MHA Today | December 8, 2023

Staff Contact: Brian Kinkade

Gov. Parson and House and Senate budget leaders announced an agreement on state general revenue collections that will be available for the SFY 2025 budget, which is expected to be $13.16 billion, or growth of only 0.2% over the revised estimate for SFY 2024. The budget writers revised the revenue estimate for SFY 2024 to $13.14 billion. Previously, 2024 revenues were expected to grow by 0.7%; however, the revised projection for 2024 revenues fall by 0.7%. The flat projections reflect the end of a period of record state revenue growth that was driven by pandemic-era federal stimulus and the implementation of tax reductions passed by the General Assembly. Parson will release his budget recommendations in January.

MHA submitted comments to CMS’ RFC on ways for state Medicaid programs to effectively measure and improve parity between mental health and medical treatments for Medicaid participants.

CMS approved two IMD exclusion waivers for Missouri’s Medicaid program, including for participants with SUD and serious mental illness. The 1115 waivers will allow the MO HealthNet Division to reimburse psychiatric hospitals for inpatient care for adult Medicaid participants. Federal Medicaid laws prohibit states from reimbursing institutions for mental disease (i.e., psychiatric hospitals) for adult inpatients. This prohibition commonly is referred to as the IMD exclusion. The waivers provide an exception to the exclusion and open a new revenue stream for psychiatric hospitals. MHD policy guidelines for implementing the waivers are pending.

DHSS issued a health alert regarding detected cases of Candida auris within health care facilities in the Saint Louis Metro area that are believed to be locally acquired. Previously, Missouri had no prevalence of locally acquired C. auris infection, and it is implicitly reportable in Missouri as an emerging or unusual disease.

The CDC issued a health advisory on a separate clade of Mpox not yet seen in the U.S. but now has spread in the Democratic Republic of the Congo. This clade is caused by human-to-human transmission and has a 10% fatality rate. Diagnosis, testing and treatment options remain the same as the current clade of Mpox seen in the U.S.

HIDI posted the 2022 Annual Survey 7-Year Trends report for subscribers of the Premier Reporting Package. This report displays tables and graphs depicting 7-year trends of a comprehensive set of financial metrics, as reported on the most recent Annual Licensing Survey. Reports are categorized by various peer groups, such as bed size, geographic region, ownership type, hospital type and congressional district. The report can be found on HIDI Advantage^® in the following location.

• File Location: Premier Subscriptions/Stand-Alone Premier Reports
• File Name: MO0000_7-Year_Trends_2022 (12 2023).pdf

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

Monica Gooch will replace Tom Tisone as the interim CEO of Rusk Rehabilitation Hospital until a permanent replacement is named. Tisone has served as the CEO since 2020. Gooch assumed CEO responsibilities on Dec. 1.