MHA Today | May 16, 2018

MHA Today: News for Healthcare Leaders

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May 16, 2018

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

Congressional Column

MHA invited each member of Missouri’s Congressional Delegation to share a column outlining their health care priorities.
U.S. Congressman Sam Graves
Congress Must Stop The Rural Hospital Closure Crisis

We have a crisis in rural health care. In my district, which consists of mostly rural areas, we’ve seen several hospitals close or reduce services. Others are doing everything they can to keep the doors open. However, the problem certainly isn’t limited to north Missouri. We are seeing it across the country.

As of April 2018, 83 rural hospitals have closed, and 673 more are on the brink of closure. Nearly 12 million Americans living in rural areas are at risk of losing access to the closest emergency room. This comes as nearly 80 percent of rural counties are facing primary care health professional shortages, and 9 percent have no physician at all. These closures have left millions of Missourians, particularly the elderly, exposed during times of medical emergency.

Hospitals in rural communities, like my local hospital in Fairfax, Mo., are hugely important to our local economies and ensuring people can continue to live in rural communities without worrying about access to adequate medical care. That’s why I’ve introduced legislation to stop the impending flood of rural hospital closures and provide needed access to care for rural America. The Save Rural Hospitals Act would eliminate the Medicare Sequester for rural hospitals and provide a permanent extension of the rural ambulance and super-rural ambulance payments.

Furthermore, the Save Rural Hospitals Act eliminates burdensome regulations, such as the “96 hour rule,” which forces rural hospitals to transfer or discharge a patient within 96 hours for the hospitals to get paid under Medicare. It also changes the way Recovery Audit Contractors burden hospitals with unnecessary audits. Finally, this bill provides an innovative new model for rural hospitals that continue to struggle. The Community Outpatient Hospital model will ensure access to emergency care and allow hospitals the choice to offer outpatient care that meets the population health needs of their rural community.

It is evident that rural health care is a different type of animal that merits a different approach. Rural hospitals typically care for residents who are older, poorer and have higher rates of chronic disease than those who live in more urban areas. My legislation shines a light on the rural health crisis in Missouri and across the country. If we accept this reality and neglect this much needed conversation, rural hospitals in Missouri will continue to close. Every rural hospital closure leaves thousands more without access to health care, which puts lives in jeopardy. This simply is not acceptable, and I will continue to fight in Congress for quality health care for rural America.

U.S. Congressman Sam Graves

In This Issue
General Assembly Enacts New Medical Liability Service Of Process Standards
Trajectories: Advancing Population Health: Assessment And Action In Missouri Hospitals

state and federal health policy developments

General Assembly Enacts New Medical Liability Service Of Process Standards

Staff Contacts: Daniel Landon or Rob Monsees

The General Assembly enacted House Bill 2562 and Senate Bill 871. Each bill was amended by MHA to create a new service of process requirement to ensure timely notification of the filing of medical malpractice or wrongful death litigation.

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Quality and Population Health

Trajectories: Advancing Population Health: Assessment And Action In Missouri Hospitals

Staff Contact: Peter Rao

The May 2018 issue of Trajectories focuses on understanding where hospitals are positioned to implement population health management and recognizing the necessary steps to achieve readiness. It also highlights two targeted initiatives to implement population health management.

To estimate population health and community health improvement program maturity among Missouri hospitals, MHA’s population health task force identified five phases of implementation and integration, which was adapted from the Journal of Health Information Management. The five phases of the maturity scale developed for use in Missouri was pre-foundational 1, pre-foundational 2, foundational, proficient and transformational. Each phase includes defined key characteristics and recommended steps.

Assessment results indicate that Missouri hospitals are positioned throughout the five phases of maturity. With 36 percent of the hospitals in the foundational phase, May 2018 Trajectories 34 percent fall below and 30 percent above the foundational phase. The table to the right shows the breakdown by hospital type, as well as organizational state with regard to population health maturity phase.

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Consider This ...

According to the Centers for Disease Control and Prevention's Workplace Health in America Survey, 83 percent of hospitals in the U.S. provide workplace wellness programs, compared to 46 percent of all employers, and 63 percent of hospitals offer health screenings, also known as biometrics, compared to 27 percent of all employers.

Source: Centers for Disease Control and Prevention