MHA Today | September 7, 2018   

September 7, 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.


Herb Kuhn, MHA President & CEO For every day of 2017, on average, 190 patients were treated in a Missouri hospital emergency department and outpatient clinic for opioid-related symptoms. Too often, this care has been episode-based. Fortunately, that’s changing.

Wednesday, the September edition of Trajectories, was released. This edition focuses on the investments and partnerships that are improving the care delivery model for individuals with opioid use disorder. In addition, it investigates emerging treatment programs for newborns suffering from neonatal opioid withdrawal syndrome, and supporting their mothers with OUD.

Substance use disorder is a chronic brain disease. However, for a variety of clinical and cultural reasons, SUD management hasn’t always mirrored long-term disease management strategies common for patients with other chronic conditions, such as diabetes or heart disease. Missouri’s model recognizes and addresses this problem.

Missouri has adopted a “medication first” model incorporating both naloxone as a rescue medicine and buprenorphine to treat OUD. This has resulted in getting naloxone, the rescue medication for overdose, in the hands of a broader set of stakeholders — not just clinicians, but first responders, family members and opioid users. Education and distribution continues, but the efforts so far are certain to save lives.

Similarly, progress is being made to expand prescriber certification for buprenorphine. Missouri currently has 501 waivered providers, and the next PCSS-MAT training will be held Sept. 15 in St. Louis. Buprenorphine has proven effective as a tool in recovery therapy, allowing opioid-addicted patients to better manage and ultimately beat their addictions.

Medication-assisted therapy is medication first, but not medication only.

The Engaging Patients In Care Coordination program in St. Louis — which now is emerging at other sites throughout the state — begins in the ED. EPICC stabilizes the patient with medication and begins the coordination between providers and recovery service programs. The program includes connecting patients with a peer recovery coach who also is in recovery. EPICC increases the success rate of recovery by turning episode-based care on its head. Through the program, patients are offered a full set of resources managed at the clinical and community level throughout their recovery. It’s working. In the St. Louis EPICC program, 70 percent of patients receiving MAT still were engaged with the therapy services after 30 days.

Pregnancy also may provide a gateway to opioid-related SUD care. Expecting mothers who suffer from OUD can benefit from MAT during pregnancy, and after, if the condition is identified during prenatal care. New legislation authorizes an extension of post-delivery Medicaid coverage for new mothers who receive substance use treatment within 60 days after the birth. Although the extension is contingent upon federal approval and funding, the access to health services provided by the law could be life changing for both the mother and child.

The opioid problem is significant, and best practices still are emerging. State and federal resources are providing a foundation for new knowledge, better coordination and better care. Missouri has made important progress through state legislation, county level investments — including the prescription drug monitoring program and EPICC in the eastern region — and new partnerships among stakeholders. There have been real results. Lives have been improved and saved.

One of the most important and powerful aspects of the opioid crisis is that it has pulled back the curtain of stigma and shame often associated with substance use. Accepting that OUD is a chronic condition, requiring chronic care management, is a paradigm shift. Less stigma will encourage individuals to access the help they need — before an overdose, ED visit or worse.

Hospitals are on the front line of the opioid crisis and, as such, are active participants in the programs discussed in Trajectories. However, there isn’t enough room in this column to do justice to every aspect of the report. I would encourage you review it and share it with the appropriate members of your hospital team.

Send me an email with your thoughts. .
Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
HIDI Releases Second Quarter CY 2018 Update To Discharge Data-Based Quality Indicators
CMS Announces OQR Education Session
FORHP Requests Focus Group Participants On Rural Needs In Response To The Opioid Crisis

HIDI Tech Connect

HIDI Releases Second Quarter CY 2018 Update To Discharge Data-Based Quality Indicators

Staff Contact: Josette Bax

The Readmissions data, the Hospital Acquired Conditions data and the AHRQ Quality Indicators data have been refreshed within HIDI Analytic Advantage® PLUS to include measure calculations based on discharge data from the second quarter of calendar year 2018.

These quality data updates can be found in various reports in the following Analytic Advantage PLUS locations.

  • Quality > Benchmarking
  • Quality > Readmissions
  • Quality > Strategic Quality Initiatives

Technical questions regarding these measures should be directed to Josette Bax. For questions about accessing the website or running these reports, please contact HIDI.

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Quality and Population Health

CMS Announces OQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Outpatient Quality Reporting Program has been scheduled on Wednesday, Sept. 19. The webinar is offered at 9 a.m. and 1 p.m. and will discuss common reports for the OQR program, as well as the most currently reported data for selected web-based measures. Registration is required.

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FORHP Requests Focus Group Participants On Rural Needs In Response To The Opioid Crisis

Staff Contact: Dana Dahl

The Federal Office of Rural Health Policy is interested in partnering with Flex hospitals to help determine the needs of state Flex programs and critical access hospitals as related to the opioid crisis. Volunteers are invited to participate in an interactive webinar focus group to inform potentially new funding opportunities within the Health Resources and Services Administration-funded Rural Communities Opioids Response Program. Both the state- and CAH-level perspective is needed. The webinars will last no longer than one hour and are scheduled as follows.

  • CAHs only – Thursday, Sept. 13 at 3 p.m. ET
  • CAHs only – Monday, Sept. 17 at 11 a.m. ET and 3 p.m. ET

If you'd like to participate or have questions, email Please include your name, organization, and the webinar date and time.

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Did You Miss An Issue Of MHA Today?

September 4, 2018
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

September 5, 2018
Senate Passes CHGME Reauthorization; Bill Awaits President’s Signature
Ways And Means Letter To CMS Recommends Red Tape Reduction
Hospitals Refile Lawsuit To Reverse 340B Payment Cuts
CMS Releases New Rules For PRRB
Trajectories — Integrating Evidence-Based OUD Treatment: A Medication First Model

September 6, 2018
MHA Files Legal Brief Challenging Medicaid Reimbursement Rule
MHA Comments On Medicare Physician Fee Schedule Proposed Rules
MLN Connects Provider eNews Available

Consider This ...

Influenza can be fatal: 180 children died from the flu during the 2017-18 season, according to the Centers for Disease Control and Prevention, and about 80 percent of those children were unvaccinated.

Source: The New York Times