Thursday, MHA released a Population Health Assessment based on a 2020 survey of Missouri hospitals. There’s good news. Overall, Missouri hospitals’ efforts to engage in population health improvement activities are advancing. Each participating hospital will receive hospital-specific results.
Understanding and addressing population health challenges are essential to the journey from volume to value. The survey identifies hospitals’ status along nine domains — leadership, patients and family, workforce, finance, data and technology, operations, legal/regulatory, outcomes, and policy and advocacy. Compared to the survey conducted in 2017, the 2020 report finds progress in each area.
The study identifies participating hospitals’ maturity in population health along a five-step scale, including Pre-Foundational 1, Pre-Foundational 2, Foundational, Proficient and Transformational. Ranking is weighted, with all but a few hospitals ranked between Pre-Foundational 2 and Proficient. Despite the growth in survey participation, growth primarily is in the foundational and proficient maturity categories.
Comparing hospitals that participated in both 2017 and 2020, there was an increase in mean scores in each of the domains. When comparing all 2020 hospitals to the 2017 status, there was a minor decline in the “patients and family” domain — a three-point drop from a mean of 56 to 53 — and a sustained score in “policy and advocacy.”
Half of all hospitals’ population health programs are located within hospital administration, and 53% are either overseen by the CEO or the CMO. Among the biggest challenges to population health leadership are driven by data and a lack of staff with population health as their primary focus and responsibility. However, more than 40% listed financial risk assessment as a challenge while just under 40% listed nonemployed clinician alignment.
Since a growing number of hospitals are participating in shared savings or shared risk models — 13% more than in the 2017 report — data and alignment are essential to success. The survey indicated a 21% increase in the number of hospitals with patient records that span the inpatient and outpatient environments. However, challenges in fully developing the value of data for population health persist. For example, nearly 94% of hospitals can capture race, ethnicity and language data, and nearly 63% actively document ICD-10 Z codes to identify social determinants. Far fewer hospitals use these data to identify quality challenges or disparities, or to prioritize investments. This offers an opportunity for both MHA and hospitals.
Interestingly, the COVID-19 pandemic has had limited influence on population health activities. While 20% of hospitals suspended their population health activities, 16% accelerated them. The majority either revised their activities or made no changes.
The movement from volume to value will continue to drive quality improvement efforts and influence reimbursement policy. These reports can help hospitals identify where they are relative to their peers in population health improvement and identify gaps in operational preparedness for the model.
As I indicated at the beginning of this column, this report generally is good news on the progress toward population health improvement maturity. I hope the individual, hospital-specific reports will help advance your efforts toward more coordinated, data-driven care, and support future investments in systems that improve care and health in the communities you serve.
House Budget Committee Revises, Advances State Budget
Abortion Amendment Stalls FRA Reauthorization Debate
House Committee Approves COVID-19 Liability Legislation
Legislative Committees Act On Rural Physician Incentives
House Approves Occupational Therapy Licensure Compact
Committee Considers Bill On Hospital Treatment Of State Wards
MLN Connects Provider eNews Available
HIDI Offers MUR Data Submission Website Training
Updated COVID-19 Vaccine Dashboard Available
CMS Announces IPFQR Program Webinar
TJC Offers Complimentary Webinar Regarding Disease-Specific Care Certification
MHA Launches Updated Missouri Health Matters Website
Qualivis Now Offers Locum Tenens Solutions To APS Members
Centerpoint Medical Center Celebrates Vaccine Milestone
The state House Budget Committee revised and approved its version of the state budget. The appropriations bills will be debated by the House of Representatives next week and then move to the Senate. MHA will be working to resolve the following significant issues in the committee’s budget.
Elimination of $1.9 billion in funding to implement Medicaid expansion approved by the state’s voters in August 2020. The committee segregated expansion funding into a separate bill, House Bill 20, and voted to defeat the measure on a party-line vote, 9-20.
No changes were made to the outpatient fee schedule proposed by the MO HealthNet Division. MHA developed a proposal to increase the payment rates of the proposed Medicaid outpatient hospital fee schedule for all hospitals. It does so without requiring new general revenue spending.
Inclusion of a policy directive to deny Medicaid payment to not-for-profit hospitals that deny medically necessary services to Medicaid enrollees. It arises from Medicaid managed care plan contracting disputes with hospitals and is intended by the committee chair to promote resolution to those issues.
Capping Medicaid payment for treating out-of-state patients at the level of the current state fiscal year.
The state Senate’s adoption of an amendment on Medicaid coverage of abortifacients and some contraceptives halted debate of Senate Bill 1, which reauthorizes the hospital Federal Reimbursement Allowance and the other state provider taxes. The sponsor set aside the bill to consider options.
A House committee approved House Bill 906. The legislation would authorize state grants to primary care physicians who practice in rural counties with populations of 35,000 or fewer. Another House committee approved House Bill 689, which would authorize state tax credits for physicians and physician assistants providing preceptorships for medical or physician assistant students in primary care and psychiatric specialties. The tax credit’s cost to the state would be offset by an increase in physician and physician assistant licensure fees.
The state House of Representatives unanimously passed House Bill 542, which would authorize Missouri’s participation in an interstate compact providing for reciprocal licensure of occupational therapists. The bill now moves to the Senate.
A state Senate committee reviewed Senate Bill 561, which would require state payment for a child’s continued hospitalization if the Children’s Division has legal custody and fails to take physical custody when the child is medically ready for discharge. The bill also addresses authorization for emergency psychiatric treatment of Children’s Division wards. MHA developed the bill.
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.
Medicare Shared Savings Program: application deadlines for Jan. 1, 2022, start date
HIDI is updating its user interface for uploading and processing monthly utilization reports. Along with uploading the traditional Excel form, users now will be able to input the data directly into the website. Once submitted, team members can immediately see any errors associated with the data and make the necessary corrections. This will not affect the reports provided to participating hospitals on HIDI Analytic Advantage, rather only the upload of data to HIDI.
Two webinar opportunities are available to learn more about the system, and how to upload and correct data. The training is complimentary for all hospital team members, and the content of the webinars is the same for both sessions. Registration is required and is available at the respective links below.
The interactive Vaccine Administration dashboard now is available with doses administered through March 25. This dashboard is accessible to authorized users of HIDI Analytic Advantage. If you need a user ID and password or have questions about accessing these dashboards, please contact HIDI.
An outreach and education webinar for participants in the Inpatient Psychiatric Facility Quality Reporting Program is scheduled at 1 p.m. Wednesday, April 7. The presentation describes ways the IPF community can leverage the QualityNet question and answer tool to review published articles and submit questions regarding new topics, as well as how the inpatient psychiatric facility community can access publicly reported IPFQR Program data on the Medicare Care Compare and Provider Data Catalog websites. Registration is required.
More than a decade ago, MHA created Missouri Health Matters to serve as an online community of Missourians who care about health care in the state. The Missouri Health Matters community now is comprised of more than 100,000 advocates statewide.
Today, a new Missouri Health Matters website was launched to better educate Missourians on health care issues, while also making it easy for users to take action on issues that directly impact Missouri health care and hospitals. Visit the new website, and also follow Missouri Health Matters on Facebook and Twitter to stay up-to-date and join the conversation on Missouri health care.
APS members can now take advantage of a comprehensive locum tenens solution through Qualivis, a provider of temporary allied health and traveling workforce services. For additional details, visit the APS website or contact Dennis George at 913-327-8730.
Centerpoint Medical Center, located in Independence, Mo., administered its 13,000th COVID-19 vaccine since beginning vaccination efforts in December 2020. According to a Facebook post, “This includes more than 1,500 mission-critical first responders, nearly 7,000+ seniors 70 and older, and others in Phase 1A of the state vaccine distribution guidelines.”