MHA Today | September 25, 2018

September 25, 2018
MHA Today: News for Healthcare Leaders

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September 25, 2018

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 Releases Policy Brief On Social Determinants Of Health
Legislative Committee Takes No Action On Medicaid Outpatient Payment Regulation
MO HealthNet Revises Claim Form For Therapies For Severely Traumatized Children
MHD Tightens Claims Requirements For Prescribing Providers
MHA Conducts Weekly Flu Monitoring Beginning This Thursday
Improvement Sprints “UP” The Ante In Missouri Hospitals
Fellowship Application Period Open


Upcoming SEMINAR
2019 Joint Commission Accreditation Update for Hospitals and Critical Access Hospitals

Wednesday, Dec. 5, and Thursday, Dec. 6
Courtyard by Marriott
Columbia, Mo.
Register on or before Wednesday, Nov. 21.

Spotlight


MHA Releases Policy Brief On Social Determinants Of Health

Staff Contact: Mat Reidhead

National Voter Registration Day Today, MHA released new research that evaluates the frequency and consistency of social determinants of health coding for Missouri patients. The policy brief identifies the types of SDOH codes used and the characteristics of socially complex patients compared to the larger population, and characterizes the predictive properties of SDOH codes in risk-adjusted hospital super-utilization modeling.

Although recent policies suggest the potential for future financial impacts related to SDOH coding through risk-adjustment or direct reimbursement, hospitals and health systems may find immediate use for the codes in identifying high-risk patients and addressing social factors through community and population health improvement initiatives.

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Advocate
state and federal health policy developments


Legislative Committee Takes No Action On Medicaid Outpatient Payment Regulation

Staff Contact: Daniel Landon or Jane Drummond

The state legislative Joint Committee on Administrative Rules met today to consider whether to vote to recommend disapproval of a state Medicaid regulation that imposes onerous payment cuts for various hospital outpatient services and drugs. MHA challenged the validity of the regulation, filing a legal brief asking the committee to use its authority to recommend disapproval based on various violations of state law governing the regulatory process.

After more than an hour of discussion, the committee adjourned without taking action. This means the regulation will take effect once it goes through the final stages of rulemaking. In its deliberations, some committee members expressed concern that its action might be viewed as a “thumb on the scale” in possible litigation regarding the regulation. Others suggested that a vote to recommend disapproval and send the matter to the General Assembly might invalidate the committee’s review powers or the ability of state agencies to issue future regulations. Other discussion topics included expected agency and legislative responses to JCAR’s disapproval, the need for legislation to define the boundaries of legislative and executive branch powers, and the jurisdiction of the committee itself.

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MO HealthNet Revises Claim Form For Therapies For Severely Traumatized Children

Staff Contact: Brian Kinkade

The MO HealthNet Division updated the invoice that qualified providers use to deliver evidence-based therapies for children who have experienced severe trauma to claim enhanced reimbursement for their services. Qualified providers should begin using the revised form immediately.

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Regulatory News
the latest actions of agencies monitoring health care


MHD Tightens Claims Requirements For Prescribing Providers

Staff Contact: Brian Kinkade

MO HealthNet Division claims for drug reimbursement with dates of service on and after Sunday, Oct. 14, will be paid only if the prescribing provider is an enrolled MHD provider and if the prescribing provider’s National Provider Identifier is included in the claim. Drug Enforcement Administration numbers no longer will be accepted after this date. Prescribers who need to enroll as an MHD provider to comply with this requirement may apply with the Missouri Audit and Compliance Unit. All outpatient or medical claims billed using the National Drug Codes with the appropriate HCPCS or CPT procedure code for the medication administered also must include an actively enrolled MHD prescriber. This includes, but is not limited to, C-codes, G-codes, J-codes, Q-codes, S-codes and non-VFC vaccination CPT codes. For medications billed on outpatient claims, the attending provider is treated as the prescriber, and for medical claims, the rendering provider is used.

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Quality and Population Health


MHA Conducts Weekly Flu Monitoring Beginning This Thursday

Staff Contact: Jackie Gatz or Carissa Van Hunnik

In response to the high number of hospitalizations due to seasonal influenza during the 2017-2018 season requiring increased staffing, additional supplies and reconfigured space, MHA revised its monitoring strategy for this year. Today, a memo and guidance were distributed to Missouri hospital emergency preparedness and infection control directors outlining this process. The revised strategy proactively establishes a set of standardized questions, providing staff with advance notice of the information to be collected. MHA will utilize EMResource to conduct weekly queries of Missouri hospitals, with the first query scheduled for this Thursday, Sept. 27, in hopes of establishing a baseline dataset before increased influenza activity. The data collected is critical in identifying early warning signs of increased flu activity that may have a direct impact on hospital resources, bed availability and staffing levels. MHA staff will provide a summary of baseline data this Friday in MHA Today and as warranted through the forthcoming flu season.

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Improvement Sprints “UP” The Ante In Missouri Hospitals

Staff Contact: Amanda Keilholz

MHA invites members to join the first improvement sprints on the UP Intervention. Improvement sprints are a simple way to apply concentrated efforts to generate improvement over a short time period. Throughout the sprints, each UP component will be broken down to support hospitals in policy development, compliance review, and technical and educational resources. The UP Intervention is a low-cost, low-effort, high-value intervention that, if used consistently, may result in positive impacts to your organization’s Value-Based Purchasing program. Building the three foundational UP questions into the culture of daily practice will simplify safe care, streamline interventions and reduce multiple forms of harm. The UP intervention is an easy-to-accomplish activity for all staff to use with every patient to create highly reliable care.

UP consists of four components.

  • Wake UP promotes prevention of over-sedation.
  • Get UP promotes mobilization of patients.
  • Soap UP promotes hardwiring hand hygiene.
  • Script UP promotes the optimization of inpatient medications.
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Noteworthy


Fellowship Application Period Open

Staff Contact: Mat Reidhead

The Commonwealth Fund Fellowship in Minority Health Policy at Harvard University announced the call for applications for the 2019-2020 year. At Harvard Medical School, applications are being accepted for a one-year, degree-granting, full-time fellowship beginning July 2019. The application deadline is 5 p.m. Eastern Time Dec. 1, 2018. All application materials must be submitted in the online application system by the deadline. Information on how to apply and a link to the electronic application system can be found online. Potential applicants are invited to attend an upcoming informational webinar at 3 p.m. ET Wednesday, Oct. 3.

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Consider This ...

Today is National Voter Registration Day. In 2016, more than 750,000 voters used this day to register to vote across all 50 states.

Source: National Voter Registration Day 2018