MHA Today | April 26, 2019

April 26, 2019
MHA Today: News for Healthcare Leaders

linkedin twitter facebook
April 26, 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 Remember paper highway maps? They’re still around, but unless you’re in a pinch or a cartographical Luddite, you’ve probably advanced to GPS navigation or integrated travel into your car’s information system. Today, you can connect your vehicle to your smart phone, open an app, choose a destination and let Google lead the way. If you’re on a long trip, it’s likely that your app will offer several different options — alternatives that are the fastest, shortest or most economical, for example — to get where you’re going.

Expanded or full health insurance coverage for Americans is a destination that has almost universal support. How we get there matters.

Despite that fact that the “Obama” in Obamacare is in the health care system’s rear view mirror, the 2018 elections proved that health care continues to be a visceral issue for voters. In many cases during the last cycle, candidates for Congress made the Affordable Care Act repeal efforts a centerpiece of their campaigns. And, it is increasingly apparent that health care will remain relevant in 2020. The proposal gaining the most attention, Medicare for All — or M4A in shorthand — has become the lodestar for candidates from the left. And, why not? Medicare is one of the most important institutions established in the last 100 years, right? Unfortunately, getting to full coverage through Medicare could destroy Medicare. It could be the very definition of a pyrrhic victory.

Medicare as we know it is in trouble without the potential of a massive influx of new beneficiaries. According to the new Medicare Trustees’ report, the program’s deficit in 2018 was $1.6 billion. This follows nearly a decade of deficits, exacerbated by the recession and the growing number of “baby boomers” entering the program, totaling approximately $132.2 billion.

Nonetheless, a string of presidential aspirants and elected officials have embraced the idea of M4A. But, not all have. Speaker Nancy Pelosi has been guarded in her embrace of the proposal. While allowing hearings of M4A in the House, with the first scheduled next week, she has been advocating for a more limited health policy approach — keeping coverage and other aspects of the ACA center stage, while working on prescription drug costs. Meanwhile, health care stocks have tumbled, and Senate Majority Leader Mitch McConnell appears poised to feed the health care debate right back to Democrats, calling the M4A agenda, “Medicare for None.” His overarching message — government’s role in health care should be smaller, not larger.

As detailed this week in The New York Times, hospitals have a tremendous stake in the outcome of the debate. Medicare is essential, but it fails to pay its share of health care costs presently. One of the major problems of M4A as proposed is that it fails to clearly articulate how the government would pay for the program’s expansion — costing as much as $30 trillion over a decade — and what the program would pay providers. As understood, M4A could cost hospitals $155 billion annually.

Hospitals aren’t the only stakeholders. Bringing millions of new beneficiaries into a system that underpays only will lead to a more warped system, where cost-shifting becomes increasingly necessary, and unnecessary care more attractive to pad the bottom line — two of the most perverse aspects of the existing system. This means that individuals outside of the M4A system potentially will be carrying more of the freight for the health system, without better results.

Let me move back to where I started — maps. If you get a map of the right scale, New York and San Francisco don’t seem that far apart. For the record, they are approximately 2,900 miles apart, no matter the scale of your map. Google can get you to your destination, but it requires real choices. Do you want the trip to be the fastest, shortest or most economical?

These are real choices with real consequences. If you’re starting your journey behind a vehicle with an M4A bumper sticker, be careful. That vehicle may not be on the same journey. And, once they unfold their map, it’ll be really hard to get it folded back correctly.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Interstate Compact For Psychologist Licensure Gets Underway
Deadline Nears For Visionary Leadership Award Applications
CMS Announces Preview Period For July 2019 Hospital Compare Data
CMS Updates April 2019 Hospital Compare Downloadable Data
CMS Announces IPFQR Education Session

state and federal health policy developments

Interstate Compact For Psychologist Licensure Gets Underway

Staff Contact: Daniel Landon

With Georgia’s enactment of state legislation authorizing participation in an interstate compact for reciprocal licensure of psychologists, the threshold has been reached for implementation of the compact. The Missouri General Assembly endorsed participation in 2018. The compact is designed to streamline telepsychology and temporary in-person consultations. A compact commission will be formed to develop rules and bylaws. Missouri’s professional licensure agency offers more information. In addition to psychologists, Missouri legislators have endorsed participation in interstate licensure compacts for nurses, physical therapists and emergency medical services practitioners.

Back To Top


Quality and Population Health

Deadline Nears For Visionary Leadership Award Applications

Staff Contact: Leslie Porth

Reimagine Rural Health The application window to submit applications for the Visionary Leadership Award closes at 5 p.m. Friday May 3. The award recognizes innovative service and program initiatives led by the CEO that result in improved clinical and population-based health outcomes. Focus areas include access to quality care within the community, improved clinical outcomes, care coordination between the community and acute care settings of chronic diseases, improved safety outcomes, or partnerships to address population-health issues.

Last year’s Visionary Leadership Award went to Darren Bass, President of Cox Monett Hospital and System Vice President of Community Hospital Group. View his award video on MHA’s website.

Back To Top

CMS Announces Preview Period For July 2019 Hospital Compare Data

Staff Contact: Sherry Buschjost

The preview period for hospitals to review July 2019 Hospital Compare data ends Tuesday, May 21. The preview period is applicable for hospitals and facilities participating in the following programs.

  • Hospital Inpatient Quality Reporting
  • Hospital Outpatient Quality Reporting
  • Prospective Payment System Exempt Cancer Hospitals Quality Reporting

Additional details are available on QualityNet.

Back To Top

CMS Updates April 2019 Hospital Compare Downloadable Data

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services refreshed facility data in the downloadable files on Since CMS is returning to the usual Hospital Compare schedule of quarterly updates (i.e., January, April, July, October), the Hospital Compare website will not refresh until the July 2019 update. Data currently displayed on Hospital Compare was refreshed Feb. 28. Additional details are available.

Back To Top

CMS Announces IPFQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting Program is scheduled at 1 p.m. Thursday, May 2. Registration is required for the webinar, “IPFQR Program: FY 2020 IPF PPS Proposed Rule.”

Back To Top


Did You Miss An Issue Of MHA Today?

April 22, 2019
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

April 23, 2019
Legislative Committee Votes To Block Medicaid Contracting Amendment
CMS Releases Proposed FY 2020 Payment And Policy Updates To The Inpatient And LTCH PPS
Missouri DHSS Releases Draft Medical Marijuana Rule For Physicians
MHA Receives HIIN Extension
2019 Aim For Excellence Award Call For Applications Reminder
Bothwell Regional Health Center Names New CEO

April 24, 2019
FRA Reauthorization Advances In Senate After Extended Debate
Assistant Physician Bill Creates Alternative Path To Physician Licensure
State Legislators Consider Medicaid Managed Care Reform
DHSS Releases Proposed Hospital Licensing Regulations
Hospitals Sue Over Liver Allocation Policy
SSM Health St. Clare Hospital Hosts Addiction Conference

April 25, 2019
HHS Delays Controversial Liver Allocation Policy
House Committee Approves FRA Authorization
Senate Passes State Fiscal Year 2020 Budget
Legislative Committee Reviews Short-Term Insurance Expansion
DHSS Releases CARE Consent Form
MLN Connects Provider eNews Available

Consider This ...

Tomorrow is National Prescription Drug Take Back Day. In total, National Take Back Days have collected 10,878,950 lbs. of prescription drugs.

Source: Take Back Day