It’s been a big week for vaccines. Monday, MHA released the first edition of our COVID-19 Interactive Dashboard that includes influenza monitoring data. Tuesday, Gov. Mike Parson and First Lady Teresa Parson received their flu vaccine, joining statewide promotions of vaccination for influenza, which the state formally rolled out this week. Finally, the state presented its COVID-19 vaccine plan to Parson for state participation, as mandated by the U.S. Department of Health and Human Services.
On Tuesday’s MHA call with Parson, Missouri Department of Health and Senior Services Director Randall Williams indicated that the state’s target for influenza vaccination was 60% statewide. The administration’s goal represents the urgency of avoiding a “twindemic” of influenza and COVID-19, which could further limit already strained hospital and health care resources. It is a goal that we all share.
In other years, some patients approach the flu vaccine with a healthy dollop of skepticism. After all, there often are side discussions of whether any year’s vaccine is well matched, if the vaccine is worth the trouble of arranging for a provider to administer it and whether protection matters if you aren’t in an at-risk population. This year, the stakes are very different.
It is too early to know when a COVID-19 vaccine will be available to priority populations, let alone the public. Conversely, the flu vaccine is readily available, and early evidence suggests that the public health precautions that are being used to control COVID-19 are what experts recommend for controlling influenza.
However, one of the most interesting aspects of the influenza monitoring tab of the dashboard addition is the bottom chart which displays vaccination rates and timing, and inpatient and outpatient utilization, for influenza-like illness. If you look at the data for 2018, you can see a clear correlation between vaccination and utilization.
Vaccine complacency is real. It’s clear that diseases like measles are creeping back into the population because of unfounded concerns about vaccinations and science. Facebook and Google “scientists” actively propagate anecdote-based conspiracies spreading false narratives — that real scientists don’t know diddly about how vaccines work. The truth is, vaccines have transformed modern life.
While the influenza vaccination campaign and the future COVID-19 vaccine efforts are not necessarily similar, they are parallel. Our success at one will create a bridge to the other. Today, far too many hospitals are filling up with COVID-19 patients. A flu surge on top of a COVID-19 surge could easily overwhelm our capacity.
Vaccination can be a literal and figurative pain. However, it reduces illness — which the 2018 data validates — and provides the time and space for us to manage through the pandemic. As a result, it is a pain we all should endure.
MHA Distributes Analysis Of Final Medicare Inpatient PPS For FFY 2021
MHD Publishes Orders Of Rulemaking
Missouri Medicaid Caseload Growth Continues
MLN Connects Provider eNews Available
MHA Publishes EPICC Statewide Status Report
Appellate Court Hears Arguments In Price Transparency Lawsuit
MHA released a summary and analysis of the federal fiscal year 2021 Inpatient Prospective Payment System final payment and policy updates. The analysis includes the financial effects of market basket updates, the budget neutrality adjustment, reductions mandated by the Affordable Care Act, Medicare disproportionate share changes, quality-based payment adjustments and coding adjustments. Results are illustrated in national, Missouri, health system and individual hospital groupings. IPPS hospitals in Missouri are projected to receive an estimated 1.7% increase in Medicare payments. Although footnoted, the effects of the Medicare sequestration are not included.
Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage®.
These rules authorize the use of a quadratic regression for the projected days’ calculation, and established the Federal Reimbursement Allowance assessment rate and trend factors for state fiscal year 2021. MHD accepted MHA’s comments and amended the final rules to reflect the changes. The rules become effective 30 days after publication in the Code of State Regulations.
The Missouri Medicaid caseload grew by nearly 16,000 in September to 991,000. Enrollment in all eligibility categories increased: elders, disabled, parents, kids and pregnant women. This marks the eighth straight month of caseload growth after more than two years of steady declines. Since Jan. 31, Missouri’s Medicaid caseload has grown by 145,000, or 17%. The number of children covered has increased by nearly 90,000 during this span.
The growth in the caseload is expected. To qualify for a 6.2% increase in federal matching funds available to the state under the Families First Coronavirus Relief Act, those currently eligible for Medicaid coverage will remain covered unless they move to another state, die or request that their coverage end. Also, because Medicaid is an income-tested program, the deteriorating economy and massive unemployment caused by COVID-19 shutdown orders is increasing the number of citizens qualifying for coverage.
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.
CMS takes action to protect integrity of COVID-19 testing
new waived tests
provider compliance tips for glucose monitors and diabetic accessories/supplies — revised
MHA is honored to provide the EPICC Statewide Status Report on behalf of all the local and state partners that work to connect patients from hospitals to evidence-based substance use treatment and grassroot recovery supports. Collectively, there are 118 unique Missouri agencies (80 active and 38 planning) that are participating in EPICC programming and/or infrastructure development. This broad base of EPICC stakeholders are supported actively by a technical assistance team comprised of an additional 10 agencies — with representation from local and state institutions.
Developing strong links between health care, first responder programs, education, transportation infrastructure, community services, mobile treatment centers, telemedicine support, the justice system and others is critical to providing a rich network of access points to local, regional and state opioid use disorder treatment and recovery support services (e.g. medication-assisted treatment telemedicine).
It is unclear what additional challenges COVID-19 will have on our ability to thoughtfully serve our communities that struggle with OUD. Although, the power of coming together and beginning to discuss how we can improve our systems of care is a necessary first step.
MHA would like to give a special thanks to all the certified peer specialists who share the gift of recovery and fellowship, and make EPICC possible.
The Court of Appeals for the District of Columbia Circuit heard oral arguments Oct. 15 in the American Hospital Association’s challenge to the Centers for Medicare & Medicaid Services’ 2019 rule requiring hospitals to publicly display their charges, including negotiated rates with commercial insurers. A federal district court upheld the rule, which ruling AHA appealed. Should the court decline to overturn the rule, it will go into effect Jan. 1, 2021.