MHA Today | March 29, 2019

MHA Today: News for Healthcare Leaders

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March 29, 2019

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 Earlier this week, the Missouri House adopted a budget for the 2020 state fiscal year, totaling approximately $30 billion. I mention this for context. On Wednesday, MHA released new data on the state and national costs of the opioid crisis. The toll of the opioid crisis in Missouri — societal costs for those with opioid use disorder and the estimated value of lost life — was $14 billion. Missouri won’t spend $14 billion, but we’ll lose that much in societal value — this is the equivalent of 4.6 percent of our gross state product and nearly half of the state’s 2020 budget.

The research identifies the nationwide economic cost of the opioid crisis at $685 billion in 2017, or 3.5 percent of GDP. Fatality costs, which are associated with premature mortality, account for 93 percent of the toll. Missouri’s burden as a percent of GDP stands 20th highest among the states.

Policy Brief: Economic Cost of the Opioid Crisis Hospitals, the state, local public health and community stakeholders are aligning efforts to mitigate the costs in lives and lost value. Since 2017, several new programs have come online, including provider- and state government-driven interventions that reduce the risk of opioid misuse and overdose deaths.

On Monday, April 1, the state’s Medicaid program will implement an array of new complementary and alternative therapies for Medicaid patients who suffer chronic pain. The expanded services include cognitive behavioral therapy, chiropractic treatments, physical therapy and acupuncture. Making these services available under the state’s Medicaid program will give primary care providers new tools to treat patients’ chronic pain in ways that will reduce opioid misuse, improve pain management skills, reduce avoidable costs and improve health outcomes. We applaud the Parson administration for its forward-thinking approach. These measures will help address the state’s OUD crisis by giving primary care doctors new options to treat patients’ pain.

The federal government has provided significant resources to the effort. Sen. Roy Blunt has been a champion of increased funding for programs that increase access to behavioral health services that serve as an essential bridge to a continuum of care from symptoms through recovery.

Despite these efforts, more must be done. In 2017, President Trump declared the opioid crisis a public health emergency. However, the administration’s requested funding for drug prevention in 2018 was $200 million less than in 2017, and the requested funding for drug treatment was just 2 percent above the previous year.

Policy Brief: Economic Cost of the Opioid Crisis The data always will lag our collective efforts. However, what this data finds is the problem was growing between 2015 and 2017, and that the resources put in place at that time were not bending the upward curve. Although reductions in prescribed opioids are noted, in just two years — and driven almost exclusively by fentanyl — the national death toll grew by 46 percent, or 15,000 additional lives claimed by the crisis.

We have engaged stakeholders from our federal and state partners to providers and community leaders. Each life saved reduces the fatality cost of the epidemic, and each life transformed through recovery reduces the societal, nonfatality cost.

Programs designed to both reduce the risk of dependence and increase the chance of recovery, including medication-assisted treatments, are expanding in Missouri. And, better tools — including Rep. Holly Rehder’s prescription drug monitoring bill that was heard in the Senate this week — have the potential to reduce the state’s toll.

Solving the state’s opioid crisis will have a cost — in effort and expenditure. But, lost lives will harm Missouri significantly if the fatality costs continue. Supporting recovery-oriented systems of care will help reduce the burden to the state, businesses and communities, allowing those in recovery to reestablish themselves in their communities, live healthier lives and contribute to the economy.

OUD isn’t a lack of moral fiber, it is a chronic health condition. Our investments in treating Missourian’s with OUD will bring long-term gains while reducing long-term costs. We have a long way to go.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Legislative Proposals Win Committee Approval
MHA Comments On Proposed DHSS Lab Test Fee Hike
HRSA Announces Rural Maternity And Obstetrics Management Strategies Program
CDC Issues Health Alert On Influenza Activity
CMS Announces VBP Program Education Session

state and federal health policy developments

Legislative Proposals Win Committee Approval

Staff Contact: Daniel Landon or Bill Anderson

State legislative committees approved the following health-related bills this week.

  • House Bill 941, which concerns the obligation of air ambulances to be part of insurer networks
  • House Bill 907, which would authorize state licensure of “paramedic practitioners,” who would provide services through a collaborative practice arrangement with a physician
  • House Bill 83, which would expand the capacity to sell short-term insurance plans with restricted benefit packages
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Regulatory News
the latest actions of agencies monitoring health care

MHA Comments On Proposed DHSS Lab Test Fee Hike

Staff Contact: Daniel Landon

MHA submitted comments regarding a proposed state regulation to raise the State Public Health Laboratory’s fees for testing newborn blood samples for various genetic and metabolic disorders. State law mandates various tests and requires that they be done by the state lab. MHA comments that “fees to implement new testing requirements should be increased when those requirements happen, not based on speculation that they may someday occur.”

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HRSA Announces Rural Maternity And Obstetrics Management Strategies Program

Staff Contact: Sarah Willson

The Health Resources and Services Administration published a new Notice of Funding Opportunity, the Rural Maternity and Obstetrics Management Strategies Program. The purpose of the RMOMS program is to improve access to and continuity of maternal and obstetrics care in rural communities. The goals of the RMOMS program include the following.

  • develop a sustainable network approach to coordinate maternal and obstetrics care within a rural region
  • increase the delivery and access of preconception, pregnancy, labor and delivery, and postpartum services
  • develop sustainable financing models for the provision of maternal and obstetrics care
  • improve maternal and neonatal outcomes

The closing date to submit an application is Friday, May 24. For questions about this funding opportunity, contact Find more details, and download the application instructions at

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Quality and Population Health

CDC Issues Health Alert On Influenza Activity

Staff Contact: Jackie Gatz or Carissa Van Hunnik

Yesterday, the Centers for Disease Control and Prevention issued a health advisory to notify clinicians that influenza activity in the U.S. remains elevated and widespread. The report also indicates that the season is expected to last several more weeks.

MHA continues to conduct weekly EMResource queries to monitor flu impacts to inpatient facilities throughout the state. Facilities have reported slight increases in staff shortages and surge planning efforts, and although a slight decrease in admitted flu inpatients was reported, data continue to reflect the elevated activity levels indicated in CDC reports.

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CMS Announces VBP Program Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Hospital Value-Based Purchasing Program has been scheduled at 1 p.m. Thursday, April 4. The presentation will provide an overview of the fiscal year 2021 Hospital VBP Program and the baseline measures report, including evaluation criteria for hospitals within each domain and measure, eligibility requirements, and an explanation of the scoring methodology. Registration is required.

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Did You Miss An Issue Of MHA Today?

March 25, 2019
Thousands Of Missouri Nurse Licenses Expire Friday, April 26
CMS Regulatory Burdens Cost IPFs $1.7 Billion Annually
Mosaic Life Care Finalizes Acquisition Of SSM Health St. Francis Hospital

March 26, 2019
House Advances Substance Abuse Policy Legislation
Legislative Committees Approve Practitioner Licensure Bills
MHA Comments On VA Community Access Rule
The National Academies Press Releases New Book

March 27, 2019
MHA Releases New Research On The Economic Cost Of The Opioid Crisis
House Passes State Fiscal Year 2020 Budget
Senate Committee Reviews Prescription Drug Monitoring Program Legislation
MHD To Accept Assistant Physician Claims
MHD Makes Alternative Therapies Available To Chronic Pain Patients
HIDI Offers Webinars On New Market Forecaster

March 28, 2019
Legislative Committee Advances Certificate Of Need Changes
Medicaid “Global Waiver” Bill Advances In Senate
DHSS Releases New Controlled Substances Schedules
MLN Connects Provider eNews Available
HIDI Releases Fourth Quarter CY 2018 Update To Discharge Data-Based Quality Indicators
MHA Presents At NACCHO Preparedness Summit

Consider This ...

Tomorrow is National Doctors Day. The first observance was in 1933 in Winder, Ga. To honor physicians, greeting cards were mailed and flowers placed on the graves of deceased doctors.

Source: National Day Calendar