MHA Today | December 10, 2018

December 10, 2018

MHA Today: News for Healthcare Leaders

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December 10, 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
TJC Issues Additional Suicide Measures
Trajectories — Trauma Informed Care: Improving Health and Resiliency
CMS Releases IPF Specific Reports For Claims-Based Measures
CMS Publishes Addendum To QRDA Category I Implementation Guide

What You Need To Know This Week

  • Saturday is the final day to enroll for 2019 coverage in the Healthcare Marketplace.
  • In anticipation of the start of the 2019 session of the Missouri General Assembly, look for MHA’s annual legislative guide to be distributed early next week.

Regulatory News
the latest actions of agencies monitoring health care


TJC Issues Additional Suicide Measures

Staff Contact: Sarah Willson

The Joint Commission recently issued an R3 Report on the updated National Patient Safety Goal relative to suicide. The seven new and revised elements of performance will impact all hospital and psychiatric facilities who are accredited by TJC. The EPs are at NPSG 15.01.01 and center on using evidence-based practice screenings, assessment tools and environmental assessments for safety at both psychiatric and general acute facilities.

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Quality and Population Health


Trajectories — Trauma Informed Care: Improving Health and Resiliency

Staff Contact: Leslie Porth

Across the health care continuum, policymakers, payers and providers are beginning to truly understand the importance of assessing and treating the whole person. The December 2018 issue of Trajectories explores how factors outside of the health care delivery system influence health outcomes. Integrating trauma awareness and documenting social determinants of health will transform systems of care, ultimately improving the health of patients and communities.
Maslow's Hierarchy of Needs
And, it all comes back to the sage wisdom of Abraham Maslow, who in 1943, posited that human beings are motivated by a hierarchy of needs. At its foundation, physiological needs such as food, water and shelter drive human motivation. As basic needs for existence are met, human beings then are motivated to fulfill other deficits: safety, belonging and esteem. Only when most of these needs have been fulfilled are humans motivated to grow as a person, hence the final stage of Maslow’s hierarchy: self-actualization. Since Maslow, research has more clearly connected long-term health outcomes to social, economic and environmental factors. Research into one of those factors — childhood adversity — provides new understanding about barriers and opportunities for achieving good health.

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CMS Releases IPF Specific Reports For Claims-Based Measures

Staff Contact: Sherry Buschjost

Inpatient psychiatric facilities specific reports for claims-based measures are available for download through the QualityNet Secure Portal. The reports allow IPFs to review information that will be publicly reported in February 2019 for the follow-up after hospitalization for mental illness and 30-day all-cause unplanned readmission following psychiatric hospitalization in an IPF measures, which are calculated by the Centers for Medicare & Medicaid Services using administrative claims data. Facilities are encouraged to review their ISRs and supporting documents for discrepancies or concerns regarding the data available for public reporting. Any requests for corrections of the data, measure results, measure scores, or notation of measure results must be submitted by Thursday, Jan. 3. IPFs are not allowed to submit corrections or add new claims to the data used to calculate the rates during this time.

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CMS Publishes Addendum To QRDA Category I Implementation Guide

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services published an addendum to the 2018 CMS Quality Reporting Document Architecture Category I Implementation Guide, originally published in July 2017. The addendum includes six new conformance statements specific to CMS programs and updates the description of one other conformance number. The IG provides technical instructions for QRDA Category I reporting for eligible and critical access hospitals reporting electronic clinical quality measures for the calendar year 2018 reporting period for the following programs.

  • Hospital Inpatient Quality Reporting Program
  • Medicare and Medicaid Promoting Interoperability Programs for eligible hospitals and CAHs

The conformance numbers, validations performed, and descriptions of the error messages and file rejections are intended to be included in Table 13: Other Validation Rules for HQR Programs in section 5.3 of the updated IG. Details are available.

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Consider This ...

The mortality rate from Alzheimer's disease in the U.S. has increased significantly since 2000, from 18.1 Alzheimer's deaths per 100,000 to 31 per 100,000 in 2017.

Source: Centers for Disease Control and Prevention