MHA Today | August 3, 2018

August 3, 2018
MHA Today: News for Healthcare Leaders

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August 3, 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 At an event in Springfield on Wednesday, Gov. Mike Parson talked about evaluating the results delivered by the state’s Department of Economic Development. Parson has made workforce concerns a center of his agenda since taking office earlier this year.

Also on Wednesday, MHA released the 2018 workforce report. This year’s report, “Harnessing the Power of Partnerships,” points directly to the need for greater coordinated, targeted investment in the hospital workforce.

The 2018 report finds increased turnover rates among the majority of hospital-based health care positions. Vacancy rates decreased for several employee categories, including registered nurses, between 2016 and 2017. However, combined turnover among all professions surveyed increased statewide from 16 percent in 2016 to 17.7 percent in 2017.

2018 Workforce Report - Vacancy The drop in nurse vacancy was good news. However, in spite of the drop, staff nurses — nurses working at the hospital bedside — still lead vacancy rates among hospital professionals. In 2017, Missouri had 32,635 staff nurses working in patient care and 4,985 vacant positions. And, hospitals indicated greater levels of difficulty in recruiting nurses in care specialties and behavioral health.

Turnover remains high and costly among staff nurses. Each nurse turnover can cost a hospital between $40,000 and $60,000 to recruit, onboard, train and orient the new employee. Turnover among registered nurses was 16 percent.

Building a strong workforce remains a hospital communitywide priority. There are very successful programs — a few of which are included in the report — that are opening access to nontraditional workforce entrants, defining and supporting career pathways, and encouraging employee retention. Local and statewide coordination is improving, leading to expanded awareness of the opportunities in health care and better workforce resource allocation.

Although we’re making headway, the challenges to building the workforce that hospitals need to serve their communities continue to meet with powerful headwinds. The aging health care workforce, growing demand for health care services among an aging population, a constricted pipeline for replacement professionals, and incentives to move within and outside of the hospital workforce, all influence the ability to make real progress.
2018 Workforce Report - Entry-level Occupations
Gov. Parson’s announcement is great news. Missouri’s focus often has been on the big prize — a new auto plant, an airplane manufacturing contract or other high-profile manufacturing target. These industries have been important to Missouri in the past, and it is understandable that leaders would look to stabilize and grow manufacturing jobs. However, there are high-value opportunities within health care, as well. We desperately need entry-level workers and have growing demand for bedside caregivers. In addition, these positions include opportunities to advance up career pathways that serve hospitals, the employee and communities throughout the state.

Hospitals can’t achieve this alone. Throughout the past two decades we’ve established and grown our partnerships with government, academic institutions, and regional workforce and economic development organizations. A stronger, more focused commitment from the state would be a welcome addition to the health care workforce partnership. The state’s senior policymaker seems to understand that a strong business community requires a strong, prepared workforce.

That’s good news.

You can find the report and the regional data online.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MHA Submits Comments In Opposition To MO HealthNet Outpatient Rate Cuts
CMS Revises Transparency Requirements In The IPPS And LTCH FY 2019 Final Rule

Regulatory News
the latest actions of agencies monitoring health care

MHA Submits Comments In Opposition To MO HealthNet Outpatient Rate Cuts

Staff Contact: Brian Kinkade

MHA staff submitted comments in opposition to reductions in outpatient reimbursement at a public hearing conducted by the MO HealthNet Division staff this afternoon. The cuts are the first that MHD has taken in its plan to convert Missouri Medicaid outpatient reimbursement from percent of charges to fee schedules, one of the hotly debated cost savings strategies MHD proposed this past legislative session. The reductions at hand with the greatest impact on Missouri hospitals are the following.

  • reducing outpatient radiology to 90 percent of the Medicare fee schedule
  • converting outpatient pharmacy from percent of charges to the retail pharmacy reimbursement schedule
  • cutting 340B pharmacy reimbursement from percent of charges to wholesale acquisition cost minus 49 percent

The radiology rate changes are to be effective Nov. 30, 2018, and the pharmacy reimbursement changes are scheduled for Dec. 16, 2018. These actions are predicated on the promulgation of a rule filed by MHD on June 1. MHA strongly opposes the proposed rule and anticipates appealing the rule to the General Assembly’s Joint Committee on Administrative Rules later this month.

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CMS Revises Transparency Requirements In The IPPS And LTCH FY 2019 Final Rule

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the federal fiscal year 2019 acute inpatient and long-term acute care hospital prospective payment system payment and policy updates. Within the rule, CMS revised the price transparency requirements. Effective Jan. 1, 2019, the “hospitals’ list of standard charges” are to “be made available to the public via the internet in a machine readable format.” Hospitals are to “update this information at least annually, or more often as appropriate.” CMS says, “This could be in the form of the chargemaster itself or another form of the hospital’s choice, as long as the information is in machine readable format.” MHA is assessing hospitals’ options, as well as its Focus on Hospitals website, given the lack of clarity in CMS’ comments.

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Did You Miss An Issue Of MHA Today?

July 30, 2018
New Opioid Treatment Program And Community-Based Care Coming To Mid-Missouri
MO HealthNet Increases Certain DME Reimbursement Rates
CMS Releases HSRs For FY 2019 HAC Reduction Program
Children’s Mercy Kansas City Names New President And CEO

July 31, 2018
In ED Study, Researchers Find 2.6 Percent Of Patients Suffer From Agitation

August 1, 2018
Medicare Issues Final FY 2019 Payment And Policy Updates For SNF, IRF and IPF
HHS Releases Short-Term Insurance Policy
Medicare Part D Premiums Decline In 2019
MHA Releases 2018 Annual Workforce Report
NEIP Provides Positive Impact On Nursing Programs Statewide

August 2, 2018
Congressional Committee Queries 340B Contract Pharmacies
MO HealthNet Offers Assistance For Providers With Managed Care Concerns
DHHS OIG Catalogs Unimplemented Recommendations On Fraud And Abuse
CMS Releases Final FY 2019 Payment And Policy Updates For IPPS And LTCH
Medicare Issues Final FY 2019 Payment And Policy Updates For Hospice
CMS Issues Clarification To Guidance On Psychiatric Environmental Risks
MLN Connects Provider eNews Available
Sierra Leone Reports New Ebola Species
Landmark Hospital Of Columbia Names New CEO

Consider This ...

At least 23 percent of the 13,500 children in the care of Missouri's Children’s Division were taking one or more psychotropic drugs as of December 2017. This mirrors a national trend: Children in foster care are at least twice as likely to be taking these powerful drugs than kids outside the system.

Source: Buzzfeed News