Minnesota Hospital Association


December 11, 2012

MHA Newsline

In this issue:

Minnesota faces $1.1 billion budget deficit

The state’s economic forecast shows Minnesota with a $1.1 billion deficit for the Fiscal Years 2014-15.

Although there was a $1.3 billion surplus for FY2013, the money is already obligated to pay back money borrowed from schools to fix previous deficits and a small amount paid to the state’s cash reserves.

However, a bright spot in the forecast is lower than expected spending in health care. Almost half of the savings comes from a federal provision allowing states to claim rebates on pharmaceuticals purchased for managed care Medicaid programs. Efforts by hospitals, health systems and other providers to reduce utilization of services, as well as lower enrollment and other changes, account for the rest of the almost $200 million in savings in the Medicaid program.

This year’s November forecast is unusual in that while it is based on current law and conditions, the federal negotiations and fiscal cliff could dramatically change the state’s economic outlook. The economic picture could worsen considerably if negotiations to avoid the automatic tax increases and across-the-board spending cuts.

Gov. Dayton will base his initial budget on this economic forecast and present it to the 2013 Legislature by Jan. 22. An updated forecast released in late February will guide the Legislature’s budget process and also require the governor to submit a supplemental budget based on the new information. If the deficit remains, or increases, legislators and the governor will mostly likely face cutting spending in areas like health care. Gov. Dayton has also indicated interest in raising taxes on certain high-income Minnesotans, while the new DFL majority leadership in the House and Senate have both committed to “tax reform,” although they have not listed specifics.

More information on the 2012 November forecast can be found online.

Help Minnesota hospitals keep their commitment to care

MHA created a brief video designed for social media (MHA Twitter and MHA Facebook) that demonstrates the important role hospitals play in our communities. In the coming weeks, state and federal lawmakers will have to make very difficult decisions about where to spend—and where not to spend—money. Please share this video with your stakeholders showing the impact cutting hospital payments would have.

Click the image to watch the video:

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MHA testifies to IRS regarding federal billing and debt collection proposed rule

As a follow-up to written comments submitted in September, Ben Peltier, MHA vice president of legal services, testified in person at a Dec. 5 hearing convened by the Internal Revenue Service regarding a proposed rule on billing and debt collection. The hearing was held in Washington, D.C. and witnesses represented hospitals, debt collectors and patient advocacy organizations.

The proposed rule formalizes requirements imposed on non-profit hospitals in the Affordable Care Act. It provides overly prescriptive requirements on hospital financial assistance policies, billing the uninsured, and limits on “extraordinary collection actions” by hospitals.

During oral testimony, Peltier reviewed current Minnesota standards in the areas covered by the proposed rule. He encouraged the IRS to abandon its one-size-fits-all approach and finalize a rule that provides more deference to state requirements already in place. Peltier told the IRS panel that the rule, if finalized without changes, would divert scarce hospital resources by requiring Minnesota hospitals to comply with two sets of standards on debt collection and billing the uninsured. He also encouraged federal officials to focus enforcement resources on areas not already covered by regulatory requirements.

In response to Peltier’s comments, the IRS asked for additional information and data on Minnesota’s requirements for billing the uninsured.

Read MHA’s comment letter on this website. For questions or additional information on the proposed regulations, MHA’s letter, or MHA’s oral testimony contact Ben Peltier, MHA vice president of legal services, 651-603-3513.^top of page

Road map guides hospitals in preventing perinatal injuries

MHA has rolled out a new road map to help hospitals develop a comprehensive perinatal safety program on key areas to prevent adverse perinatal injuries. The Perinatal Patient Safety Road Map provides evidence-based recommendations/standards for Minnesota hospitals, including strategies in the following areas: patient education, elective delivery, fetal/uterine assessment, operative vaginal delivery, maternal/ obstetric morbidity and mortality reduction, trial of labor after a previous Caesarean section and provider/nurse training.

One of the focus areas for Minnesota hospitals is on ending elective deliveries prior to 39 weeks gestation, unless medically necessary. In addition to the recommendations put forth in the road map, MHA has partnered with the March of Dimes to promote the Healthy Babies are Worth the Wait® Campaign to educate providers and the public on the importance of staying pregnant until at least 39 weeks. Research shows that important development takes place to a baby’s brain and lungs during the last few weeks of pregnancy. According to the Centers for Medicare and Medicaid Services, decreasing the rate of early elective deliveries means:

  • More mothers get safe, evidence-based care.
  • Infants improve their chances for good physical and developmental health.
  • Lower costs for public and private payers because there are fewer caesarian sections performed, they have less neonatal intensive care unit admissions, and less associated complications for the newborns.

Click here to access the road map and a tool kit that hospitals can use to implement the Perinatal Safety Road Map recommendations in their facilities.^top of page

MDH making progress on Health Records Access Study

At a public meeting held Dec. 6, staff from the Minnesota Department of Health revealed emerging themes regarding providers' medical record privacy practices. Based on information gathered through both focus groups and surveys over the last two months, hospitals and clinics were generally found to have processes in place to monitor unauthorized access to electronic medical records, and to notify patients if it occurs. The ability to produce audit logs upon request is also widespread, though participants have not experienced much patient demand for this information. Participants have also noted that the ability to detect unauthorized access to electronic records is significantly greater than in paper records. Areas for improvement were also identified, including a desire for less labor-intensive manual review of unauthorized access and more user-friendly audit logs that do not put employees at risk.

The Health Records Access Study was requested by the 2012 Legislature and is due by February 2013. ^top of page

Hammerschlag to present on authenticity and leadership at Winter Trustee Conference

Author, physician and psychiatrist Carl Hammerschlag will present the closing keynote at this year’s Winter Trustee Conference, Authenticity and Leadership: Sustaining Your Passion and Purpose. Hammerschlag, a popular speaker at last year’s Winter Trustee Conference, will discuss how personal and professional success depends on being authentic—a person or organization whose words, actions and principles are all telling the same story. He’ll share his experience and wisdom in ways that will kindle your passion and purpose.

The Winter Trustee Conference takes place Jan. 11-13, 2013 at the Minneapolis Marriott Northwest in Brooklyn Park. Click here to learn more about the conference sessions or to register.

Continuing Education
This conference has been approved by the Minnesota Board of Examiners for Nursing Home Administrators for up to 15 clock hours.

Trustees participating in MHA’s Board Education Certification program can earn up to 15 credits toward certification.

Marriott Reservation Deadline
The reservation deadline at the Marriott is Dec. 20, so be sure to register now by clicking here or calling 763-536-8300. Mention you are with MHA to receive the group rate. ^top of page

Avera Marshall announces plans to build Cancer Institute

Avera Marshall Regional Medical Center has announced plans to build a new cancer center and expand local cancer care services. The Avera Marshall Cancer Institute will offer radiation therapy in addition to existing services including chemotherapy, surgery, pharmacy, dietitian consultation, home medical equipment, on-site CT and MRI. The expanded services will bring a much-needed asset to the people of southwest Minnesota and will allow them to receive care closer to home. According to the American Cancer Society, southwest Minnesota has some of the highest rates of colon, breast, cervical and prostate cancer in the state.^top of page

Regions opens new inpatient mental health building

Last Friday, Regions Hospital hosted a ribbon-cutting ceremony and open house in honor of its new in-patient mental health building. Regions Hospital president and CEO Brock Nelson paid tribute to the health care professionals who deliver high-quality mental health care every day.

The building was designed specifically for providing quality and respectful mental health care that values patients and their privacy. Patients, families, and mental health experts were deeply involved in the design process. The features within the building reflect the care theme of “a circle of support.” Patients will begin moving into the new building Dec. 10.

Regions and HealthPartners also kicked off an anti-stigma campaign, MakeItOk.org. With one in four people developing a mental illness in a given year, it is more important than ever to support people experiencing mental illness.

Find more information on Regions’ new building online.^top of page