MHA Today | April 22, 2019

April 22, 2019

MHA Today: News for Healthcare Leaders

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April 22, 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
New Report Says Medicare Trust Fund To Deplete In Seven Years
CMS Releases Proposed Medicare Hospice Payment Rate Update For FY 2020
CMS Releases Proposed Medicare SNF Payment And Policy Update For FY 2020
HHS Announces Medicare Primary Care Initiative
MHD Offers Behavioral Health Workshop
HIDI HealthStats — Assessing Community Health Needs With exploreMOhealth

What You Need To Know This Week

  • On Friday, the MHA board will meet at the offices in Jefferson City.
  • Last week, and again this week, MHA published issue briefs on several proposed CMS rules. They can be found on MHA's website.
    • CMS Issues Proposed Inpatient Rehabilitation Facility FY 2020 PPS Update (4/18/19)
    • CMS Releases Proposed Inpatient Psychiatric Facilities PPS Update for FY 2020 (4/19/19)
    • CMS Releases Proposed FY 2020 Hospice Wage Index, Payment Rate and Quality Reporting Requirements (4/22/19)
    • CMS Proposes Skilled Nursing Facility FY 2020 PPS Update (4/22/19)

Advocate
state and federal health policy developments


New Report Says Medicare Trust Fund To Deplete In Seven Years

Staff Contact: Andrew Wheeler

The Medicare Board of Trustees released the annual report on Medicare’s hospital insurance trust fund and the supplementary medical insurance trust fund. According to the report, the hospital insurance trust fund will be able to pay benefits until 2026. Medicare costs are projected to grow from 3.7 percent of gross domestic product in 2018 to 5.9 percent by 2038, increasing to 6.5 percent by 2093. The Trump administration states that the president’s budget would strengthen and extend the solvency of the program by increasing choice in Medicare Advantage, adding supplemental benefits to the MA program, offering more care options for people with diabetes, providing new telehealth services, lowering prescription drug costs and continuing to advance price transparency policies.

The Centers for Medicare & Medicaid Services Administrator Seema Verma stated, “At a time when some are calling for a complete government takeover of the American health care system, the Medicare Trustees have delivered a dose of reality in reminding us that the program’s main trust fund for hospital services can only pay full benefits for seven more years. The Trump administration is working hard to protect and strengthen Medicare and lower costs while improving quality in order to protect the program…”

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Regulatory News
the latest actions of agencies monitoring health care


CMS Releases Proposed Medicare Hospice Payment Rate Update For FY 2020

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released proposed updates to the fiscal year 2020 Medicare hospice payment rate. The update includes changes to the hospice quality reporting program, the aggregate cap and modifications to the existing hospice election statement requirements. A more notable proposed change is a shift to using the prior year prefloor, prereclassified hospital wage index to a concurrent inpatient prospective payment system wage prefloor, prereclassified wage index. CMS is proposing a 2.7 percent increase for FY 2020, amounting to $540 million. Comments are due Tuesday, June 18. MHA published an issue brief with additional details.

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CMS Releases Proposed Medicare SNF Payment And Policy Update For FY 2020

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released proposed payment and policy updates to the FY 2020 Medicare skilled nursing facility prospective payment system. The proposed rule includes a transition to a new case-mix model known as the Patient Driven Payment Model, and changes to the Value-Based Purchasing Program and the Quality Reporting Program. CMS is estimating payments under the SNF PPS will increase by $887 million, or 2.5 percent. Comments are due Tuesday, June 18. MHA published an issue brief with additional details.

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HHS Announces Medicare Primary Care Initiative

Staff Contact: Andrew Wheeler

The U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services announced a new set of payment models intended to transform primary care to deliver better value. The CMS Primary Cares Initiative builds upon lessons learned from previous models and will reduce administrative burdens on providers, allowing them to spend more time with patients. HHS Secretary Alex Azar stated, “For years, policymakers have talked about building an American health care system that focuses on primary care, pays for value and places the patient at the center. These new models represent the biggest step ever taken toward that vision.” The new model consists of five model options under two paths.

Primary Care First and Direct Contracting:

  • Primary Care First
  • Primary Care First – High Need Populations
  • Direct Contracting – Global
  • Direct Contracting – Professional
  • Direct Contracting – Geographic
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MHD Offers Behavioral Health Workshop

Staff Contact: Sarah Willson

The MO HealthNet Division is offering workshops for behavioral health providers that will cover billing, program benefits, precertification processes, compliance and documentation requirements. Missouri Medicaid Audit & Compliance, Managed Care Providers, Conduent, and other consultants will present during the workshop. The two workshops are limited to 40 attendees, and the same information will be covered in each workshop. The dates of the workshops are Thursday, April 25, and Thursday, June 27. Those wishing to attend should email MHD.PROVTRAIN@dss.mo.gov, indicating a preferred date to attend.

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HIDI Tech Connect


HIDI HealthStats — Assessing Community Health Needs With exploreMOhealth

Staff Contact: Mat Reidhead

HIDI HealthStats In March 2018, MHA and Missouri Foundation for Health released exploreMOhealth, a community health needs assessment platform developed through a partnership with the University of Missouri’s Center for Applied Research and Engagement Systems. The platform was designed to assist community heath stakeholders in the development of impactful CHNAs using two rich sources of health-related data that are unique to Missouri — the Missouri County-Level Study from MFH, and the Missouri ZIP Health Rankings from the Hospital Industry Data Institute and Washington University School of Medicine.

The Missouri ZHR data included on exploreMOhealth.org were updated on April 1 to reflect the most recent information on the health and social well-being of populations living in 940 Missouri ZIP codes. Several new measures also were added to the dataset, including hospital utilization for opioid misuse, dental caries and 13 prevention quality indicators on preventable inpatient admissions. Learn more by reading the April 2019 HIDI HealthStats.

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Consider This ...

Almost half of all U.S. worksites offered some type of health promotion or wellness program in 2017.

Source: Centers for Disease Control and Prevention