MHA Today | September 4, 2018

September 4, 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
MHA Challenges Medicaid Payment Reduction Regulation
Evaluation Of CJR Model Finds Savings
Home Health, Hospital And CAH Provider Interpretive Guidance Available
September Marks Sepsis Awareness Month
CMS Announces Deadline For Submission Of 2Q2018 HCAHPS Survey Data
Quality Data Model Version 5.4 Available
Wright Memorial Hospital Names Interim CEO


REGISTRATION OPEN
MHA 96th Annual Convention and Trade Show

Thursday, Nov. 8, and Friday, Nov. 9
Tan-Tar-A Resort
Osage Beach, Mo.

Register online before noon, Monday, Nov. 5. Hotel reservations at Tan-Tar-A must be booked by Monday, Oct. 8. The group access code is “MHAR.”

What You Need To Know This Week

  • Tomorrow, oral arguments will be heard by a Texas federal district court on a challenge by 20 states' attorneys general (including Missouri) on ACA coverage of preexisting conditions. This is becoming an issue in Missouri’s U.S. Senate campaign between Attorney General Josh Hawley and Senator Claire McCaskill.
  • Watch for an MHA comment letter on the proposed Medicare physician fee schedule. Comments are due by Sept. 10.

Advocate
state and federal health policy developments


MHA Challenges Medicaid Payment Reduction Regulation

Staff Contact: Jane Drummond or Daniel Landon

The Missouri Hospital Association has sent a letter to the legislative Joint Committee on Administrative Rules asking for a hearing to challenge the validity of the MO HealthNet Division’s new final regulation to authorize onerous Medicaid payment reductions for various outpatient services and drugs. The Joint Committee on Administrative Rules is a state legislative committee authorized to recommend disapproval of state regulations that violate various standards in state law. The MO HealthNet Division revised its original proposal to fend off a JCAR challenge, but MHA is pursuing the challenge on other grounds. If the committee grants a hearing on the matter, it likely will be held in conjunction with the General Assembly’s annual veto session on Sept. 12-13. MHA staff is preparing a legal brief to support JCAR’s deliberations.

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Evaluation Of CJR Model Finds Savings

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services’ Center for Medicare & Medicaid Innovation released an evaluation of year one of the Comprehensive Care for Joint Replacement Model. According to the report, the average total payments for lower extremity joint replacement decreased 3.3 percent or $910. Reductions in payments also occurred in both historically high- and low-cost metropolitan statistical areas. The report indicates reduced payments did not reduce quality of care.

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Regulatory News
the latest actions of agencies monitoring health care


Home Health, Hospital And CAH Provider Interpretive Guidance Available

Staff Contact: Jim Mikes

The Centers for Medicare & Medicaid Services has issued two separate interpretive guideline memos — one for home health agencies, and one for hospitals and critical access hospitals. CMS provided state survey agencies with draft interpretive guidelines for home health agencies in January 2018, however clearance of the final guidelines was delayed. The IGs are now complete and the advanced copy of the final document is included in QSO-18-25-HHA. In a separate memo, QSO-18-26-Hospital/CAH, CMS issued guidance to surveyors addressing revisions to swing-bed requirements. Appendix T has been deleted and the guidance for the special requirements for hospital providers of long-term care services now are located in Appendix A under §482.58. The special requirements for CAH providers of LTC services in Appendix W at §485.645 have been revised to reflect the provisions of the final rule that changes the requirements for LTC facilities in 2017. Revisions to Appendix A and Appendix W of the state operations manual are highlighted in the memo.

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Quality and Population Health


September Marks Sepsis Awareness Month

Staff Contact: Jessica Stultz

Know Sepsis Graphic Increased awareness of sepsis care — early recognition and intervention — are contributing to better sepsis treatment and better patient outcomes. September is Sepsis Awareness Month. During September, hospitals can review their sepsis protocols and share educational materials with patients and the public to increase awareness. Hospitals are making progress in the fight against sepsis through early recognition and treatment — improving outcomes and saving lives.

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CMS Announces Deadline For Submission Of 2Q2018 HCAHPS Survey Data

Staff Contact: Sherry Buschjost

Wednesday, Oct. 3, is the submission deadline for the Hospital Consumer Assessment of Healthcare Providers and Systems patient perspectives on care survey data for second quarter 2018 discharges — from April 1 to June 30. The Centers for Medicare & Medicaid Services encourages all hospitals to submit data at least two days before the deadline to allow time to address any submission issues. Inpatient PPS hospitals participating in the Inpatient Quality Reporting Program must collect and submit HCAHPS data to qualify to receive their full annual payment update. Non-IPPS hospitals must meet the same submission deadline for their data to appear on Hospital Compare.

The review and correction period is Oct. 4-10. At that time, participating hospitals have the opportunity to access and review the HCAHPS data review and correction report. New data cannot be added to the warehouse during this period. However, errors in warehouse-accepted data delivered by the Oct. 3 deadline may be corrected and resubmitted.

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Quality Data Model Version 5.4 Available

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services has published the Quality Data Model (QDM), v5.4. The standard has been updated to align with the emerging standard, Health Level Seven International Fast Healthcare Interoperability Resources, and add increased explicit capabilities. Support for these features and modifications will be implemented in the production version of the Measure Authoring Tool to be released in fall 2018. Measures produced using the QDM v5.4 publication are anticipated for implementation in calendar year 2020; QDM v5.3 will be used in calendar year 2019. The document updates minor errata in attribute Table 22 (page 51) initially published to the eCQI Resource Center in June 2018 and adds the following attributes.

  • daysSupplied for Medication, Order; Medication, Dispensed; and Medication, Discharge
  • prescriberIdentifier to Medication, Order and Medication, Dispensed
  • dispenserIdentifier to Medication, Dispensed

Previously published versions of the QDM (through v4.3) included the data model and logic required to compare one data element to another. With the adoption of Clinical Quality Language in the fall of 2017, the QDM includes only the data model. This and future versions of the QDM require the use of CQL as a separate method for expressing logic. QDM will continue to evolve based on stakeholder input and feedback from the QDM User Group.

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CEO Announcements


Wright Memorial Hospital Names Interim CEO

Staff Contact: Carol Boessen

Saint Luke’s Health System in Kansas City announced Steve Schieber was named Interim CEO of Wright Memorial Hospital in Trenton, effective Aug. 30. He succeeds Gary Jordan, who had served as CEO since November 2011. Schieber also has served as CEO of Hedrick Medical Center in Chillicothe since September 2015. A list of CEO changes is available online.

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Consider This ...

Sepsis is a dangerous medical condition that is difficult to predict, diagnose and treat. Patients with sepsis are about eight times more likely to die compared to patients without sepsis.

Source: HIDI HealthStats