MHA Today | December 7, 2018

December 7, 2018
MHA Today: News for Healthcare Leaders

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December 7, 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 Tuesday, I attended Gov. Mike Parson’s Rural Summit in Bolivar. The issues addressed were certainly of great magnitude for rural Missourians. The best coverage of the summit appeared in Bolivar’s hometown weekly paper, the Herald Free-Press.

I took a lot of notes during the meeting. Although the event was a summit — not a policy rollout — there were some notable statements from speakers who are state agency heads responsible for steering a new direction for Parson. Reflecting the governor’s approach, they spoke of expanded opportunities to improve rural health policy and delivery.

Parson praised Citizens Memorial Hospital as a strong hospital that is a statewide and national model. Stating that health care follows only the economy as a driver of rural prosperity, he acknowledged that his hometown of Bolivar and the surrounding communities tend to take the hospital system for granted. Later in the lineup, Randall Williams, M.D., Director of the Department of Health and Senior Services, reinforced that point, calling hospitals “a true economic engine.”

Parson opened his remarks by commenting on Medicaid expansion. “We have to fix the current system before we can expand the system,” he said. “In order to fix the system, we have to ask, ‘How can we do better?’” Parson added that, “To fill current and future demands, every tool needs to be on the table. Missouri Medicaid cost increases of $300-400 million per year cannot be sustained.”

Parson’s new MO HealthNet Director, Todd Richardson, reiterated these concerns and opportunities. His focus will be on reforming and improving the Medicaid system, which is massive and complex.

Parson and his team are saying the right things. Director Richardson’s focus on value could create new opportunities, and hospital leaders should continue to reach out to help share their challenges and point out opportunities within the MO HealthNet system. MHA and its members should be fully engaged in the discussion.

Emphasizing the importance of engagement, Richardson made it clear that the state can’t do it alone. He noted that reform plans will not be written solely by the state agency leaders in the room or by the governor. They will be written, he said, by the experts and stakeholders in the room, in collaboration with the Governor’s Office, agency officials and legislators. Building on the saying, “If it is to be, it is up to me,” Richardson commented that with health care, “If it is to be, it is up to us.”

Parson was in all corners of the state this week talking about health care. He underscored the need for additional action to address the state’s opioid epidemic, including supporting the adoption of a statewide Prescription Drug Monitoring Program.

He talked workforce as well. Building the economy and strengthening the workforce are at the top of Parson’s agenda. A Parson economic development official told the audience, “Health care is an integral part of the local and regional economy. No single industry sector can win over an economy. However, health care is key.”

The governor’s workforce agenda is synchronized with ours. We look forward to the opportunity to build stronger connections. The future of rural health, and health care throughout the state, depends on sustained workforce investment. Parson is the right governor at the right time to reshape and reinvest in these essential and well-paying jobs. I noted that several state cabinet officials speaking to the summit cited MHA reports and graphics regarding rural workforce challenges.

As I said, this wasn’t a policy rollout. However, it is a strong signal that the Parson administration understands the importance of rural health and the need to engage stakeholders to address its challenges.

In this endeavor, we should be the partner of choice for Parson and his administration.

Let me know what you think.
Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
2017 National Health Expenditure Data Available
MedPAC Posts Slides About Payment Adequacy
CMS Finalizes Rule On Risk Adjustment Program
CMS Announces Deadline For Submission Of 3Q2018 HCAHPS Survey Data
Tomorrow Wraps Up National Hand Hygiene Awareness Week

state and federal health policy developments

2017 National Health Expenditure Data Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services Office of the Actuary released 2017 national health expenditures data. National health spending grew at a rate of 3.9 percent in 2017. The growth was nearly 1.0 percentage point slower than the growth in 2016. Hospital spending growth was 4.6 percent in 2017, as compared to 5.6 percent in 2016. The slower growth was due to slower use and intensity of services and outpatient services, while growth in inpatient days increased at about the same rate in 2016 as in 2017. According to the report, consumer out-of-pocket spending grew by 2.6 percent in 2017, which was significantly lower than a 4.4 percent growth in 2016.

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MedPAC Posts Slides About Payment Adequacy

Staff Contact: Andrew Wheeler

The Medicare Payment Advisory Commission released a slide deck from the meeting, “Assessing Payment Adequacy and Updating Payments: Hospital Inpatient and Outpatient Services,” which was held on Dec. 6. Within the document, the following observations were made.

  • Medicare fee-for-service hospital spending increased 4.3 percent to $190.1 billion in 2017.
  • Access to hospital care remains good.
  • Access to capital remains strong.
  • Quality of care improved, based on patient experience, readmission rates and mortality rates.
  • Overall hospital Medicare margins decreased to -9.9 percent in 2017.
  • Efficient providers Medicare margins equated to -2.0 percent in 2017.
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Regulatory News
the latest actions of agencies monitoring health care

CMS Finalizes Rule On Risk Adjustment Program

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the final rule that “reissues, with additional explanation, the Department of Health and Human Services-operated risk adjustment methodology previously established for the 2018 benefit year.” With the risk adjustment in place, premiums can reflect the differences in scope of coverage and other plan factors. CMS Administrator Seema Verma stated, “Today’s final rule continues our commitment to provide certainty regarding this important program, to give insurers the confidence they need to continue participating in the markets, and, ultimately, to guarantee that consumers have access to better coverage options.”

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Quality and Population Health

CMS Announces Deadline For Submission Of 3Q2018 HCAHPS Survey Data

Staff Contact: Sherry Buschjost

The submission deadline for the Hospital Consumer Assessment of Healthcare Providers and Systems patient perspectives on care survey data for third quarter 2018 discharges — from July 1 to Sept. 30 is Thursday, Jan. 3, 2019. The Centers for Medicare & Medicaid Services encourages all hospitals to submit data well 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 Jan. 4-10, 2019. During 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 Jan. 3 deadline may be corrected and resubmitted.

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Tomorrow Wraps Up National Hand Hygiene Awareness Week

Staff Contact: Toi Wilde

Personal hygiene begins and ends with our hands, so to wrap up National Hand Hygiene Awareness Week, below are five super clean facts about hand hygiene.

  1. Handwashing equals happiness: According to the Centers for Disease Control and Prevention, handwashing can prevent one in three diarrhea-related illnesses and one in five infections, including the flu.
  2. Beware the twin killers for kids: About 1.4 million children under age five die from diarrheal diseases and pneumonia — the two most deadly afflictions for children worldwide.
  3. The dirty secret of public restrooms: The CDC reports that only 31 percent of men and 65 percent of women washed their hands after using a public restroom.
  4. Handwash your way to health: Using antibiotics creates antibiotic resistance. Handwashing prevents many sicknesses, so people need less antibiotics. Therefore, less antibiotic resistance.
  5. Sneezes are mini hurricanes: A typical human sneeze exits the body at about 200 miles per hour and emits around 40,000 droplets into the air.
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Did You Miss An Issue Of MHA Today?

December 3, 2018
OIG Releases Semiannual Report To Congress
Myers And Stauffer LC Requires Completion Of DSH Surveys
MHA Releases Notes From MHD/Hospital Systems Meeting
CMS Releases FY 2019 Value-Based Purchasing Program Results
Missouri Provider Associations Release Updated Voluntary Opioid Prescribing Guidelines

December 4, 2018
DIFP Releases Report On The Missouri Health Insurance Market
CMS Publishes CY MPFS Final Rule Summary
MHA Launches Annual Safety And Preparedness Assessment
MHA Extends Lean Six Sigma Application Deadline
Preview Data For February 2019 Hospital Compare Available

December 5, 2018
Federal Agencies Issue Report On Health Care Competition And Choice
CMS Releases February 2019 Hospital Compare Star Rating HSRs
MHA Offers Webinar On Community Paramedics And Their Role In Value-Based Care
CMS Announces Outreach And Education Webinars

December 6, 2018
CMS Releases Marketplace Week 5 Enrollment Data
MLN Connects Provider eNews Available
October MUR Available On HIDI Analytic Advantage®
HIDI And Market Innovations Host Webinar On Healthcare Provider Predictive Scorecard
PCSS Offers Online Buprenorphine Waiver Training
CMS Announces IPFQR Webinar

Consider This ...

Progress in reducing secondhand smoke exposure among U.S. nonsmokers has stalled since 2011. 58 million Americans still are exposed to secondhand smoke, including two in five children.

Source: Centers for Disease Control and Prevention