MHA Today | May 22, 2020

May 22, 2020


MHA Today: News for Healthcare Leaders

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May 22, 2020

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

Editor's Note: MHA Today will not be published Monday, May 25, in observance of Memorial Day. Publication will resume Wednesday, May 27.

COVID-19 Updates


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


Herb Kuhn, MHA President & CEOAccording to Anthony Costello, former director of maternal and child health at the World Health Organization, “Testing is the basis of public health detective work to shut down an epidemic.”

Throughout the past months, Missouri hospitals have taken unprecedented steps to build treatment capacity for COVID-19 patients. As we move toward mitigation, the linchpin for keeping the virus at bay for the next 12 to 24 months will be testing. Until we have community immunity, and a vaccine is discovered and deployed, large scale testing permits us to identify those who have the disease and arrange for them to get needed care.

This week, I wrote to both U.S. Department of Health and Human Services Secretary Alex Azar and Gov. Mike Parson about the importance of COVID-19 testing. Both moved aggressively to waive hundreds of rules and regulations to expand health care providers’ tools to treat COVID-19 patients. Soon we will see a similar effort to unwind those rules. However, until COVID-19 is controlled populationwide, coverage for COVID-19 testing must continue.

On March 11, following a meeting with President Trump, health insurers announced that “no one should hesitate to see their doctor to get tested and treated for COVID-19 because of costs.” The announcement included the removal of barriers to care including testing and treatment, prior authorization, and telehealth. Yet, some insurers are beginning to push back “demanding the plans have more discretion deciding what gets covered.”

It’s certainly not fair for insurers to be expected to pay for unproven tests from unscrupulous sources. However, a clear signal that they will continue to cover diagnostic and antibody tests is essential to state and federal public health efforts. Moreover, insurers — including Medicare and Medicaid — should ensure payments cover the cost of much testing. If the payment is below the cost of the supplies to collect the sample and run the test, then barriers to testing could develop.

There’s an alternative perspective. Given the significant risk to the economy and our health care system, COVID-19 testing could transition into the sphere of wellness benefits. Wellness benefits are offered through Medicare, Medicaid and commercial insurance plans. Throughout the past decade, the efforts to target prevention and promote health behavioral changes — such as health screenings, expanded immunizations, and testing for diabetes and other chronic diseases — have led to reduced medical costs and absenteeism.

A Health Affairs policy brief studied 36 peer-reviewed papers on the value of wellness programs offered by large employers. The researchers found that, on average, employer medical costs fell by $3.27 for every dollar spent on wellness. The value of reduced absenteeism was $2.73 per wellness dollar. According to the Health Affairs brief, more than 50 published studies demonstrated that health promotion programs of all sizes resulted in an overall reduction of 25% in sick leave, health plan costs, and workers' compensation and disability costs. It’s safe to assume that testing for COVID-19 patients will accrue benefits as well — particularly in identifying the asymptomatic, those with potential exposure, for presurgical evaluation and to help Missourians return to work. To manage our ongoing mitigation efforts, Missouri would need to test approximately 8,000 individuals daily. Viewing tests as prevention- and wellness-related would help us meet these goals as tests become more available.

For President Trump’s “Opening Up America Again” plan and Gov. Parson's “Show Me Strong Recovery" plan to succeed, public health officials must identify those with the virus, contact trace and quarantine. Without these tools, the sacrifice of so many individuals and businesses will have been in vain.

Testing is the path to wellness and past COVID-19.

Let me know what you think.

Herb Kuhn, MHA President & CEO

Herb B. Kuhn
MHA President and CEO

In This Issue
CMS Issues 2021 Medicare Advantage And Part D Final Rule
MLN Connects Provider eNews Available
HRSA Announces Children’s Hospitals Graduate Medical Education Payment Program
Ste. Genevieve County Memorial Hospital Receives Recognition For Innovation In Care Coordination

Regulatory News
the latest actions of agencies monitoring health care

CMS Issues 2021 Medicare Advantage And Part D Final Rule

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services released the contract year 2021 Medicare Advantage and Part D final rule. The rule implements certain Cures Act provisions, revises the medical loss ratio, strengthens network adequacy rules and codifies several special election period exceptional conditions.

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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.

  • Hospitals: submit Medicare GME affiliation agreements by Oct. 1 during the COVID-19 PHE
  • Nursing home quality initiative: updated MDS 3.0 item sets
  • CMS releases additional waivers for hospitals and ground ambulance organizations
  • Hospice Quality Reporting Program: quarterly update for January through March

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Workforce News

HRSA Announces Children’s Hospitals Graduate Medical Education Payment Program

Staff Contact: Jill Williams

The Health Resources and Services Administration is accepting applications for the fiscal year 2021 Children’s Hospitals Graduate Medical Education Payment Program. The CHGME Payment Program funds freestanding children’s hospitals to support the training of pediatric and other residents in graduate medical education programs.

Eligible applicants are freestanding children’s hospitals who meet the following qualifications.

  • inpatients that are predominantly under 18 years of age
  • an approved GME program
  • a Medicare payment agreement
HRSA expects approximately $320 million to be available in FY 2021 to fund 58-65 grantees. The application cycle closes on Friday, July 24.

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Ste. Genevieve County Memorial Hospital Receives Recognition For Innovation In Care Coordination

Staff Contact: Dana Dahl

Ste. Genevieve County Memorial Hospital has been chosen as one of four national critical access hospitals to receive recognition for demonstrating excellence and innovation in care coordination. The CAH Recognition certificate was established by the National Rural Health Resource Center and the Federal Office of Rural Health Policy to recognize the excellent work of CAHs throughout the country. The recognition, nominated by the state Flex Programs, promotes excellence and innovation, and honors the achievements and results of CAHs through Flex-supported activities and impact.

SGCMH’s swing bed transitional care project and hospital will be profiled with an article in the Technical Assistance and Services Center’s Rural Route e-newsletter. Additionally, the hospital team will host a webinar for members of the Critical Access Hospital Network. Contact Dana Dahl for registration information.

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Did You Miss An Issue Of MHA Today?

May 18, 2020
FCC Authorizes Over $7.5 Million For Rural Broadband Projects
AHA Releases Resource For Proactive Care Planning
New Webinar: Treating Substance Use Disorders Through A Trauma-Informed Lens

May 20, 2020
MHA Publishes 2020 State Legislative Session Summary
MHA Distributes FFY 2021 Proposed Medicare IRF PPS Analysis
Management And Productivity Report Available
Swope To Retire From Mercy
Mercy Rehabilitation Hospital Springfield Names New CEO

Consider This ...

In March, as states across the country began implementing stay-at-home orders and commuters got off the road, traffic dropped, but a new National Safety Council report finds that the number of motor vehicle fatalities per miles driven increased by 14% compared with the March 2019 rate.

Source: NPR