Moreover, they were genuinely glad to see the more than 40 rural hospital representatives who made the trip. Recent visits with members of Missouri’s delegation and staff have been virtual. While necessary because of the pandemic, these earlier visits offered less opportunity for the give-and-take that in-person advocacy offers. In-person, we had a robust conversation about various topics related to COVID-19, and the future of health and health care.This, my penultimate column, touches on MHA’s federal advocacy trip to Washington, D.C. — a place where I spent more than 30 years working on health care issues. During the visits this week, I was reminded how important what happens in our nation’s capital is to the everyday operations of hospitals. Legislative, executive and regulatory work in D.C. sometimes can feel a world away from bedside patient care. It isn’t. Decisions in Washington matter. And, it was abundantly clear that our congressional delegation is well informed about health care in Missouri.
One of the areas that was touched on in nearly all of the meetings was challenges to the present and future health care workforce. Although COVID-19 — and especially the most recent surge in cases — has stressed the workforce to the breaking point, the state’s hospitals entered the pandemic with significant workforce challenges. This includes structural issues related to getting the right skills into the right positions in communities throughout the state, as well as an aging workforce balanced against a boomer-driven anticipated spike in demand.
Unlike other workforce segments, preparation for most categories of caregiver have a four-to-eight-year time horizon. The disruption caused by COVID-19 is not fully known. However, delays in nursing clinicals, for example, are near-term problems. In the long term, we may see an unexpected exodus in some of the hardest-hit professions at a time when demand is already eclipsing supply.
In our visits, we reinforced our commitment to helping build the workforce and the importance of having a strong federal partner. Our delegation gets it.
The workforce wasn’t the only issue on the agenda. Although the delegation had a good line of sight on COVID-19, we reinforced that the state isn’t out of the woods, and that federal support was essential to maintaining the strength of hospitals. This includes federal relief payments, which may be the difference between positive and negative margins for hospitals — especially for hospitals that were facing fiscal challenges before the pandemic.
In addition, we briefed the delegation on the importance of prior authorization reform in Medicare Advantage and the importance of protecting access to the 340B Drug Discount Program for community providers.
During this trip, we focused on visits with our rural lawmakers. The meetings validated their understanding of, and concerns about, the strength of rural hospitals and their role in the overall health care ecosystem. They understand hospitals provide the foundation of rural health in Missouri.
MHA Distributes Analysis For FFY 2022 Medicare Final LTCH PPS
HRSA Refers Six Pharmaceutical Companies To OIG For Violating 340B Law
MO HealthNet Requires PDMP Check For Medicaid Controlled Substance Prescriptions
MLN Connects Provider eNews Available
CDC Issues Pfizer COVID-19 Booster Dose Recommendations
HIDI Releases First Quarter 2021 HHVBP Payments Model
HIDI Releases Third Quarter FFY 2021 Inpatient, Outpatient Databases
The Gratitude Group Offers Workforce Resources
MHA released an analysis illustrating the financial effect of the federal fiscal year 2022 Medicare Long-term Care Hospital Prospective Payment System final rule. After the application of the site-neutral payment reduction, the net effect on Missouri hospitals will be an estimated 3.2% increase in payments. Although footnoted, the effects of the 2% Medicare sequestration are not included. This analysis, which will be available online for authorized users of HIDI Analytic Advantage, includes a summary for the nation, Missouri, health systems and individual hospitals.
The Health Resources and Services Administration previously sent letters calling for drug manufacturers “to comply with its 340B statutory obligations and to immediately begin offering” “covered outpatient drugs at the 340B ceiling price to covered entities that dispense the discounted medications through their contract pharmacy arrangements.” Due to the drug manufacturers’ refusal to comply, HRSA has referred Eli Lilly, AstraZeneca, Novartis, Novo Nordisk, Sanofi and United Therapeutics to be reviewed by the U.S. Department of Health and Human Services’ Office of Inspector General for violating 340B law.
Beginning Friday, Oct. 1, MO HealthNet will require providers prescribing controlled substances for MO HealthNet participants to check a Prescription Drug Monitoring Program. Documentation requirements are found at Section 13.22 of the MO HealthNet Pharmacy Manual.
This policy applies only to providers in jurisdictions that participate in the St. Louis PDMP. Providers in nonparticipating jurisdictions are exempt.
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 launches new Medicare.gov feature to compare nursing homes by vaccination rate
DMEPOS items: ordering or referring practitioner requirements
Drugs of abuse testing: comparative billing report in September
Today, the director of the Centers for Disease Control and Prevention endorsed the CDC Advisory Committee on Immunizations Practices’ recommendation for Pfizer COVID-19 vaccine booster doses and added a recommendation that individuals in high-risk occupational and institutional settings also receive a Pfizer booster dose. The CDC recommends the following individuals receive a booster shot of Pfizer-BioNTech’s COVID-19 vaccine at least six months after their Pfizer primary series.
people ages 65 and older, and residents in long-term care settings, should receive a booster shot
people ages 18 to 49 years with underlying medical conditionsmay receive a booster shot, based on their individual benefits and risks
people ages 18 to 64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional settings may receive a booster shot, based on their individual benefits and risks
These recommendations only are for individuals who received a primary series of the Pfizer COVID-19 vaccine. Recommendations for Moderna and Johnson & Johnson vaccine recipients are anticipated in the coming months.
The Missouri Department of Health and Senior Services is working to update the statewide Pfizer COVID-19 vaccine standing order. Vaccinators using the standing order should wait to administer these booster doses until this document has been updated. MHA will route the standing order as soon as it is available.
The Home Health Value-Based Purchasing Payments Model is a companion utility to the HHVBP Analysis that was produced for hospitals on Aug. 17. The HHVBP Payments Model is an interactive tool that provides hospitals with the ability to manipulate their hospital-specific scores to evaluate the associated change to estimated HHVBP payments.
The HHVBP Payments Model is provided to subscribers of the 2021 Premier Reporting Package. The modeling utility is located on HIDI Analytic Advantage in the following location.
Folder: “Finance and Policy/Premier Reports” or “Quality/Premier Reports”
Hospitals interested in subscribing to the HIDI Premier Report Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.
The third quarter federal fiscal year 2021 inpatient and outpatient databases, including HIDI-reporting hospitals in Missouri, Illinois and Kansas City, Kan., now are available for download to subscribers of the Premier Data Package on HIDI Analytic Advantage. The databases consist of a patient-level limited dataset, including all HIDI-reported discharges and visits to hospitals. Files are delivered as both text files and ready-to-query Microsoft Access database files. The files are located in the “Strategic Planning\Premier Data” folder and are organized in the following categories.
Q3 FFY2021, Inpatient
Q3 FFY2021, Outpatient Classified
Q3 FFY2021, Outpatient Unclassified
Hospitals interested in subscribing to the 2021 HIDI Premier Data Package should review the package information. Current subscribers with questions about downloading files should contact HIDI.
A new platform from Quint Studer, the Gratitude Group offers easily accessible, complimentary workforce resources. The goal of the website is to provide tools, techniques and methodology to help individuals feel grateful about themselves, their job and their organization.
