MHA Today | October 19, 2018

MHA Today: News for Healthcare Leaders

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October 19, 2018

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

Insights


Herb Kuhn, MHA President & CEO When a child is missing and endangered, law enforcement often issues an “Amber Alert” to notify other agencies and the public to be on the lookout. If you’ve had your phone on when an Amber Alert was issued, you’ve likely heard the distinctive ring — often in concert with the phones of others near you. It is hard to miss.

Missouri’s Medicaid program recently released enrollment statistics for September. Throughout the past 12 months, 31,593 fewer children were enrolled in Medicaid, with significant dips in enrollment in July and September 2018 — 16,564 and 11,269, respectively. Other Medicaid eligibility categories had year-to-year changes, but none had the magnitude of the reduction among kids. Nearly two-thirds of the total Medicaid enrollees in Missouri are kids. However, more than three-quarters of the reduction in enrollees were kids.

There was no alarm on your phone. There was no signal that thousands of kids had been dropped from coverage. I’d wager this is probably the first time you’re hearing about it.

The most likely culprit is the enrollment system itself. The state’s new management system for eligibility determination now is in place, and any information that the system can’t independently verify requires follow up and documentation by the enrollee or their parent. If the verification isn’t returned in time, the individual is dropped from the program.

Just because a child is dropped from the Medicaid roll doesn’t mean they aren’t actually qualified to be covered or that the child doesn’t need health care. However, it does shift more burden of coordinating enrollment activities to health care providers. Eventually, the child will need medical attention, and it will be the health care provider’s staff who will direct mom and dad through the application process, and juggle appointments and billing so the child can be seen and the provider paid.

There’s significant value in covering kids. Medicaid opens access to prevention and wellness. Low cost interventions now can mitigate high cost and high intensity interventions later. The MO HealthNet Division should be asking itself what is happening and define what they can do to reverse the trend.

Enrollees, or their parents, have a shared responsibility to demonstrate their eligibility where the state has questions. Alternatively, a well-designed system would be user-friendly for enrollees. Considering the costs of churning Medicaid participants on and off coverage, is the precision we strive for in the administration of public assistance programs penny-wise and pound-foolish public policy?

In just two months — July and September — more than 34,000 Missourians were cut from the program. Between June and September, 3.29 percent of enrollees were dropped. The majority were kids.

These numbers are the signal.

Let me know what you're thinking.


Herb Kuhn, MHA President & CEO



Herb B. Kuhn
MHA President and CEO

In This Issue
MHD Implements Updated 2019 ICD-10 Updated Codes
First Improvement Sprint Deadline Nears
MHA Preparedness Publication Assesses Threats And Identifies Critical Areas Of Focus
This Week Is International Infection Prevention Week

Regulatory News
the latest actions of agencies monitoring health care


MHD Implements Updated 2019 ICD-10 Updated Codes

Staff Contact: Brian Kinkade

The MO HealthNet Division implemented the 2019 update to ICD-10 procedure and diagnosis codes. The updated codes must be used for claims for services delivered on and after Oct. 1.

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Quality and Population Health


First Improvement Sprint Deadline Nears

Staff Contact: Amanda Keilholz

MHA invites members to join the first improvement sprint on the UP Intervention. Improvement sprints are a simple way to apply concentrated efforts to generate improvement over a short time period. The first sprint is Script UP, and the enrollment deadline is Wednesday, Oct. 24. Don't miss this opportunity to hear from a national subject matter expert on the Script UP Intervention and how it's applied.

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.

The UP Intervention includes the following 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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MHA Preparedness Publication Assesses Threats And Identifies Critical Areas Of Focus

Staff Contact: Jackie Gatz

Yesterday, attendees of our Annual Emergency Preparedness and Safety Conference received the following publication. The report outlines the threats and risks affecting Missouri hospital, and draws attention to the three crucial areas of patient surge, infrastructure resiliency and resource management. Although today concludes our recognition of Healthcare Security and Safety Week, our work will continue.

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This Week Is International Infection Prevention Week

Staff Contact: Toi Wilde

International Infection Prevention Week takes place the third week of October each year and raises awareness of the role infection prevention plays to improve patient safety. Patient safety is a clear priority for infection preventionists and health care professionals.

The theme of IIPW 2018 is Protecting Patients Everywhere. According to the Centers for Disease Control and Prevention, approximately one in 25 people are diagnosed with healthcare-associated infections each year in the U.S. Not only does this cost the health care system billions in excess costs, but it also results in the deaths of 75,000 patients each year.

Preventing infection is our number one goal. Whether it be in an outpatient clinic, emergency room or long-term care facility, we all play a role in influencing the patient’s health. Celebrate the infections prevented and lives saved this year.

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Did You Miss An Issue Of MHA Today?


October 15, 2018
CMS Announces 2019 Medicare Premiums And Deductibles
MHD To Begin Denying More Claims For Services Ordered By Unenrolled Providers
MHA Policy Repository Available To Support Workplace Violence Prevention
Today Is Global Handwashing Day
Southeast Health Center Of Ripley County Closes
National Cybersecurity Awareness Month

October 16, 2018
CMS Proposes Drug Price Disclosure In Television Ads
CMS Begins Sending New Medicare Identification Numbers To Beneficiaries In Missouri
HIDI Releases Annual Licensing Survey Raw Data File And User-Defined Report Generator
Treatment Of Crime Victim Resources Available For Health Care Providers

October 17, 2018
Active Shooter Resources Available For Hospitals To Promote Safe Care Environments
IHO To Host Free Webinar On Optimizing Patient Flow Before Flu Season

October 18, 2018
MLN Connects Provider eNews Available
Missouri Health Care Providers Gather For Annual Preparedness And Safety Conference



Consider This ...

Nearly 800,000 Missourians live in poverty, and nearly 2 million Missourians live near the poverty line. Poverty in Missouri has declined since 2016, but about 56 percent of people who earn less than $20,000 a year spend more than half their earnings on housing.

Source: St. Louis Public Radio