MHA Today | December 21, 2018

December 21, 2018
MHA Today: News for Healthcare Leaders

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December 21, 2018

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

Editor's Note: MHA Today will not be published Monday, Dec. 24, through Tuesday, Jan. 1. Publication will resume Wednesday, Jan. 2. Happy Holidays!


Herb Kuhn, MHA President & CEO This will be the last column before we sail into 2019. As I was thinking about a holiday message, I heard a reference on television to “ballast.” They weren’t talking about hospitals, health care or even the holidays, but it got me thinking about what hospitals and health care workers do to provide stability and balance throughout the holidays.

Hospitals can’t just shut down for the holidays. That means that many hospital workers — physicians, administrators, nurses, medical technicians, and all of the staff who provide support to patients and caregivers — will be working to care for patients. Hospitals keep moving forward through the holidays, managing the wind and the waves that can buffet patients’ lives, without regard to days on a calendar.

Often, we talk about hospitals as powering communities. That’s thinking of hospitals as sails. However, any sailor knows that what’s under the sails — the ballast-filled keel — is what rights the ship. That’s what our communities count on — stability and certainty when the hard wind blows and the seas get rough.

They won’t all work this holiday, but many of the 150,000 hospital staff members — members of our team, family members, friends and neighbors — will provide that sense of stability and balance to patients and their communities throughout the coming weeks. For Missourians who don’t interact with hospitals this season, they’ll see hospitals from above the waterline — moving ahead deliberately like trusted institutions do. Unless they need us, they won’t see the force that’s keeping local health care headed in the right direction, the ballast that allows hospitals to travel into the strong winds. That’s the hospital workforce.

Most patients and hospital staff members would rather be celebrating the holidays elsewhere — with family in Missouri where the winter has begun to set in, or on a warm beach watching the sailboats glide majestically through the water. However, illness, accident or the choice of a profession that reflects the very spirit of the holidays, means some cannot.

I’d encourage you to reach out to coworkers who will be working shifts throughout the holidays to recognize their sacrifice. Remind them in an email or post on social media that their commitment is clear and appreciated.

In health care, calm waters aren’t common. Neither are the people who provide it.

Happy holidays. Let me know what you’re thinking.

P.S. — One final shout out to an outstanding Missouri hospital leader. Jeff Tindle, CEO of Carroll County Memorial Hospital in Carrollton, was recognized as a finalist for the American Hospital Association’s Rural Hospital Leadership Award for his efforts to improve health care delivery in his community. Congratulations!

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Requests Feedback On AO Conflicts Of Interest
DHSS Releases Maternal And Neonatal Level Emergency Rule
CMS Finalizes New ACO Rule “Pathways to Success”
HHS Requests Information On HIPAA Rules
CMS Releases Addendum To 2019 OQR Specifications Manual

state and federal health policy developments

CMS Requests Feedback On AO Conflicts Of Interest

Staff Contact: Sarah Willson

In a recent news release, the Centers for Medicare & Medicaid Services noted they are seeking comment regarding the appropriateness of some Medicare-approved Accrediting Organizations offering fee-based consultative services to Medicare-participating providers and suppliers that they also accredit as part of their business model. CMS is considering whether actual or perceived conflicts of interest exist when a provider utilizes an AO for consulting and as an accreditor for the Medicare program. CMS states the initiative is part of their commitment to strengthening oversight of AOs. MHA encourages hospitals to provide comments, questions or thoughts in response to the Request for Information published in the Federal Register. The comment period closes at 5 p.m. Tuesday, Feb. 19, 2019.

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Regulatory News
the latest actions of agencies monitoring health care

DHSS Releases Maternal And Neonatal Level Emergency Rule

Staff Contact: Sarah Willson

Yesterday, the Department of Health and Senior Services released an emergency rule and subsequent proposed rule (19 CSR 20-60.010) on hospital designation of maternal and neonatal levels of care. All Missouri hospitals with obstetric beds, neonatal intensive care units and birthing centers are required to report levels of maternal care and neonatal care designations, per Senate Bill 50 adopted in 2017 (Section 192.380 RSMo), to the department. Hospitals must submit their LOCATe assessment on or before Thursday, Jan. 31, 2019, to Missouri Department of Health and Senior Services, Office of Epidemiology, P.O. Box 570, Jefferson City, MO 65102-0570. Any inquiries regarding the assessment tool may be sent to

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CMS Finalizes New ACO Rule “Pathways to Success”

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services finalized a rule that overhauls the Medicare Accountable Care Organization model. Pathways to Success is “designed to advance five goals: accountability, competition, engagement, integrity and quality.” One of the major implications of the rule is that ACOs are forced to transition from a single-sided to a two-sided risk model. Under the BASIC track, eligible ACOs will begin under a one-sided risk model and incrementally phase-in higher levels of risk. The ENHANCED track will be comprised of current Track 3 ACOs and will take on the highest level of risk. Both BASIC and ENHANCED tracks will be considered an Advanced Alternative Payment Model.

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HHS Requests Information On HIPAA Rules

Staff Contact: Sarah Willson or Jane Drummond

The Department of Health and Human Service’s Office for Civil Rights posted a Request for Information on modifying HIPAA rules aimed at improving coordination of care. HHS seeks feedback on changes to the HIPAA rules, which would promote value-based care by increasing flexibility of how protected health information is shared. Comments are due by Tuesday, Feb. 12, 2019. For additional information, contact Marie Meszaros, HHS, at 800/368–1019 or 800/537–7697 (TDD).

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Quality and Population Health

CMS Releases Addendum To 2019 OQR Specifications Manual

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released an addendum to the Hospital Outpatient Quality Reporting Program specifications manual for encounters dated Jan. 1 through Dec. 31, 2019. Version 12.0a includes the following major changes.

  • removed web-based measure OP-27 beginning with the CY 2020 payment determination
  • removed web-based measures OP-12, OP-17 and OP-30 beginning with CY 2021 payment determination
  • removed claims-based measures OP-9, OP-11 and OP-14 beginning with the CY 2021 payment determination
  • added language to OP-5: Aspirin at Arrival — Data for OP-5
    • will no longer be collected after first quarter 2019 (encounter dates Jan. 1 through March 31, 2019) for the OQR program
    • the last data submission deadline for OP-5 will be Aug. 1, 2019
  • update program background section to include Paperwork Reduction Act disclosure
  • update hospital outpatient quality measure data transmission section to include measures submitted via a web-based tool submission instructions
  • update Appendix A: ICD-10-CM Diagnosis and CPT® Code Tables

Full details of the changes are available in the release notes on QualityNet.

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Did You Miss An Issue Of MHA Today?

December 17, 2018
Federal Judge Rules ACA Unconstitutional
Trajectories — Trauma Informed Care: Improving Health and Resiliency

December 18, 2018
MHA Releases 2019 Legislative Guide
CMS And TJC Release IQR Specifications Manual Version 5.6

December 19, 2018
CMS Releases Marketplace Week 7 Enrollment
Trump Signs Maternity Care Bill
CMS Releases Addendum To 2018 OQR Specifications Manual
I-70 Community Hospital Names Interim CEO

December 20, 2018
MLN Connects Provider eNews Available
HHS Releases Naloxone Prescribing Guidance
CMS Releases Abstraction Resources
TJC Announces eCQM Expert to Expert Webinar
Funding Opportunity Available For Nurse Practitioners

Consider This ...

Half of the paper America consumes is used to wrap and decorate consumer products. And, if every family reused just two feet of holiday ribbon, the 38,000 miles of ribbon saved could tie a bow around the entire planet.

Source: Vanderbilt University