicine, Coverage Of Out-of-Network Services And Emergency Care
Sen. McCaskill Introduces Legislation On Air Ambulances
MLN Connects Provider eNews Available
HealthCurve Analytics To Co-Host Town Hall MIPS Webinar With SpectraMedix
MFH Offering Free Translation And Interpretation Services
Technology And The Workforce Of The Future

Consider This ...

This week is National Nurses Week. Eighty-two percent of Americans consider nurses to have high or very high honesty and ethical standards. Two other health care professions, medical doctors and pharmacists, also score high on trust with an excess of 60 percent feeling they have high or very high honesty and ethical standards.

Source: Forbes