MHA Today | May 31, 2019

MHA Today: News for Healthcare Leaders

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May 31, 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 Congressman Billy Long of Southwest Missouri, touring the damage in Carl Junction, wished that he could introduce legislation removing May 22 from the calendar. This year’s May 22 tornado damaged several communities in his district, as well as in Jefferson City, Eldon and other mid-Missouri communities. In 2011, the May 22 tornado resulted in catastrophic damage and loss of life, and on May 22, 1986 — as his daughter was being born — his wife’s hospital bed had been moved to the hallway at Mercy Hospital in Springfield because of the danger of a tornado. It’s hard to not share his sense of outrage and helplessness.

There’s a quip that I like to use sometimes that is reflective of Long’s comment. “Everybody talks about the weather, but no one does anything about it.” It’s clever. Nonetheless, with an abundance of evidence that we can’t effectively or reliably change nature, we can change how we prepare for it.

Throughout the week, several Missouri hospitals have been participating in preparedness exercises to improve their ability to respond to emergencies. The largest was an integrated, multi-hospital drill to identify and transport a suspected case of Ebola from a front-line facility to an assessment hospital and on to a Centers for Disease Control and Prevention-designated treatment facility.
Statewide Ebola Drills
Throughout the week, we’ve chronicled exercise participants in MHA Today and on our social media channels. They include Texas County Memorial Hospital, which launched its exercise on Tuesday; CoxHealth and Mercy Hospital Springfield in southwest Missouri, Saint Francis Medical Center in Cape Girardeau, Lee’s Summit Medical Center, and Mercy Hospital St. Louis on Wednesday; and Barnes-Jewish Hospital in St. Louis on Thursday. Missouri lawmakers attended some of the sessions to increase their understanding of the system and watch hospitals in action.

Today, in a separate exercise, University of Missouri Health Care’s Women’s and Children’s Hospital simulated a patient surge designed to test the statewide pediatric surge and transport plan. This exercise included cooperation by regional hospitals for some patients and Missouri’s urban children’s hospitals for high-acuity, specialty cases.

These exercises are complex under normal circumstances. There’s an added degree of difficulty when they are undertaken during real-world challenges. In fact, it was suggested that the exercises be postponed to allow room for preparedness leaders to focus on the flooding and severe weather throughout Missouri. However, realizing that these challenges enhance the value of the exercises, the participants agreed the benefits of working under the additional pressure increased the “all hazards” value of the effort.

Preparedness and response resources are mature in Missouri. However, the only way to identify weaknesses, learn from them and improve is to test. That’s what hospitals have been doing this week.

For nearly two decades, hospitals and other stakeholders have been building our capacity to protect the communities we serve. The system has evolved from one viewed through the prism of natural or man-made disasters, to a broad, all-hazards approach. During this time, community resilience has increased as well — contributing to decreased loss of life and better systems of recovery.

We can’t control nature. Earthquakes are always a possibility, tornadoes and floods will continue to disrupt and destroy, and illnesses like measles or Ebola will present public health challenges. What we can control is how we react to these incidents.

We may be tempted to remove May 22 from our calendars. However, the day is a strong reminder that the worst can happen, and that the time we spend working on how to reduce harm will save lives.

Send me a note to let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Georgetown University Study Highlights Decline In Children’s Medicaid Coverage
MHD Changes Remittance Advice
Children’s Hospitals And State Partners Simulate Evacuation Exercise
Nearly 1,000 U.S. Measles Cases Already This Year

state and federal health policy developments

Georgetown University Study Highlights Decline In Children’s Medicaid Coverage

Staff Contact: Brian Kinkade

The Georgetown University Health Policy Institute’s Center for Children and Families released its report on the dramatic decline in the number of children qualifying for Medicaid coverage nationwide during 2018. In 2018, Missouri’s child Medicaid caseload fell by 55,634, or 9 percent, a greater decline than all other states except Tennessee. The Missouri Department of Social Services routinely cites the improving economy as the reason for the reduction. However, the Georgetown report finds “scant evidence” that the reduction can be attributed to an improving economy and that it likely results from a myriad of factors, including the repeal of the Affordable Care Act’s coverage mandate and inefficient or overly complicated administrative processes.

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MHD Changes Remittance Advice

Staff Contact: Kim Duggan or Andrew Wheeler

The MO HealthNet Division informed providers by Hot Tip that, effective with the April 19 Health Care Claim Payment/Advice (835), it implemented a required system change to correct what is reported as the submitted line item charge on the 835 for crossover claims. MHD noted that this will affect both 837I and 837P claims types. Due to the change in the Medicaid remittance advice, hospitals may need to change processes in identifying and reporting bad debts that are reimbursable through the Medicare cost report.

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Quality and Population Health

Children’s Hospitals And State Partners Simulate Evacuation Exercise

Staff Contact: Jackie Gatz

MU Women's & Children's Exercise Today, in central Missouri, health and medical partners tested medical surge capacity, hospital evacuation and transportation coordination during a simulated evacuation of University of Missouri Health Care’s Women’s and Children’s Hospital. The exercise tested the hospital’s capability to respond to a no notice mass casualty incident and coordinate appropriately with local, regional and state networks to facilitate safe and appropriate patient care. Staff from St. Louis Children’s Hospital, MHA, the Missouri Department of Health and Senior Services, and the Missouri State Emergency Management Agency were on site in Columbia to support exercise objectives.

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Nearly 1,000 U.S. Measles Cases Already This Year

Staff Contact: Jessica Stultz or Jackie Gatz

On Thursday, the Centers for Disease Control and Prevention reported 971 cases of measles so far this year, the highest annual total in more than 27 years and with seven months still to go. The previous recent high was 963 cases in 1992. There already has been a 161 percent increase in the number of cases in 2019 compared to all of 2018 when only 372 cases of measles were reported. Outbreaks in ultra-Orthodox Jewish communities in New York City and Rockland County, N.Y., which have been going on for nearly eight months, are driving the epidemic. The U.S. will lose its World Health Organization designation for eliminating measles if the New York outbreaks continue into the fall. The measles elimination goal, first announced in 1966 and accomplished in 2000, was a monumental task. Before widespread use of the measles vaccine, an estimated 3 to 4 million people got measles each year in the U.S., along with an estimated 400 to 500 deaths and 48,000 hospitalizations.

The U.S. was able to eliminate measles for two main reasons.

  1. Availability and widespread use of a safe and highly effective measles vaccine, and
  2. Strong public health infrastructure to detect and contain measles.
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Did You Miss An Issue Of MHA Today?

May 28, 2019
Hospitals Practice Response To Highly Infectious Patient
Rural Americans Identify Health Care Challenges
Number Of U.S. Births Drops Fourth Year In A Row

May 29, 2019
DHSS Finalizes Proposed Medical Marijuana Rules
CMS Finalizes Changes To The PACE Program
MHA Distributes Analysis For Proposed Updates To 2020 SNF PPS
Missouri Hospitals Continue Hospital Preparedness Exercises
2019 Trustee Of The Year Call For Nominations

May 30, 2019
MHA Increases Support For Small Rural Hospitals Through SHIP Grant
Trajectories — Neonatal Abstinence Syndrome: A Conversation That Could Save Two Lives
MLN Connects Provider eNews Available

Consider This ...

Tomorrow is National Say Something Nice Day. The positive effects of kindness are experienced in the brain of everyone who witnesses the act, improving their mood and making them significantly more likely to “pay it forward.” This means one good deed in a crowded area can create a domino effect and improve the day of dozens of people.

Source: Random Acts of Kindness