MHA Today | June 28, 2019

June 28, 2019
MHA Today: News for Healthcare Leaders

linkedin twitter facebook
June 28, 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 If you open your Junior Woodchuck guidebook to the section on hospital price transparency, there’s a complete guide to educating the public about their options for selecting the most value for their health care dollar. The guidebook even reviews how health care consumerism will help bend the cost curve systemwide. That’s one of the reasons that Junior Woodchucks always carry their guidebook — it has answers to the most intractable questions.

Unfortunately, the Junior Woodchucks of the World are an imaginary organization created in the mind of a Disney cartoon writer. By extension, the Junior Woodchuck guidebook is fiction, too.

This week, President Trump issued an executive order directing the Department of Health and Human Services to write rules to assist consumers in understanding what they pay for health services. The rules will relate to hospitals and insurers, and require transparency of costs based on negotiated rates in a “patient-friendly” format. Meanwhile, the Health, Education, Labor and Pensions Committee of the U.S. Senate advanced legislation this week encompassing 54 health-related proposals — including billing and transparency-related policy.

There’s a small body of evidence that suggests that better information on price could drive consumer behavior. Whether gains derived from reduced costs on “shoppable services,” such as lab tests or imaging, would offset the potential for unintended consequences is unknown. It’s unlikely.

At the same time, transparency of negotiated rates could lead lower-cost providers to increase their rates toward the average or high charge, undermining the effort significantly. I saw this happen when I was at the Centers for Medicare & Medicaid Services. We assembled a group of providers and offered them robust data about their utilization patterns and that of their peers in the group. The result wasn’t more efficient care systems, but more care. The model’s transparency produced a perverse incentive — one that focused on an expanded bottom line. Transparency is generally good, it isn’t universally good.

Nationally, reform probably is overdue given the outcry over surprise billing. Patients must be protected. The administration — and Congress for that matter — are taking the issue seriously. Focusing on “shoppable” aspects of health care makes sense as a starting point. However, the nation’s low health literacy in general, and the inherent information asymmetry between patients and providers in particular, lead me to think that identifying value may be more difficult than just having price differences.
MHA Price and Quality Transparency
For more than a decade, Missouri’s hospital community has been evolving its system of informing consumers. Our Focus on Hospitals website provides data on quality and community benefit, and since 2016 has included price data to help Missourians understand costs and value. We’ve worked to help engage consumers with meaningful information, and as an association, we’ve articulated our collective values on transparency.

The national conversation will determine the future of transparency. However, the direction HHS is moving isn’t yet clear.

This is an important moment for hospitals. Building a system that produces value for consumers will require real partnerships between providers, insurers, lawmakers and regulators, with benefit for patients as the goal. We’re not there yet.

In a Junior Woodchuck world, we’d just open the guidebook and put together the system. Unfortunately, in the real world, there isn’t an easy answer.

Let me know what you’re thinking.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
Senator Blunt Honored As Champion Of Children’s Health
MHA Releases Analysis Of The Medicare Programs And Quality Trends Reports
MLN Connects Provider eNews Available
CMS Announces IPFQR Program Data Submission Period
CMS Announces OQR Education Session
CenterPointe Hospital Of Columbia Names New CEO

MHA Seeks Member Feedback

MHA Today now is only published on Mondays, Wednesdays and Fridays. As we work to redesign the publication, MHA seeks feedback to better meet the needs of our membership.

state and federal health policy developments

Senator Blunt Honored As Champion Of Children’s Health

Staff Contact: Brian Kinkade
Sen. Blunt Honored as a Champion of Children's Health
Children’s Mercy Hospital President and CEO Paul Kempinski presented Senator Roy Blunt with the Children’s Hospital Association’s Champions for Children Heath Award in Washington, D.C., on June 26. Sen. Blunt was recognized as an original co-sponsor of the Advancing Care for Exceptional Kids Act, as well as his strong support for the Children’s Hospital Graduate Medical Education program. The ACE Kids Act will give states a Medicaid option to fund health home-based care coordination services for children with serious health conditions.

Back To Top

MHA Releases Analysis Of The Medicare Programs And Quality Trends Reports

Staff Contact: Andrew Wheeler

MHA released an analysis of the Medicare Inpatient Prospective Payment System Value-Based Purchasing Program, the Hospital-Acquired Condition Reduction Program and the quality trends reports. The VBP reports are limited to IPPS payment hospitals and include estimated Medicare payment adjustments. The quality program measures trends are available to both IPPS and critical access hospitals. MHA has complimentary, on-demand webinars about the Medicare pay-for-performance programs. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage.®

Back To Top


Regulatory News
the latest actions of agencies monitoring health care

MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

Updates to MLN Connects Provider eNews were issued by the Centers for Medicare & Medicaid Services. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.

  • Merit-based Incentive Payment System data validation and audit for performance years 2017 and 2018
  • Fiscal Year 2020 ICD-10-CM diagnosis coding updates
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies competitive bidding: Round 2021 webcast series

Back To Top


Quality and Population Health

CMS Announces IPFQR Program Data Submission Period

Staff Contact: Sherry Buschjost

The Inpatient Psychiatric Facility Quality Reporting Program fiscal year 2020 data submission period begins Monday, July 1. All eligible IPFQR providers must complete all program requirements by the Thursday, Aug. 15, deadline to qualify for the full IPF Prospective Payment System annual payment update. Related data submission and verification checklists are available on the Quality Reporting Center. CMS encourages all IPFs to complete data submission at least two days before the deadline to allow time to address any submission issues.

Back To Top

CMS Announces OQR Education Session

Staff Contact: Sherry Buschjost

An outreach and education session for hospitals participating in the Outpatient Quality Reporting Program has been scheduled on Wednesday, July 10. The webinar, “The Escape Room: The Search for Clues in Your Data Abstraction,” is offered at 9 a.m. and 1 p.m. Registration is required.

Back To Top


CEO Announcements

CenterPointe Hospital Of Columbia Names New CEO

Staff Contact: Carol Boessen

Phil Sheridan was named CEO of CenterPointe Hospital of Columbia, effective June 21. He replaces Mike Talmo who had served as CEO since December 2018. Sheridan most recently served as vice president of hospital development and CEO of Cottonwood Creek Hospital with Haven Behavioral Healthcare in Boise, Idaho. A list of CEO changes is available online.

Back To Top


Did You Miss An Issue Of MHA Today?

June 24, 2019
Trump Signs Executive Order On Health Care Transparency
MO HealthNet Division Ends “Grandfathering” For Most Drugs
CMS Releases HSRs For 2019 DRA HAC Measures
National Alliance For Recovery Residences Conference Comes To St. Louis
CMS Updates IQR Known Issues Document

June 26, 2019
Missouri’s Approach To Price And Quality Transparency
U.S. Senate Committee Advances Health Proposal
President Reauthorizes Preparedness Program Funding
Governor Approves New Laws On Opioids And Radiologic Technologists
CBO Releases Long-Term Budget Outlook
MHA PFAC Releases Part Two In Vlog Series

Consider This ...

International Joke Day is Monday, July 1. Studies have shown laughing has far-reaching positive effects for the mind and body. It gives the immune system a boost by decreasing stress hormones, it improves heart health by increasing blood flow and can even burn calories.

Source: National Today