Minnesota Hospital Association


February 04, 2013

MHA Newsline

In this issue:

Hospitals testify in support of provisions in Gov. Dayton’s proposed budget

Hospital representatives last week testified to the Senate Health and Human Services Finance Committee in support of provisions in Gov. Dayton’s proposed Health and Human Services budget. Hospitals expressed their support for the governor’s budget prioritizing health care and coverage for low-income Minnesotans. The key provisions in the proposed HHS budget are the expansion of Medicaid for adults without children to 138 percent of federal poverty guidelines (FPG) and the expansion for children to 275 percent of FPG. The governor’s budget proposes a $128 million increase for HHS, and includes the first provider rate increase in several years. Testimony from MHA and member hospitals highlighted many of the provisions in Gov. Dayton’s budget, which will allow hospitals to continue to deliver nation-leading, high quality care to meet the needs of patients.

Among the provisions that hospitals support is the restoration of Medical Education and Research Costs (MERC) funding to FY11 levels; approximately $12.8 million. MHA Vice President of Government Relations Mary Krinkie told members of the committee that the governor’s budget, and the federal matching funds it leverages, will “help hospitals, clinics and pharmacies maintain their training programs for our state’s future physicians, advanced practice registered nurses, pharmacists and dentists.”

Anna Youngerman, director of policy and advocacy at Children’s Hospitals and Clinics spoke of the importance of expanding Medicaid coverage for children to 275 percent FPG. Youngerman added support for the governor’s proposed increases in Medical Assistance rates. “While the proposed rate increases won’t come close to filling the gap [between costs], they will help us in balancing our commitment to serving all children regardless of ability to pay with our expectations of delivering innovative, high quality care,” said Youngerman.

In addition to speaking in support of Medicaid expansion and restoration of MERC funding, Shawntera Hardy, government relations manager for HealthPartners and Regions Hospital, expressed the importance of continuing to fund Emergency Medical Assistance for cancer and dialysis care, calling it “a positive step to ensure access to care.” The governor’s proposed budget provides $5.3 million for this program.

Legislators will begin the process of introducing their own budget bills, which will be based on the state’s next budget forecast on Feb. 28.^top of page

Annual Adverse Health Events report released

Members provide great perspective on the good work happening in hospitals

Last week, the ninth annual Adverse Health Events report was released, which details the adverse events captured by the reporting system throughout the year. While hospitals were disappointed to see an increase in patient harm and deaths, members did a great job of telling the story behind the numbers of the good work taking place in your facilities every day. For example, in speaking to the Owatonna People’s Press, Owatonna Hospital President David Albrecht shared specific examples of notable safety accomplishments in their hospital. He also reiterated the importance of a “culture of openness, continuous learning and improvement.” The St. Cloud Times shared a story of how hospital staff prevented a critically injured, immobile patient who spent 23 days in the hospital, from developing pressure ulcers. Beth Honkomp, the director of quality and patient safety, explained that it’s not about the numbers, “…I’m more concerned about what we find out from the events that are happening, and what we are doing to improve, based on what we learn.”

In addition, MHA reached out to the media and spoke to nearly all of the major statewide media outlets in advance of the report’s release. We also sent MHA’s press release to legislators, hospital trustees and other opinion leaders outlining the key points in the report and reiterating the high quality care that is delivered in our hospitals.

While this report shines a light on adverse health events, we know that hospitals are hard at work to prevent adverse health events throughout the year. Thank you for the hard work you do to keep patients safe every day!^top of page

Minnesota hospitals selected for shared savings contracts

Minnesota hospitals are once again at the forefront of payment and delivery reforms. Gov. Mark Dayton and Department of Human Services (DHS) Commissioner Lucinda Jesson have announced Health Care Delivery System (HCDS) contracts with six health care providers: Children’s Hospitals and Clinics of Minnesota, Essentia Health, CentraCare Health System, North Memorial Health Care, Federally Qualified Health Center Urban Health Network (FUHN), and Northwest Metro Alliance (a partnership between Allina Health and HealthPartners). Combined, these providers will serve over 100,000 Minnesotans enrolled in publicly-funded programs.

The HCDS contracts are an opportunity for hospitals and other providers to explore alternative payment methods with the state of Minnesota while at the same time delivering high quality care in an innovative delivery model. The providers and state will share the resulting savings to the Medicaid program. MHA initially advocated for DHS to adopt a voluntary request for proposal (RFP) process for accountable care organization-like payment reforms in 2011 and worked with DHS to make improvements to the initial RFP.

“HCDS is exactly the kind of reform needed to lower costs in our health care system while at the same time delivering high quality care to Minnesotans. We are proud of our members for stepping up to experiment with payment and delivery reforms,” said Lawrence Massa, MHA president and CEO. “This is a sign of our members’ commitment to pursuing strategies that will help slow health care’s rate of growth.”

DHS has also issued an RFP for new HCDS contracts to begin Jan. 1, 2014. MHA is pleased to see DHS offer another opportunity to explore shared savings arrangements, especially at a time when we expect the Medicaid program to expand. The RFP is available online. Proposals are due by 3 p.m. on April 16.^top of page

Minnesota to participate in CMS Medicaid and CHIP Learning Collaborative

Minnesota has been selected to participate in the Centers for Medicare and Medicaid Services’ (CMS) “Expanding Coverage under the Affordable Care Act (ACA) Learning Collaborative.” Along with California, New Mexico, New York, Oklahoma, Oregon, Tennessee, Washington and West Virginia, Minnesota will work closely with CMS to design and implement new Medicaid eligibility and enrollment policies to ensure that eligible individuals have access to high-quality coverage. In particular, the states will focus on strategies for streamlined implementation of Medicaid expansion under the ACA.

The collaborative is one of five Medicaid and CHIP learning collaboratives designed to bring together state and federal partners to address critical issues to establishing solid state health insurance infrastructure. For more information about the learning collaboratives, visit www.Medicaid.gov.^top of page

MHA members encouraged to attend the American Hospital Association’s annual meeting, April 28 - May 1 in Washington D.C.

Congress will be out-of-session during the American Hospital Association (AHA) annual meeting and while our representatives and senators may be home in Minnesota, MHA is encouraging meetings with their legislative and health policy staff. Our representatives and senators turn to their staff for issue expertise and our ongoing discussions are key to ensuring that hospital concerns remain a priority.

AHA will host a strong lineup of speakers who will address the most pressing issues facing hospitals, and with approximately 1,500 attendees in attendance this is also a unique opportunity to network with peers across the country.

To register for the meeting, visit aha.org". About a week prior to the meeting, MHA staff will send participants additional information on special “Minnesota-only” events.

For more information please contact Ann Gibson, MHA vice president of federal relations/workforce, 651-603-3527. ^top of page

CMS moving forward with bundled payments demonstration

After being delayed by nearly a year, the Centers for Medicare and Medicaid Services (CMS) announced on Jan. 31 its intent to move forward with its bundled payments initiative. This is a program designed to allow providers to submit proposals and to commit to providing an array of services for an established price. Several models were made available including one (Model 2) that allows hospitals to target specific Medicare severity diagnosis-related groups (MS-DRG) to bundle hospitalization with physician services along with services provided post-discharge ranging to 90 days, for a single agreed-upon price.

More than 500 organizations were chosen to move forward with Phase 1 implementation including two Minnesota hospitals: Essentia Health St. Mary’s Medical Center in Duluth and Winona Health Services. In the first phase, organizations will receive new data from CMS on care patterns and engage in shared learning in how to improve care. The initiative aims to better coordinate care for patients and reduce costs. ^top of page

100 hospital leaders take to Capitol for MHA Advocacy Day

Last week, nearly 100 hospital leaders met with state legislators during MHA’s Advocacy Day at the Capitol. Members from across the state advocated on behalf of hospitals and discussed key hospital priorities: expanding Medicaid to 138 percent of federal poverty guidelines; implementing a Minnesota-based health insurance exchange; restoring Medical Education and Research Costs funding; and supporting new payment models that support value over volume. It is important that we continue to communicate our priorities throughout the legislative session. MHA will host another Advocacy Day on Wednesday, Feb. 20. It will coincide with the Minnesota Organization of Nurse Leaders’ day on the hill so we suggest you bring nurse leaders, staff nurses and others to help tell the hospital story. For questions about MHA’s Advocacy Day, contact Carol Eshelman, 651-603-3539. To see more pictures from the Jan. 30 Advocacy Day, visit us on Facebook.^top of page

photo of members with legislators

Tiffany Zitzewitz, vice president of strategy and development
and Larry Taylor, CEO at North Memorial Medical Center in
Robbinsdale talk with Speaker Paul Thissen and Majority Leader
Erin Murphy during MHA Advocacy Day.

Leaders from Allina's Unity Hospital in Fridley talk with
Sen. Michelle Benson during MHA Advocacy Day.