January 28, 2019
MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.
In This Issue
Emergency Physicians Make Out-of-Network Billing Recommendations
HIDI HealthStats – Predicting Opioid Risk in Hospital Patients
HIDI Releases Fourth Quarter FFY 2018 Inpatient, Outpatient, Databases
CMS Seeks Comments On Follow-Up After Psychiatric Hospitalization Measure
CDC Reschedules Influenza COCA Call
state and federal health policy developments
Staff Contact: Daniel Landon or Andrew Wheeler
The American College of Emergency Physicians issued recommended policies for addressing billing and payment for emergency care delivered by out-of-network providers. The recommendations address limits on patient payments as well as insurer obligations, including prompt payment standards. Billing and payment disputes would be resolved through arbitration.
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HIDI Tech Connect
Staff Contact: Mat Reidhead
Recent data from state and national sources suggest Missouri continues to be disproportionately impacted by the opioid epidemic, which may be an artifact of its distinction as the only state without a state-legislated prescription drug monitoring program. This places Missouri’s clinicians and prescribers in a position of “catch-up” with regard to reversing the nearly two-decade trend of overdose deaths and other adverse outcomes related to OUD in the state. Large geographic areas remain in Missouri, where health care providers are limited to their own experiences and observational data to identify patients with, or at risk of, developing OUD.
The January 2019 issue of HIDI HealthStats highlights results from a predictive model that suggests a strong ability to prospectively identify patients who will experience an opioid-related hospital encounter. Availability of the model results provided in near real-time to the point of care would greatly enhance clinician and prescribers’ ability to identify high-risk patients and moderate the impact of the opioid crisis in Missouri.
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Staff Contact: Shane VanOverschelde
The fourth quarter federal fiscal year 2018 inpatient and outpatient databases, including HIDI-reporting Hospitals in Missouri, Illinois and Kansas City, Kan., now are available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage®. The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in “Strategic Planning/Premier Data” and are organized in the following categories.
Hospitals interested in subscribing to the 2019 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.
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Quality and Population Health
Staff Contact: Sherry Buschjost
The Centers for Medicare & Medicaid Services is seeking comments on the new Follow-Up After Psychiatric Hospital quality measure, which is being developed under the Inpatient Psychiatric Facility Outcome and Process Measure Development and Maintenance Project. The measure assesses the percentage of inpatient discharges with select principal mental illness or substance use disorder diagnoses for which the patient received appropriate follow-up care for mental illness or SUD within seven days and 30 days of discharge. Additional information about the project is available. The public comment period ends Wednesday, Feb. 13.
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Staff Contact: Jackie Gatz or Carissa Van Hunnik
The Centers for Disease Control and Prevention Clinician Outreach and Communication Activity rescheduled the 2018-2019 influenza season COCA call. The call, which was supposed to take place tomorrow, now will be held on Tuesday, Feb. 5. The call will address clinical issues and pertinent updates.
MHA continues to conduct weekly baseline flu queries in EMResource® to monitor influenza impacts and inform coordination at the regional and state levels.
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Since October, 11 people across eight states, including Missouri, have been infected with a particular strain of salmonella, and all but one of those infected said they had contact with a hedgehog. The CDC warns not to kiss or snuggle pet hedgehogs because they can spread salmonella germs to your face and mouth.
Source: The New York Times