MHA Today | July 26, 2019

July 26, 2019
MHA Today: News for Healthcare Leaders

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July 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 In 1960, while GM and Ford together controlled 75 percent of the U.S. automobile market, Toyota wasn’t among the top 20 vehicle manufacturers in the U.S. By 1970, Toyota was the 6th largest manufacturer, and by 1980 — as the “Big Three” U.S. manufacturers’ sales were plummeting — Toyota had reached the number four spot. Since the Great Recession, Toyota intermittently has moved from second to third place and back, never falling below third.

Toyota has a system — the Toyota Production System — that governs all aspects of its business. The TPS is designed to help Toyota employees and their suppliers identify expenditures of material, effort and time that do not generate value. TPS has been a force behind the company’s growth and the quality of its vehicles. In fact, what’s known in business and engineering circles as the “Toyota Way” may be driving change in your hospital. Much of the “lean” business model is predicated on TPS thinking.

Hospitals aren’t automobile assembly plants, and patients aren’t automobiles. Nonetheless, hospitals are on a similar journey — to reduce waste and variation, improve our services for end users, and create value.

Our partners are asking for help. In 2017, Missouri officials sought input through the “NO MO Red Tape” initiative to review every regulation with the goal to eliminate ineffective, unnecessary or unduly burdensome rules. Although MHA had been working to streamline hospital licensing regulations for years, the initiative presented a new opportunity to work collaboratively toward both fewer and better rules.

The Centers for Medicare & Medicaid Services has undertaken a similar program through their “Patients Over Paperwork” initiative. The program’s goals include reducing unnecessary burden, increasing efficiencies and improving the beneficiary experience. CMS is accepting comments on “ideas for regulatory, subregulatory, policy, practice and procedural changes that reduce unnecessary administrative burdens for clinicians, providers, patients and their families.” Missouri hospitals are encouraged to participate and share submissions or ideas with MHA.

If Toyota managers were asking themselves how to bring value from Patients Over Paperwork, they would go to the front line of care. And, it seems that CMS is asking for exactly this type of guidance. The request for information states to “provide complete, clear and concise comments that include, where practicable, data and specific examples.”

Despite the circular headline announcing recent regulatory relief actions, CMS is taking the Patients Over Paperwork seriously and using the program to drive administrative change. It’s important that the next generation of rules — rules that will significantly influence the future of health care — are informed by hospitals and providers at the front lines of care.

In 1987, while Toyota was solidifying its place as a world-class auto producer — and when 60 percent of the top 10 manufacturers in the U.S. by market share were from Asia — the Yugo made its brief appearance on the scene. The Yugoslavian car had a starting price of $3,990 for the entry-level GV, which stood for “Good Value.” It was neither.

It’s hard to provide something world class without world-class systems and the commitments of all stakeholders to a common vision. We need a health system that delivers Camrys and Corollas. A system that focuses on cost and not value results in a Yugo.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
DHSS Issues Emergency Rule On Legionella
Pharmacy Technician Discipline And Termination Notification
MHA And Board Of Pharmacy Hosts Webinars On August 15
MLN Connects Provider eNews Available
HIDI Releases New Inpatient Risk-Adjusted Mortality Report To Missouri Participating Hospitals
HIDI Releases Second Quarter FFY 2019 Inpatient, Outpatient, Databases

MHA Seeks Member Feedback by July 31

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. Please complete the short survey by Wednesday, July 31.

Regulatory News
the latest actions of agencies monitoring health care

DHSS Issues Emergency Rule On Legionella

Staff Contact: Sarah Willson or Jackie Gatz

The Department of Health and Senior Services Division of Community and Public Health published an emergency rule (pg. 2,081-2,084) and a proposed rule (pg. 2,124-2,126) in the Aug. 1 Missouri Register, moving Legionellosis from the list of diseases or findings that must be reported within three days to the list of diseases or findings that must be reported within one day. The emergency rule was effective July 8 and expires Feb. 27, 2020. The proposed rule is open for comment until Friday, Aug. 30.

MHA encourages hospitals to submit comments of support or opposition to Adam Crumbliss, Director, Department of Health and Senior Services, Division of Community and Public Health, P.O. Box 570, Jefferson City, MO 65102. MHA also requests hospitals share their positions with MHA by contacting Sarah Willson.

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Pharmacy Technician Discipline And Termination Notification

Staff Contact: Sarah Willson

The Missouri Board of Pharmacy issued a release noting that pharmacy technician terminations and disciplinary actions submitted July 1-17 were not received. They are asking entities to resubmit termination notices and disciplinary notices. For more information, please contact the Board of Pharmacy at 573/751-0091.

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MHA And Board Of Pharmacy Hosts Webinars On August 15

Staff Contact: Sarah Willson

The United States Pharmacopeia finalized revisions to USP <797> and <800> guidelines. USP <797> focuses on sterile compounding standards while USP <800> is designed to improve the safety of health care workers by reducing exposure to hazardous drugs.

To help organizations understand the changes and regulatory requirements, MHA is hosting a webinar on each chapter at noon on the following dates. Additional information and registration is available at the respective links.

Also on Aug. 15 during the same time, the Board of Pharmacy is hosting a webinar discussing 2019 statutory changes related to pharmacy practice. This webinar will cover pharmacist smoking cessation prescribing, Board of Pharmacy pilot programs and mandatory controlled substance e-prescribing. Registration is available.

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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.

  • Importance of proper documentation: Provider minute video
  • Medicare Diabetes Prevention Program
    • Become a Medicare-enrolled supplier
    • Valid claims
  • New Medicare card: Questions about using the Medicare Beneficiary Identifier?
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HIDI Tech Connect

HIDI Releases New Inpatient Risk-Adjusted Mortality Report To Missouri Participating Hospitals

Staff Contact: Steve Warchol

HIDI is hosting a webinar highlighting the newly developed Risk-Adjusted Mortality quality report, which enables hospital team members to obtain information on condition-specific, risk-adjusted data regarding their facility’s performance, as well as physician-level data. All hospitals participating in HIDI’s Missouri Discharge Data Program will have access to the tool at no cost.

The repeating webinar is free and will be held on multiple days to accommodate as many schedules as possible. It will be presented at 11 a.m. on Monday, July 29, and Tuesday, July 30. Registration is available.

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HIDI Releases Second Quarter FFY 2019 Inpatient, Outpatient, Databases

Staff Contact: Shane VanOverschelde

The second quarter federal fiscal year 2019 inpatient and outpatient databases, including HIDI-reporting Hospitals in Missouri, Illinois and Kansas City, Kan., now are available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage.® The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in “Strategic Planning/Premier Data” and are organized in the following categories.

  • Q2 FFY2019, Inpatient
  • Q2 FFY2019, Outpatient Classified
  • Q2 FFY2019, Outpatient Unclassified

Hospitals interested in subscribing to the 2019 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.

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Did You Miss An Issue Of MHA Today?

July 22, 2019
HIDI Releases First Quarter 2019 VBP Payments Model
CMS Announces HAC Program Review And Corrections Period
CMS Announces IQR And Promoting Interoperability Programs Education Session
St. Louis Children’s Hospital Names New President

July 24, 2019
CDC Updates Interim Recommendations For Measles In Health Care Settings
CDC Increases Support To Ebola Outbreak, U.S. Hospital Planning Resource Available
New Guide For Medication-Assisted Treatment Available

Consider This ...

World Hepatitis Day is Sunday, July 28. World Health Organization data show an estimated 257 million people living with chronic hepatitis B and 71 million people living with chronic hepatitis C worldwide.

Source: Centers for Disease Control and Prevention