MHA Today | December 16, 2019

December 16, 2019
MHA Today: News for Healthcare Leaders

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December 16, 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
Marketplace Open Enrollment Extended Through Dec. 18
CMS Releases Marketplace Effectuated Enrollment For The First Half Of 2019
MLN Connects Provider eNews Available
MHA Addresses Delays In Care In December Trajectories
CMS Releases OQR Specifications Manual Version 13.0a
CMS Updates QRDA Conformance Statement Resource
HRSA Accepts Applications For Nursing Workforce Program
FCC Announces Shortened Suicide Prevention Hotline Number

What You Need To Know This Week

  • Watch for MHA’s annual legislative guide that will be released this week.
  • Comments to the Centers for Medicare & Medicaid Services on the proposed Stark Law are due Tuesday, Dec. 31. The American Hospital Association’s model letter can be used to help hospitals submit comments.


Advocate
state and federal health policy developments


Marketplace Open Enrollment Extended Through Dec. 18

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services announced that the open enrollment period for insurance plans purchased through Heatlhcare.gov has been extended through Wednesday, Dec. 18.

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CMS Releases Marketplace Effectuated Enrollment For The First Half Of 2019

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released a report about the effectuated enrollment data for federal- and state-based exchanges. As of Sept. 15, an average of 10.2 million individuals had effectuated their coverage through June 2019. This amounts to 1.25 million fewer plan selections than the number of individuals with plan selections at the end of the 2019 open enrollment period. The data also shows that the average monthly premium per enrollee decreased 0.4% to $593.29.

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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.

  • Open payments: Review and dispute data by Tuesday, Dec. 31
  • Long-Term Care Hospital and Inpatient Rehabilitation Facility Provider Preview Reports: Review your data by Thursday, Jan. 9, 2020
  • Payment for outpatient clinic visit services at excepted off-campus provider-based departments
    • Quality Payment Program: Check your final 2019 Merit-based Incentive Payment System eligibility status
    • MIPS low-volume threshold criteria for 2019

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Quality and Population Health


MHA Addresses Delays In Care In December Trajectories

Staff Contact: Alison Williams
Three-Delays Model
The December 2019 issue of Trajectories highlights the Three Delays Model, produced by the California Maternal Quality Care Collaborative, that visually represents delays commonly reported in maternal mortality reviews. Initially developed for under-resourced countries to address maternal mortality, the model also serves as a resource for providers and systems in the U.S. to mitigate these same delays in care.

Providers, patients and families often miss triggers or fail to adequately screen and assess reported signs and symptoms. Failure to recognize triggers and fully explore patient symptoms that may be related to pregnancy, in particular, leads to both delays in diagnosis and delays in treatment. The three delays often occur outside of the birthing unit throughout the continuum of care. In addition, failure to refer patients appropriately creates delays. Transportation, birthing unit closures and provider access limitations, along with the relatively slow growth of telehealth in maternal care provision, create maternal care deserts within Missouri, which also impact delays in care.

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CMS Releases OQR Specifications Manual Version 13.0a

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services released Hospital Outpatient Quality Reporting Specifications Manual version 13.02, effective with encounters dated Jan. 1 to Dec. 31, 2020, unless otherwise specified. A complete list of changes may be found in the associated release notes. The manual is available on QualityNet.

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CMS Updates QRDA Conformance Statement Resource

Staff Contact: Sherry Buschjost

The Centers for Medicare & Medicaid Services updated the Quality Reporting Document Architecture Category I Conformance Statement Resource to support calendar year 2019 electronic clinical quality measure reporting for the following programs.

  • Hospital Inpatient Quality Reporting
  • Promoting Interoperability Program for Eligible Hospitals and Critical Access Hospitals

Additional details are available.

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Workforce News


HRSA Accepts Applications For Nursing Workforce Program

Staff Contact: Jill Williams

The Health Resources and Services Administration is accepting applications for the Nurse Education, Practice, Quality and Retention Interprofessional Collaborative Practice Program: Behavioral Health Integration Program. The purpose of this program is to increase the access to and quality of behavioral health services through team-based care models in interprofessional nurse-led primary care teams in rural or underserved areas.

The NEPQR: BHI program will train and educate the future nursing workforce to provide integrated behavioral health services in rural communities. Eligible applicants include accredited schools of nursing, health care facilities, or partnerships of such schools and facilities.

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Noteworthy


FCC Announces Shortened Suicide Prevention Hotline Number

Staff Contact: Dave Dillon

The Federal Communications Commission announced it has initiated rulemaking on a new, three-digit suicide prevention hotline. The rule requires carriers to implement the new 988 hotline number within 18 months. Missouri has a suicide rate of 18.9 per 100,000 deaths, which is higher than the national rate of 14.5 per 100,000. The hotline routes callers to call centers where counselors are available to help individuals in crisis. In 2018, counselors received 2.2 million calls nationwide.

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Consider This ...

So far this flu season, at least 2.6 million flu illnesses and 23,000 flu-related hospitalizations have been reported. And, at least 1,300 people have died from the flu so far this season.

Source: CNN