MHA Today | May 8, 2020

May 8, 2020
MHA Today: News for Healthcare Leaders

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May 8, 2020

MHA Today is provided as a service to members of the Missouri Hospital Association. Additional information is available online at MHAnet.

COVID-19 Updates


For the latest updates and most current information on coronavirus disease 2019, visit MHA's website.


Herb Kuhn, MHA President & CEOHospitals, and the highly skilled and caring people who work for hospitals, seldom have received the attention generated by the COVID-19 crisis. As we honor nurses during National Nurses Week from May 6 to 12, and recognize National Hospital Week from May 10 through 16, it’s important to remember that our organizations have seldom been as necessary — and as threatened.

Throughout the past months, as we’ve adapted to the challenges presented by the virus, we’ve seen all members of the hospital community contribute to the health and safety of our Missouri communities. Our front-line caregivers have become foot soldiers in the battle against the virus — from health care workers at the bedside caring for those with acute COVID-19 symptoms to the many others who are supporting testing, infection control and helping shape the “new normal” created by the disease. Where the virus has struck, nurses and others have displayed uncommon valor in treating patients.

Hospitals have made difficult choices. Cancelling medically necessary elective procedures has proven costly, but it was the right thing to do to protect patients and workers as the disease unfolded in Missouri. This decision, combined with social distancing, not only harmed hospitals’ financials, but required significant management of the workforce as many service lines were shuttered, and the staff that provide care within, sidelined.

Despite these difficulties, our actions — from individual caregivers and leaders to our statewide collaborations to manage the crisis — have validated why hospitals are so essential. It has galvanized our communities in support of our missions to save lives and improve health.

Hospital Week Video To help share the story, MHA developed tools for honoring nurses and hospitals during the overlapping recognition weeks. A variety of Facebook frames are available for social media, and we are running a hospital and health care worker video online in numerous parts of the state. I encourage you to participate using MHA’s content or through your own stories.

As we begin the process of opening and returning to a more conventional system of care, National Nurses Week and National Hospital Week can provide a point to pause and to pivot. It’s certainly worth pausing to reflect on the amazing work done by Missouri’s nurses and hospitals throughout the last several months. And, we can pivot to look ahead — to a prudent, safety-focused resumption of care.

I’m very proud of the work that has been done by the entire hospital community during the COVID-19 crisis. We can’t predict how the virus will progress in the months ahead. However, we can — with certainty — know that we are as good as the challenge.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
MHA, Stakeholders Release COVID-19 Report
MHA Releases Hospital Finances Report
General Assembly Completes State Budget Enactment
DCI Releases Information On Pharmacy Technician Renewals
Promoting Interoperability Hardship Exception Application Now Available
MLN Connects Provider eNews Available
NIH Study Highlights Importance Of Hospital-Initiated Interventions For Mitigating Suicide Risk
Maternal Mental Health Awareness: Screening Tools Available

Happy Nurses Week From MHA Nurses


MHA, Stakeholders Release COVID-19 Report

Staff Contact: Mat Reidhead
Disproportionate Impact of COVID-19 in St. Louis
While age and the presence of comorbid conditions are significant predictors of morbidity and mortality among individuals contracting the COVID-19 virus, race is emerging as a critical risk factor as the number of cases and available data continue to expand.

New research — published by MHA and other key stakeholders — on the influence of COVID-19 among St. Louis-area communities finds the region’s Black and African American residents have been especially hard hit by the crisis. Through analyzing 133 ZIP codes throughout the St. Louis region, researchers found that the 19 ZIP codes with a majority Black or African American population had a combined rate of COVID-19 cases near 400 per 100,000 residents, while the 68 ZIP codes with fewer than 5% Black or African American residents had 127 cases per 100,000 residents on April 20.

The report concludes with recommendations for future research and action steps that enable prevention, mitigation and healing.

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MHA Releases Hospital Finances Report

Staff Contact: Daniel Landon or Andrew Wheeler

Hospital Finances Report MHA released a new report today on the effect of COVID-19 on Missouri hospital finances. It reviews plummeting hospital revenues associated with the loss of many outpatient and elective procedures. Based on member input, it projects anticipated reductions in inpatient and outpatient volume from the prior year for calendar quarters 2, 3 and 4 of 2020. The report also offers projections of changes in net expenses for the same period. More detail about the labor component of those expenses comes from a member survey of the types of employee personnel actions that have been implemented or are planned. Finally, the report summarizes the various governmental financial relief initiatives arising from the COVID-19 emergency.

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state and federal health policy developments

General Assembly Completes State Budget Enactment

Staff Contact: Daniel Landon or Rob Monsees

The General Assembly completed its enactment of the state budget for the state fiscal year beginning Wednesday, July 1. Today is the constitutional deadline for doing so. Highlights of the final budget for hospitals include the following. The MO HealthNet Division’s proposal to impose a Medicaid outpatient fee schedule based on 90% of Medicare payment rates was blocked. An MHA consultant’s study projected the fee schedule would cut Medicaid payments to Missouri hospitals by $100 million. The budget also includes appropriation authority to pay an additional $190 million in Medicaid DSH payments during the budget year. Overall, the state budget was trimmed by $700 million from the original version because of plummeting revenues from the economic effects of the COVID-19 emergency. Much of the burden fell on schools and colleges; Medicaid payments to hospitals were not significantly affected.

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Regulatory News
the latest actions of agencies monitoring health care

DCI Releases Information On Pharmacy Technician Renewals

Staff Contact: Sarah Willson

The Department of Commerce and Insurance’s Board of Pharmacy has released information on the renewal of pharmacy technicians. The pharmacy technician renewal deadline has been extended until Friday, July 31. All pharmacy technician registrations must be renewed by this date or the registration will be deemed expired and void. No grace period will be granted given the extended renewal date.

Please email the Board office at with questions or concerns.

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Promoting Interoperability Hardship Exception Application Now Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services requires that all eligible prospective payment system and critical access hospitals use the 2015 edition certified electronic health record technology to meet the requirement of the promoting interoperability programs. Hospitals who do not meet the standard are subject to downward payment adjustments. Eligible hospitals may be exempt from the Medicare penalties if the hospital would realize significant hardships in meeting the requirement. Hospitals who meet the hardship exception can submit applications electronically. The deadline for eligible PPS hospitals to apply is Sept. 1, and the deadline for CAHs is Nov. 30.

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MLN Connects Provider eNews Available

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. 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.

  • COVID-19: modified ordering requirements for laboratory billing
  • Hospital OPPS: new coronavirus specimen collection code
  • Home health plans of care: NPs, CNSs and PAs allowed to certify
  • CMS announces independent commission to address safety and quality in nursing homes

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Quality and Population Health

NIH Study Highlights Importance Of Hospital-Initiated Interventions For Mitigating Suicide Risk

Staff Contact: Shawn Billings

A study funded by the National Institutes of Health found that patients who visited the emergency department for an opioid overdose were 100 times more likely to die by drug overdose in the year after being discharged and 18 times more likely to die by suicide relative to the general population. Additionally, in the year after ED discharge, patients who visited for a sedative/hypnotic overdose had overdose death rates 24 times higher, and suicide rates nine times higher, than the general population. The findings, published in the American Journal of Preventive Medicine, highlights the need for interventions that reduce suicide and overdose risk that can be implemented when patients come to the ED.

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Maternal Mental Health Awareness: Screening Tools Available

Staff Contact: Alison Williams or Kelsey Hussey

With the incidence of postpartum depression affecting one in eight women, recommendations for screening for perinatal mood disorders are coming from a growing number of organizations. The U.S. Preventive Services Task Force and the Centers for Medicare & Medicaid Services, as well as the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics, all recommend screening.

ACOG’s recommendation specifically identifies the Edinburgh Postnatal Depression Scale and notes it is the most frequently used in the clinical setting for several reasons. It is comprised of 10 self-reported questions, takes less than five minutes to complete, has been translated into more than 50 different languages, and also addresses anxiety symptoms, which can be common in perinatal mood disorders.

ACOG also recognizes other screening instruments, such as the Patient Health Questionnaire (PHQ-9), the Beck Depression Inventory and the Center for Epidemiologic Studies Depression Scale. However, these screening instruments do not specifically screen for perinatal depression.

The AAP recommends utilizing the EPDS screening tool during an infant’s one-, two-, four- and six-month visits, and then transitioning to the PHQ-2 screening tool beyond the postpartum period.

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Did You Miss An Issue Of MHA Today?

May 4, 2020
Senate Committee Advances New Version Of State Budget
CMS Issues New Round Of Changes To Support COVID-19 Response
CMS Announces Promoting Interoperability Hardship Exception
SAMHSA Updates TIP 63, Medications For Opioid Use Disorder
This Week Is Maternal Mental Health Awareness Week
MU Extension Releases Rural-Focused Toolkit For Mental Health Awareness Month
John J. Pershing VA Medical Center Names Interim Director

May 6, 2020
Senate Adopts FY 2021 State Budget
MO HealthNet Announces New Services For Adult Diabetes Prevention
MHA Distributes Analysis Of The Proposed FFY 2021 IPF PPS
CMS Announces Preview Period For July 2020 Publicly Reported Data
New AHA Resource Supports Patient And Provider Communication
Using AIM’s Approach To Change Missouri’s Birth Story
Maternal Mental Health Awareness: Pediatricians Serve Integral Role Identifying Postpartum Depression
Today Marks The Beginning Of National Nurses Week
APS Announces Partnership For Home-based Cardiac Rehabilitation Solution
MRHA Hosts Complimentary Telemedicine Grant Webinars

Consider This ...

According to its annual Mother’s Day spending survey, the National Retail Federation reports that two-thirds of consumers expect to be celebrating this Mother’s Day virtually.